scholarly journals Prescribing Trends of Antidiabetes Medications in Patients With Type 2 Diabetes and Diabetic Kidney Disease, a Cohort Study

2021 ◽  
Author(s):  
Samantha T. Harris ◽  
Elisabetta Patorno ◽  
Min Zhuo ◽  
Seoyoung C. Kim ◽  
Julie M. Paik
Keyword(s):  
Cohort Study ◽  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Prescribing Patterns ◽  
Diabetic Kidney ◽  
Diabetes Medication ◽  
Medication Class ◽  
Prescribing Trends ◽  
Insurance Claims Data ◽  
Over Time

<b>Objective</b>: To assess changes in anti-diabetes medication class prescriptions over time among patients with Diabetic Kidney Disease (DKD), characteristics of patients prescribed these medications, and prescribers’ specialty. <sup></sup> <p><b>Methods</b>: A cohort study design using insurance claims data between 2013 and the first quarter (Q1) of 2020. Included are adult patients with DKD who initiated a new anti-diabetes medication between 2013 and 2020Q1 (N=160,489 patients). The primary outcome is the yearly and quarterly percent of medication initiation for each anti-diabetes medication class over all anti-diabetes medication initiations. </p> <p><b>Research Design and Results</b>: For patients with DKD, sodium-glucose co-transporter-2 inhibitors (SGLT2i) and glucagon-like peptide 1-receptor agonists (GLP-1RA) initiations steadily increased between 2013 and 2020Q1. Internists and endocrinologists were the most frequent prescriber specialties. Patients less than 65 years of age had a larger percentage of all initiations that were SGLT2i or GLP-1RA, 16% and 23% respectively in 2019, and patients older than 75 years had a smaller percentage of all initiations that were SGLT2i or GLP-1RA, 11% and 13% respectively in 2019.</p> <p><b>Conclusions</b>: For patients with DKD, SGLT2i and GLP-1RA prescriptions have increased over time, likely reflecting evolving prescribing patterns in response to the results of recent clinical trials and new clinical guidelines.</p>

scholarly journals Prescribing Trends of Antidiabetes Medications in Patients With Type 2 Diabetes and Diabetic Kidney Disease, a Cohort Study

2021 ◽  
Author(s):  
Samantha T. Harris ◽  
Elisabetta Patorno ◽  
Min Zhuo ◽  
Seoyoung C. Kim ◽  
Julie M. Paik
Keyword(s):  
Cohort Study ◽  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Prescribing Patterns ◽  
Diabetic Kidney ◽  
Diabetes Medication ◽  
Medication Class ◽  
Prescribing Trends ◽  
Insurance Claims Data ◽  
Over Time

<b>Objective</b>: To assess changes in anti-diabetes medication class prescriptions over time among patients with Diabetic Kidney Disease (DKD), characteristics of patients prescribed these medications, and prescribers’ specialty. <sup></sup> <p><b>Methods</b>: A cohort study design using insurance claims data between 2013 and the first quarter (Q1) of 2020. Included are adult patients with DKD who initiated a new anti-diabetes medication between 2013 and 2020Q1 (N=160,489 patients). The primary outcome is the yearly and quarterly percent of medication initiation for each anti-diabetes medication class over all anti-diabetes medication initiations. </p> <p><b>Research Design and Results</b>: For patients with DKD, sodium-glucose co-transporter-2 inhibitors (SGLT2i) and glucagon-like peptide 1-receptor agonists (GLP-1RA) initiations steadily increased between 2013 and 2020Q1. Internists and endocrinologists were the most frequent prescriber specialties. Patients less than 65 years of age had a larger percentage of all initiations that were SGLT2i or GLP-1RA, 16% and 23% respectively in 2019, and patients older than 75 years had a smaller percentage of all initiations that were SGLT2i or GLP-1RA, 11% and 13% respectively in 2019.</p> <p><b>Conclusions</b>: For patients with DKD, SGLT2i and GLP-1RA prescriptions have increased over time, likely reflecting evolving prescribing patterns in response to the results of recent clinical trials and new clinical guidelines.</p>

scholarly journals Prescribing Trends of Antidiabetes Medications in Patients With Type 2 Diabetes and Diabetic Kidney Disease, a Cohort Study

