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The treatment of diabetes in patients with liver and renal impairment


Authors: Martin Haluzík
Authors‘ workplace: III. interní klinika 1. LF UK a VFN Praha, přednosta prof. MUDr. Štěpán Svačina, DrSc., MBA
Published in: Vnitř Lék 2015; 61(4): 304-311
Category: Reviews

Overview

Diabetes mellitus is a progressive disease that may eventually lead to the development of chronic complications. In patients with type 2 diabetes, a simultaneous occurrence of liver or renal impairment is quite frequent. The presence of these diseases significantly increases the risk of hypoglycemia and in case of the renal impairment also the cardiovascular risk. At the same time, the options of antidiabetic treatment are markedly limited in particular in patients with more advanced impairment owing to the fact that numerous antidiabetic drugs are either metabolized or excreted by the liver or the kidney. In this paper, we focus on the treatment of diabetes in patients with renal or liver impairment including limitations of particular drugs and drug classes. We also briefly summarize the risks associated with renal or liver impairment with respect to antidiabetic treatment.

Key words:
diabetes mellitus – hypoglycemia – liver impairment – renal impairment


Sources

1. Tamayo T, Rosenbauer J, Wild SH et al. Diabetes in Europe: An update for 2013 for the IDF Diabetes Atlas. Diabetes research and clinical practice 2013; 103(2): 206–217.

2. Svačina S, Owen K. Syndrom inzulínové rezistence. Triton: Praha 2003. ISBN 80–7254–353–9.

3. Gimeno-Orna JA, Castro-Alonso FJ, Boned-Juliani B et al. Fasting plasma glucose variability as a risk factor of retinopathy in Type 2 diabetic patients. J Diabetes Complications 2003; 17(2): 78–81.

4. Pappachan JM, Sebastian J, Bino BC et al. Cardiac autonomic neuropathy in diabetes mellitus: prevalence, risk factors and utility of corrected QT interval in the ECG for its diagnosis. Postgrad Med J 2008; 84(990): 205–210.

5. Feest TG, Dunn EJ, Burton CJ. Can intensive treatment alter the progress of established diabetic nephropathy to end-stage renal failure? QJM 1999; 92(5): 275–282.

6. Haffner SM. Pre-diabetes, insulin resistance, inflammation and CVD risk. Diabetes Res Clin Pract 2003; 61(Suppl 1): S9-S18.

7. Haffner SM, Lehto S, Ronnemaa T et al. Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med 1998; 339(4): 229–234.

8. Haffner SM. Insulin resistance, inflammation, and the prediabetic state. Am J Cardiol 2003; 92(4A): 18J-26J.

9. Haluzik M, Rychlík I et al. Léčba diabetu u pacientů s onemocněním ledvin a jater. Mladá fronta: Praha 2012. ISBN 978–80–204–2671–0.

10. Škrha J (ed). Diabetologie. Galén: Praha 2009. ISBN 978–80–7262–607–6.

11. Haluzík M (ed). Praktická léčba diabetu. Mladá fronta: Praha 2009. ISBN 978–80–204–2071–8.

12. Pelikánová T, Bartoš V (eds). Praktická diabetologie. 5th ed. Maxdorf: Praha 2011. ISBN 978–80–7345–244–5.

13. Koro CE, Lee BH, Bowlin SJ. Antidiabetic medication use and prevalence of chronic kidney disease among patients with type 2 diabetes mellitus in the United States. Clin Ther 2009; 31(11): 2608–2617.

14. Meyer C, Dostou JM, Welle SL et al. Role of human liver, kidney, and skeletal muscle in postprandial glucose homeostasis. Am J Physiol Endocrinol Metab 2002; 282(2): E419-E427.

15. Meyer C, Dostou JM, Gerich JE. Role of the human kidney in glucose counterregulation. Diabetes 1999; 48(5): 943–948.

16. Sakurai M, Takamura T, Ota T et al. Liver steatosis, but not fibrosis, is associated with insulin resistance in nonalcoholic fatty liver disease. J Gastroenterol 2007; 42(4): 312–317.

17. Ali S. Fonseca V. Overview of metformin: special focus on metformin extended release. Expert Opin Pharmacother 2012; 13(12): 1797–1805.

18. Anděl M, Škrha P, Trnka J. Metformin: na pomezí diabetologie a onkologie. Diabetologie, metabolizmus, endokrinologie, výživa 2013; 16(4): 212–217.

19. Rosenstock J, Marx N, Kahn SE et al. Cardiovascular outcome trials in type 2 diabetes and the sulphonylurea controversy: rationale for the active-comparator CAROLINA trial. Diab Vasc Dis Res 2013; 10(4): 289–301.

20. Promrat K, Lutchman G, Uwaifo GI et al. A pilot study of pioglitazone treatment for nonalcoholic steatohepatitis. Hepatology 2004; 39(1): 188–196.

