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Diabetic nephropathy in type 1 diabetes

Highlights

Human kidney cross section on scientific background. 3d illustration

16-04-2020 | Nephropathy | Highlight | News

Hypoglycemia risk with even mild renal dysfunction in real-world practice

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.

Editorial Board member Jay Shubrook follows up with treatment individualization specialist David Strain on the treatment challenges presented by older adults, and the implications for tailoring hypertension therapy in this diverse population (11:08).



Learning points include:

  • The rationale for emphasizing quality over quantity of life in certain subsets of the elderly patient population.
  • The importance of incorporating understanding of key comorbidities into treatment planning, including:
    • Left ventricular and/or diastolic dysfunction
    • Chronic kidney disease 
    • Benign prostatic hyperplasia
    • Heart failure
  • Single/multi-agent therapies capable of targeting hypertension and its comorbidities.
  • The importance of early renal function testing in older adults initiated on treatments for hypertension and its comorbidities.
  • Understanding renal impairment risks in vulnerable adults treated with angiotensin-converting-enzyme (ACE) inhibitors in patients.
  • Understanding the relative risk of hyponatremia with generally well-tolerated treatments like as thiazide diuretics.
  • Best practice for avoiding adverse drug events in the acute setting.
  • The challenges associated with treating concomitant heart failure in older adults.

« Video 4: Individualization of diabetes treatment: Considerations for frail, elderly patients with heart failure