Diabetes Care ◽  
2021 ◽  
pp. dc210529
Author(s):  
Samantha T. Harris ◽  
Elisabetta Patorno ◽  
Min Zhuo ◽  
Seoyoung C. Kim ◽  
Julie M. Paik
Keyword(s):  
Type 2 Diabetes ◽  
Cohort Study ◽  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Diabetic Kidney ◽  
Prescribing Trends

scholarly journals Oxidized LDL Modifies the Association between Proteinuria and Deterioration of Kidney Function in Proteinuric Diabetic Kidney Disease

Life ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 504
Author(s):  
Stefanos Roumeliotis ◽  
Panagiotis I. Georgianos ◽  
Athanasios Roumeliotis ◽  
Theodoros Eleftheriadis ◽  
Aikaterini Stamou ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Kidney Function ◽  
Diabetic Kidney Disease ◽  
Oxidized Ldl ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Secondary Outcome ◽  
Diabetic Kidney ◽  
Egfr Decline ◽  
Over Time

Proteinuria is characterized by low accuracy for predicting onset and development of diabetic kidney disease (DKD) because it is not directly associated with molecular changes that promote DKD, but is a result of kidney damage. Oxidized low-density lipoprotein (ox-LDL) reflects oxidative stress and endothelial dysfunction, both underlying the development of proteinuria and loss of kidney function in DKD. We aimed to investigate whether ox-LDL modifies the association between proteinuria and progression of DKD in a cohort of 91 patients with proteinuric DKD and diabetic retinopathy, followed for 10 years. The primary endpoint was a combined kidney outcome of eGFR decline ≥30% or progression to end-stage kidney disease. After the end of the study, we considered the percentage change of eGFR over time as our secondary outcome. Proteinuria was associated with both outcomes, and ox-LDL amplified the magnitude of this link (p < 0.0001 for primary and p < 0.0001 for secondary outcome, respectively). After adjustment for duration of diabetes, history of cardiovascular disease and serum albumin, ox-LDL remained a significant effect modifier of the association between proteinuria and eGFR decline over time (p = 0.04). Our study shows that in proteinuric DKD, circulating ox-LDL levels amplified the magnitude of the association between proteinuria and progression of DKD.

scholarly journals Nonproteinuric Versus Proteinuric Phenotypes in Diabetic Kidney Disease: A Propensity Score–Matched Analysis of a Nationwide, Biopsy-Based Cohort Study

Diabetes Care ◽  
2019 ◽  
Vol 42 (5) ◽  
pp. 891-902 ◽  
Author(s):  
Masayuki Yamanouchi ◽  
Kengo Furuichi ◽  
Junichi Hoshino ◽  
Tadashi Toyama ◽  
Akinori Hara ◽  
...  
Keyword(s):  
Cohort Study ◽  
Kidney Disease ◽  
Propensity Score ◽  
Diabetic Kidney Disease ◽  
Diabetic Kidney

scholarly journals Burden of Undiagnosed Type 2 Diabetes in Diabetic Kidney Disease: A Japanese Retrospective Cohort Study

2020 ◽  
Vol 9 (7) ◽  
pp. 2028
Author(s):  
Hayato Tanabe ◽  
Haruka Saito ◽  
Noritaka Machii ◽  
Akihiro Kudo ◽  
Kenichi Tanaka ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cohort Study ◽  
Kidney Disease ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Diabetic Kidney Disease ◽  
Undiagnosed Diabetes ◽  
Diabetic Kidney

The risk of developing diabetic kidney disease (DKD) in patients with undiagnosed diabetes mellitus (UD) has never been evaluated. We studied the burden of UD on the risk of developing DKD in the Japanese population in a single-center retrospective cohort study. The patients with type 2 diabetes mellitus, but without DKD (estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 or proteinuria), were recruited from January 2018 to January 2019; medical records were scrutinized retrospectively from January 2003 until May 2019. The individuals, with diabetes that could not be denied based on past and current records, comprised the undiagnosed diabetes (UD) group whereas those with confirmed diagnosis comprised the diagnosed diabetes (DD) group. The group differences were tested using a Kaplan–Meier curve and Cox proportional hazards model. Among the 408 participants, 164 (40.2%) and 244 (59.8%) comprised the DD and UD groups, respectively. The baseline parameters, including age, male gender, and BMI were comparable between the groups, but the plasma glucose, HbA1c levels, and diabetic retinopathy prevalence were higher in the UD group. The risk of developing DKD (log rank test, p < 0.001), an eGFR of < 60 mL/min/1.73 m2 (p = 0.001) and proteinuria (p = 0.007) were also higher in the UD group. The unadjusted and adjusted hazard ratios for DKD were 1.760 ((95% CI: 1.323–2.341), p < 0.001) and 1.566 ((95% CI: 1.159–2.115), p = 0.003), respectively, for the UD group. In conclusion, this is the first report showing that UD is a strong risk factor for DKD. The notion that a longer duration of untreated diabetes mellitus is involved strongly in the risk of developing DKD warrants the need for the identification and monitoring of UD patients.

