La terapia del diabete nel paziente nefropatico

Diabetes therapies in renal impairment Diabetes mellitus is recognized as a leading cause of chronic kidney disease and end-stage renal failure. Until few years ago patients with diabetes should be preferably treated with insulin. The management of the patients with hyperglycemia and chronic renal failure demands a close collaboration between the diabetologist and the nephrologists. Some of the new drugs as the Dipeptydil Peptidase-4 inhibitors and GLP-1 receptor agonists recently approved for the treatment of diabetes can be used, even if with a reduction of the usual dose, in chronic kidney disease and end-stage renal failure. These drugs showed efficacy on the improvement of HbA1c, several extraglycemic effects together with a low hypoglycemic risk. This article will analyze current status of national and international guidelines and the product characteristics focusing on the treatment of diabetes in patients with impairment of renal function.