Antidiabetic drugs limitations according to GFR, a presentation from French society of Nephrology conference 2015
Dear sir, I would like to share my experience with CKD patients that one have to avoid oral ant diabetics, and promote patients to initiate short acting insulin especially for patients CKD grade 3-5 and CKD on MHD. It decreases number of hospitalisation due to hypoglycemic episodes and also improves clinical profile of patients. Though many times, patients’ profile do not allow for Insulin. In these circumstances, treating physician should select safe and short acting oral ant diabetic according to GFR.
Dear sir
Thanks for your answer and sharing experience
Ultimately the protocols for managing DM with CKD is hardly applied
I attach PDF file I wish will be useful
I recommend a reduction in insulin when CrCl is 30-60ml/min by 25%, a 50% reduction when CrCl 15-30 ml/min and a 75-100% reduction in ESRD CrCl less than 15 ml/min. Hope this helps
There was a fear of using antidiabetic drugs especially in the dialysis patients earlier.
In our institution we use oral hypoglycemic agents modified to the renal function and according to the sugar control achieved
We do use dextrose can containing 100 milligram per decilitre but have not found episodes of hypoglycemia in such patients
Actually planning to study them prospectively
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