PMID- 26581749
OWN - NLM
STAT- MEDLINE
DCOM- 20160712
LR  - 20181202
IS  - 1865-8652 (Electronic)
IS  - 0741-238X (Linking)
VI  - 32
IP  - 11
DP  - 2015 Nov
TI  - Overview of Data Concerning the Safe Use of Antihyperglycemic Medications in Type 
      2 Diabetes Mellitus and Chronic Kidney Disease.
PG  - 1029-64
LID - 10.1007/s12325-015-0261-x [doi]
AB  - INTRODUCTION: It can be a challenge to manage glycemic control in patients with 
      type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD), due to both 
      patient and medication issues. Although most antihyperglycemic medications can be 
      used in mild kidney disease, many medications are either not advised or require 
      dose adjustments in more advanced CKD. This review summarizes product label 
      information, pharmacokinetic and clinical studies, and clinical guidelines 
      relevant to use of antihyperglycemic medications in CKD. METHODS: Product labels 
      and guidelines from North America and Europe, as well as pharmacokinetic and 
      clinical studies of diabetes medication use in CKD were identified through 
      Medline and PubMed searches, up to February 2015. Available data are summarized 
      and correlations between treatment recommendations and available research are 
      discussed, as are glycemic targets for patients with CKD. RESULTS: Newer 
      medications have significantly more data available than older medications 
      regarding use in CKD, although larger clinical studies are still lacking for some 
      drugs. As CKD advances, dose adjustment is needed for many medications [numerous 
      dipeptidyl peptidase-4 inhibitors, some insulins, sodium glucose co-transporter 2 
      (SGLT2) inhibitors], although not for others (thiazolidinediones, meglitinides). 
      Some medications are not recommended for use in more advanced CKD (metformin, 
      SGLT2 inhibitors, some glucagon-like protein-1 receptor agonists) for safety or 
      efficacy reasons. There is not always good alignment between label 
      recommendations, pharmacokinetic or clinical studies, and guideline 
      recommendations for use of these drugs in CKD. In particular, controversy remains 
      about the use of metformin in moderate CKD and appropriate use of liraglutide and 
      sulfonylureas in advanced CKD. CONCLUSION: Considerable variability exists with 
      respect to recommendations and clinical data for the many antihyperglycemic drugs 
      used in patients with T2DM and CKD. FUNDING: Eli Lilly and Company.
FAU - Roussel, Ronan
AU  - Roussel R
AD  - Division of Endocrinology Diabetes and Nutrition, DHU FIRE, Groupe Hospitalier 
      Bichat-Claude Bernard, AP-HP, Paris, France. ronan.roussel@gmail.com.
AD  - INSERM U 1138, Cordeliers Research Center, Paris, France. 
      ronan.roussel@gmail.com.
AD  - University Paris Diderot-Paris 7, Paris, France. ronan.roussel@gmail.com.
FAU - Lorraine, Joanne
AU  - Lorraine J
AD  - Eli Lilly Canada, Toronto, Canada.
FAU - Rodriguez, Angel
AU  - Rodriguez A
AD  - Lilly Spain, Alcobendas, Spain.
FAU - Salaun-Martin, Carole
AU  - Salaun-Martin C
AD  - Eli Lilly, Neuilly Cedex, France.
AD  - Division of Endocrinology Diabetes and Nutrition, Hopital Max Fourestier, 
      Nanterre, France.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20151118
PL  - United States
TA  - Adv Ther
JT  - Advances in therapy
JID - 8611864
RN  - 0 (Blood Glucose)
RN  - 0 (Dipeptidyl-Peptidase IV Inhibitors)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
RN  - 0 (Receptors, Glucagon)
RN  - 0 (Sodium-Glucose Transporter 2 Inhibitors)
RN  - 0 (Sulfonylurea Compounds)
RN  - 0 (Thiazolidinediones)
MH  - Blood Glucose
MH  - Diabetes Mellitus, Type 2/*drug therapy/*epidemiology
MH  - Dipeptidyl-Peptidase IV Inhibitors/pharmacokinetics/therapeutic use
MH  - Europe
MH  - Humans
MH  - Hypoglycemic Agents/administration & dosage/adverse 
      effects/*pharmacokinetics/*therapeutic use
MH  - Insulin/pharmacokinetics/therapeutic use
MH  - Receptors, Glucagon/agonists
MH  - Renal Insufficiency, Chronic/*epidemiology
MH  - Sodium-Glucose Transporter 2 Inhibitors
MH  - Sulfonylurea Compounds/pharmacokinetics/therapeutic use
MH  - Thiazolidinediones/pharmacokinetics/therapeutic use
OTO - NOTNLM
OT  - Antidiabetic agents
OT  - Chronic kidney disease
OT  - Diabetic nephropathy
OT  - Guidelines
OT  - Hyperglycemia
OT  - Hypoglycemia
OT  - Type 2 diabetes mellitus
EDAT- 2015/11/20 06:00
MHDA- 2016/07/13 06:00
CRDT- 2015/11/20 06:00
PHST- 2015/07/23 00:00 [received]
PHST- 2015/11/20 06:00 [entrez]
PHST- 2015/11/20 06:00 [pubmed]
PHST- 2016/07/13 06:00 [medline]
AID - 10.1007/s12325-015-0261-x [pii]
AID - 10.1007/s12325-015-0261-x [doi]
PST - ppublish
SO  - Adv Ther. 2015 Nov;32(11):1029-64. doi: 10.1007/s12325-015-0261-x. Epub 2015 Nov 
      18.