21. Ahren B, Schweizer A, Dejager S et al. Mechanisms of action of the dipeptidyl peptidase-4 inhibitor vildagliptin in humans. Diabetes Obes Metab 2011; 13(9): 775–783.

22. Baetta R, Corsini A. Pharmacology of dipeptidyl peptidase-4 inhibitors: similarities and differences. Drugs 2011; 71(11): 1441–1467.

23. Cai L, Cai Y, Lu ZJ et al. The efficacy and safety of vildagliptin in patients with type 2 diabetes: a meta-analysis of randomized clinical trials. J Clin Pharm Ther 2012; 37(4): 386–398.

24. Scheen AJ. Pharmacokinetics of dipeptidylpeptidase-4 inhibitors. Diabetes Obes Metab 2010; 12(8): 648–658.

25. Neumiller JJ. Pharmacology, efficacy, and safety of linagliptin for the treatment of type 2 diabetes mellitus. Ann Pharmacother 2012; 46(3): 358–367.

26. Madsbad S. Exenatide and liraglutide: different approaches to develop GLP-1 receptor agonists (incretin mimetics) – preclinical and clinical results. Best Pract Res Clin Endocrinol Metab 2009; 23(4): 463–477.

27. Davies MJ, Kela R, Khunti K. Liraglutide – overview of the preclinical and clinical data and its role in the treatment of type 2 diabetes. Diabetes Obes Metab 2011; 13(3): 207–220.

28. Abdul-Ghani MA, DeFronzo RA. Inhibition of renal glucose reabsorption: a novel strategy for achieving glucose control in type 2 diabetes mellitus. Endocr Pract 2008; 14(6): 782–790.

29. Detournay B, Simon D, Guillausseau PJ et al. Chronic kidney disease in type 2 diabetes patients in France: prevalence, influence of glycaemic control and implications for the pharmacological management of diabetes. Diabetes Metab 2012; 38(2): 102–112.

30. Gerich JE. Role of the kidney in normal glucose homeostasis and in the hyperglycaemia of diabetes mellitus: therapeutic implications. Diabet Med 2010; 27(2): 136–142.

31. Viollet B, Guigas B, Sanz Garcia N et al. Cellular and molecular mechanisms of metformin: an overview. Clin Sci (Lond) 2012; 122(6): 253–270.

32. Owens DR, Swallow R, Dugi KA et al. Efficacy and safety of linagliptin in persons with type 2 diabetes inadequately controlled by a combination of metformin and sulphonylurea: a 24-week randomized study. Diabet Med 2011; 28(11): 1352–1361.

33. Lincoff AM, Wolski K, Nicholls SJ et al. Pioglitazone and risk of cardiovascular events in patients with type 2 diabetes mellitus: a meta-analysis of randomized trials. JAMA 2007; 298(10): 1180–1188.

34. Deacon CF. Dipeptidyl peptidase-4 inhibitors in the treatment of type 2 diabetes: a comparative review. Diabetes Obes Metab 2011; 13(1): 7–18.

35. Aletti R, Cheng-Lai A. Linagliptin: the newest dipeptidyl peptidase-4 inhibitor for type 2 diabetes mellitus. Cardiol Rev 2012; 20(1): 45–51.

36. Aaboe K, Krarup T, Madsbad S et al. GLP-1: physiological effects and potential therapeutic applications. Diabetes Obes Metab 2008; 10(11): 994–1003.

37. Bakris GL, Fonseca VA, Sharma K et al. Renal sodium-glucose transport: role in diabetes mellitus and potential clinical implications. Kidney Int 2009; 75(12): 1272–1277.

38. Iglesias P, Diez JJ. Insulin therapy in renal disease. Diabetes Obes Metab 2008; 10(10): 811–823.

39. Papa G, Baratta R, Cali V et al. Factors that influence basal insulin requirement in type 2 diabetes. Acta Diabetol 2012; 49(5): 387–393.

40. Dunn CJ, Plosker GL, Keating GM et al. Insulin glargine: an updated review of its use in the management of diabetes mellitus. Drugs 2003; 63(16): 1743–1778.

41. Thomas MC. Renal effects of dapagliflozin in patients with type 2 diabetes. Ther Adv Endocrinol Metab 2014; 5(3): 53–61.

42. Haluzik M, Frolik J, Rychlik I. Renal Effects of DPP-4 Inhibitors: A Focus on Microalbuminuria. Int J Endocrinol 2013; 2013: 895102. Dostupné z DOI: <http://doi: 10.1155/2013/895102>.

43. Cuthbertson DJ, Irwin A, Gardner CJ et al. Improved glycaemia correlates with liver fat reduction in obese, type 2 diabetes, patients given glucagon-like peptide-1 (GLP-1) receptor agonists. PloS one 2012; 7(12): e50117. Dostupné z DOI: <http://dx.doi.org/10.1371/journal.pone.0050117>.

Labels
Diabetology Endocrinology Internal medicine

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Internal Medicine

Issue 4

2015 Issue 4

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