dc.contributor.author
Busch, Martin
dc.contributor.author
Nadal, Jennifer
dc.contributor.author
Schmid, Matthias
dc.contributor.author
Paul, Katharina
dc.contributor.author
Titze, Stephanie
dc.contributor.author
Huebner, Silvia
dc.contributor.author
Koettgen, Anna
dc.contributor.author
Schultheiss, Ulla T.
dc.contributor.author
Baid-Agrawal, Seema
dc.contributor.author
Lorenzen, Johan
dc.contributor.author
Schlieper, Georg
dc.contributor.author
ommerer, Claudia
dc.contributor.author
Krane, Vera
dc.contributor.author
Hilge, Robert
dc.contributor.author
Kielstein, Jan T.
dc.contributor.author
Kronenberg, Florian
dc.contributor.author
Wanner, Christoph
dc.contributor.author
Eckardt, Kai-Uwe
dc.contributor.author
Wolf, Gunter
dc.date.accessioned
2018-06-08T03:18:55Z
dc.date.available
2016-07-11T10:41:12.804Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/14902
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-19090
dc.description.abstract
Background Diabetes mellitus (DM) is the leading cause of end-stage renal
disease. Little is known about practice patterns of anti-diabetic therapy in
the presence of chronic kidney disease (CKD) and correlates with glycaemic
control. We therefore aimed to analyze current antidiabetic treatment and
correlates of metabolic control in a large contemporary prospective cohort of
patients with diabetes and CKD. Methods The German Chronic Kidney Disease
(GCKD) study enrolled 5217 patients aged 18–74 years with an estimated
glomerular filtration rate (eGFR) between 30–60 mL/min/1.73 m2 or proteinuria
>0.5 g/d. The use of diet prescription, oral anti-diabetic medication, and
insulin was assessed at baseline. HbA1c, measured centrally, was the main
outcome measure. Results At baseline, DM was present in 1842 patients (35 %)
and the median HbA1C was 7.0 % (25th–75th percentile: 6.8–7.9 %), equalling 53
mmol/mol (51, 63); 24.2 % of patients received dietary treatment only, 25.5 %
oral antidiabetic drugs but not insulin, 8.4 % oral antidiabetic drugs with
insulin, and 41.8 % insulin alone. Metformin was used by 18.8 %. Factors
associated with an HbA1C level >7.0 % (53 mmol/mol) were higher BMI (OR = 1.04
per increase of 1 kg/m2, 95 % CI 1.02–1.06), hemoglobin (OR = 1.11 per
increase of 1 g/dL, 95 % CI 1.04–1.18), treatment with insulin alone (OR =
5.63, 95 % CI 4.26–7.45) or in combination with oral antidiabetic agents (OR =
4.23, 95 % CI 2.77–6.46) but not monotherapy with metformin, DPP-4 inhibitors,
or glinides. Conclusions Within the GCKD cohort of patients with CKD stage 3
or overt proteinuria, antidiabetic treatment patterns were highly variable
with a remarkably high proportion of more than 50 % receiving insulin-based
therapies. Metabolic control was overall satisfactory, but insulin use was
associated with higher HbA1C levels.
en
dc.rights.uri
http://creativecommons.org/licenses/by/4.0/
dc.subject
Chronic kidney disease
dc.subject
Diabetes mellitus
dc.subject
Glycaemic control
dc.subject
Hemoglobin A1C
dc.subject
Insulin therapy
dc.subject
Oral antidiabetic drugs
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit
dc.title
Glycaemic control and antidiabetic therapy in patients with diabetes mellitus
and chronic kidney disease – cross-sectional data from the German Chronic
Kidney Disease (GCKD) cohort
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation
BMC Nephrology. - 17 (2016),Artikel Nr. 59
dcterms.bibliographicCitation.doi
10.1186/s12882-016-0273-z
dcterms.bibliographicCitation.url
http://bmcnephrol.biomedcentral.com/articles/10.1186/s12882-016-0273-z
refubium.affiliation
Charité - Universitätsmedizin Berlin
de
refubium.mycore.fudocsId
FUDOCS_document_000000024975
refubium.note.author
Der Artikel wurde in einer Open-Access-Zeitschrift publiziert.
refubium.resourceType.isindependentpub
no
refubium.mycore.derivateId
FUDOCS_derivate_000000006749
dcterms.accessRights.openaire
open access