Challenges of Glycemic Control in People With Diabetes and Advanced Kidney Disease and the Potential of Automated Insulin Delivery.

IF 4.1 Q2 ENDOCRINOLOGY & METABOLISM Journal of Diabetes Science and Technology Pub Date : 2024-11-01 Epub Date: 2023-05-10 DOI:10.1177/19322968231174040
Jean C Lu, Petrova Lee, Francesco Ierino, Richard J MacIsaac, Elif Ekinci, David O'Neal
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Abstract

Diabetes is the leading cause of chronic kidney disease (CKD) and end-stage kidney disease in the world. It is known that maintaining optimal glycemic control can slow the progression of CKD. However, the failing kidney impacts glucose and insulin metabolism and contributes to increased glucose variability. Conventional methods of insulin delivery are not well equipped to adapt to this increased glycemic lability. Automated insulin delivery (AID) has been established as an effective treatment in patients with type 1 diabetes mellitus, and there is emerging evidence for their use in type 2 diabetes mellitus. However, few studies have examined their role in diabetes with concurrent advanced CKD. We discuss the potential benefits and challenges of AID use in patients with diabetes and advanced CKD, including those on dialysis.

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糖尿病合并晚期肾病患者血糖控制的挑战与胰岛素自动输送的潜力。
糖尿病是导致慢性肾脏病(CKD)和终末期肾脏病的主要原因。众所周知,保持最佳的血糖控制可以减缓慢性肾脏病的进展。然而,衰竭的肾脏会影响葡萄糖和胰岛素代谢,并导致葡萄糖变异性增加。传统的胰岛素给药方法不能很好地适应这种血糖易变性的增加。自动胰岛素输送(AID)已被确定为 1 型糖尿病患者的有效治疗方法,而且有新的证据表明其可用于 2 型糖尿病。然而,很少有研究探讨自动给药在糖尿病并发晚期慢性肾脏病中的作用。我们将讨论在糖尿病合并晚期 CKD 患者(包括透析患者)中使用 AID 的潜在益处和挑战。
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来源期刊
Journal of Diabetes Science and Technology
Journal of Diabetes Science and Technology Medicine-Internal Medicine
CiteScore
7.50
自引率
12.00%
发文量
148
期刊介绍: The Journal of Diabetes Science and Technology (JDST) is a bi-monthly, peer-reviewed scientific journal published by the Diabetes Technology Society. JDST covers scientific and clinical aspects of diabetes technology including glucose monitoring, insulin and metabolic peptide delivery, the artificial pancreas, digital health, precision medicine, social media, cybersecurity, software for modeling, physiologic monitoring, technology for managing obesity, and diagnostic tests of glycation. The journal also covers the development and use of mobile applications and wireless communication, as well as bioengineered tools such as MEMS, new biomaterials, and nanotechnology to develop new sensors. Articles in JDST cover both basic research and clinical applications of technologies being developed to help people with diabetes.
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