[Treatment of type II diabetic patients with chronic renal failure].
Glycaemic control is a key element in the management of patients with chronic renal insufficiency, associated of course with treatment of all the other associated factors. Dietary management should not merely be wishful thinking but a reality, involving the control of body weight, the maintenance of lean body mass, the observance of a sufficient carbohydrate intake and the control of protein intake, which, always tends to be excessive in diabetics. Drug treatment with oral antidiabetics may be given without risk of iatrogenic effects: glitazone has no effect on renal metabolism but may increase water retention; glinides are insulin secretagogues without renal metabolism so there is no risk of hypoglycaemia in the event of impaired renal function; if not insulin remains an excellent alternative with, however, a change in its half-life with the elevated creatinine clearance. In all cases, the goal remains the control of glycosylated haemoglobin without iatrogenic effects.
Gin
Henri
H
Service de diabétologie, université Bordeaux-ll, hôpital Sud, 33604 Pessac, France. henri.gin@chu-bordeaux.fr
Perlemoine
Caroline
C
Raffaitin
Christelle
C
Rigalleau
Vincent
V
D001786:Blood Glucose; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000178:diet therapy / Q000188:drug therapy / Q000628:therapy*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*
D001786:Blood Glucose