Diabetes complications and comorbidities: Nephropathy

A prespecified analysis of data from the DAPA-CKD trial suggests that add-on treatment with dapagliflozin slows decline in renal function among patients with chronic kidney disease irrespective of the underlying etiology.

Add-on treatment with the SGLT1 and 2 inhibitor sotagliflozin may reduce cardiovascular risk among patients with type 2 diabetes and chronic kidney disease, suggest findings from the SCORED trial published in The New England Journal of Medicine.

Real-world study findings suggest that heart failure is associated with the greatest increase in mortality risk when compared with other cardiovascular and renal complications among people with newly diagnosed type 2 diabetes.

People who meet the criteria for prediabetes during the 3 years before a type 2 diabetes diagnosis have a higher burden of vascular disease than those who do not, research shows.

A large observational study reveals a strong link between reduced kidney function and increased incidence of hypoglycemia in adults with diabetes in routine clinical practice.

Optimal glycemic control during the first years after a latent autoimmune diabetes of adulthood diagnosis could prevent people’s microvascular complication risk from equaling that seen in those with type 2 diabetes, shows an analysis of the UKPDS.

Patients with type 2 diabetes who are treated with SGLT2 inhibitors in routine clinical practice have a lower rate of kidney function decline and a reduced risk for adverse renal events compared with those given other glucose-lowering drugs, researchers report.

People with type 2 diabetes and reduced kidney function in the absence of albuminuria have an increased risk for mortality and major adverse cardiovascular events, despite a low risk for end-stage renal disease, research shows.

The CKD273 proteomic biomarker panel can predict which people with type 2 diabetes will develop detectable diabetic nephropathy, but early intervention with spironolactone does not mitigate this risk, report the PRIORITY investigators.

Luigi Gnudi discusses the findings of the PRIORITY trial and addresses whether diabetologists should consider intervening earlier in diabetic nephropathy (4:08).

Detailed analysis of renal outcomes in the DECLARE-TIMI 58 trial confirms that treatment with the sodium-glucose cotransporter 2 inhibitor dapagliflozin is renoprotective in patients with type 2 diabetes and preserved kidney function.

Findings from the CREDENCE trial indicate that the SGLT2 inhibitor canagliflozin reduces the risk for renal failure and cardiovascular disease among individuals with type 2 diabetes and albuminuric chronic kidney disease.

The results of the DECLARE-TIMI 58 trial show a broadly positive effect of dapagliflozin on cardiovascular outcomes, especially heart failure, in patients with type 2 diabetes.

Obese patients with type 2 diabetes who undergo bariatric surgery achieve large reductions in their risk for microvascular complications, shows a real-world study.

Dave N, Wu J, Thomas S. Curr Diab Rep 2018; 18: 44. doi: 10.1007/s11892-018-1010-8

Deng Z et al. Diabetes Ther 2018. doi: 10.1007/s13300-018-0448-7

Owusu Adjah ES et al. Cardiovasc Diabetol 2018; 17: 70. doi: 10.1186/s12933-018-0712-1

Research shows that intensive blood pressure control increases the risk for new-onset chronic kidney disease, particularly in patients with type 2 diabetes, creating a potential treatment dilemma.

Data from the US NHANES show that a high proportion of adults with prediabetes also have cardiovascular and renal risk factors.