scholarly journals Epidemiology and outcomes of hypoglycemia in patients with advanced diabetic kidney disease on dialysis: A national cohort study

PLoS ONE ◽  
2017 ◽  
Vol 12 (3) ◽  
pp. e0174601 ◽  
Author(s):  
Yeh-Wen Chu ◽  
Hsuan-Ming Lin ◽  
Jhi-Joung Wang ◽  
Shih-Feng Weng ◽  
Chih-Ching Lin ◽  
...  
Keyword(s):  
Cohort Study ◽  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Diabetic Kidney ◽  
National Cohort

scholarly journals P1047URICOSURIA AND URINARY GLUCOSE EXCRETION ON DIABETIC KIDNEY DISEASE (DKD) PATIENTES TREATED WITH SGLT2 INHIBITORS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Maria Marques Vidas ◽  
Alba Maroto ◽  
Ignacio Sanz ◽  
Paula López ◽  
Jose' M Portoles
Keyword(s):  
Uric Acid ◽  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Fractional Excretion ◽  
Sglt2 Inhibitors ◽  
Urinary Glucose Excretion ◽  
Diabetic Kidney ◽  
Urinary Glucose ◽  
Glucose Excretion ◽  
Over Time

Abstract Background and Aims The use of sodium glucose co-transporter 2 inhibitors (SGLT2i) is consistently associated with decrease of serum uric acid levels due to increase uricosuria coupled to glucosuria by mechanisms that are still incompletely understood. In diabetic kidney disease these drugs had shown only modest effects on HbA1c control allegedly due insufficient glucosuric effect. However, renal patients also benefit from hypouricemic effect of SGLT2 inhibitors. The aim of this study was to evaluate glucosuria and uricosuria in DKD patients treated with SGLT2i Method We prospectively analyzed glucose and urate fractional excretions of patients that were to initiate treatment with an SGLT2i, using fractional excretion classical formulas. Patients on GLP1ar or any uricosuric agent including losartan were excluded. All participants gave written consent. Results 37 patients (75.7% male) diagnosed from DKD were included, median age 69.6 years IQR [65.6-73.4], median CKD-EPI eGFR 54,10 ml/min/1,72 m2 [ 41,12- 69,68 IQR] and UACR 137 [49-443] mg/g. SGLT2i used was 53.3% dapagliflozin, 24.4% empagliflozin or 22.2% canagliflozin and mean follow- up was 1.5 years.Serum uric acid levels didn’t show any significative difference along time in this group of patients (6.8 vs 6.3; p 0.4) and %HbA1C was only slightly decreased by month 12 (7.1 vs 6.7; p0.03). Urinary uric acid fractional excretion increased by month 3 and was stabilized till month 12 when this effect seemed to decrease (figure and table) Glucosuria exhibit a similar effect: Urinary glucose fractional excretion increased immediately after the addition of the drug and stabilized over time decreasing at the end of the observation period. Spearman rank correlation test indicated dependency glucosuria and uricosuria (Spearman´s rho 0,24, p 0,03). GFR estimated by CKD-EPI kept stable along the study indicating that loss of uricosuric and glucosuric effect are independent of GFR Conclusion We conclude that uric acid renal excretion is significantly increased in patients treated with SGLT2i even in the presence of DKD but tends to diminish over time, feature that was also observed on urinary glucose excretion and that showed no correlation with GFR. Over-expression of SGLT1 after SGLT2 inhibition has been described in animal models of DKD. Whether this extends to human tubule and explains these results need to be further investigated

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