Oulahiane Asmaa, Anaddam Sara, Ouleghzal Hassan, Elhaddad Nadia, Moussaoui Souad, Yaagoubi Noussaima, Boufares Fatima, Belmejdoub Ghizlaine
Service d'endocrinologie, diabétologie et nutrition, hôpital militaire d'instruction Mohammed V, Rabat, Maroc.
Nephrol Ther. 2012 Jun;8(3):135-40. doi: 10.1016/j.nephro.2011.07.410. Epub 2011 Oct 20.
Chronic kidney disease is in continuous increase and can be found in up to 23% of patients with diabetes. Glycemic control is difficult to assess and medication therapy for diabetes may require dose adjustments part of the alteration of drug's pharmacokinetics and the insulin resistance which is predicting cardiovascular events. The recommended hemoglobin A1c goal is also lower than 7.0% without hypoglycemia. In this article, we review the therapeutic management of diabetic patients in chronic renal failure stage which is difficult and the ways to control blood glucose. Multidisciplinary approach, which is including management of comorbid diseases, is necessary to provide the optimal care of these patients.
慢性肾脏病的发病率持续上升，在高达23%的糖尿病患者中均可发现。血糖控制难以评估，糖尿病药物治疗可能需要调整剂量，这部分是由于药物药代动力学的改变以及预测心血管事件的胰岛素抵抗。推荐的糖化血红蛋白目标也低于7.0%且无低血糖。在本文中，我们回顾了慢性肾衰竭期糖尿病患者的治疗管理，这很困难，同时也探讨了控制血糖的方法。多学科方法，包括合并症的管理，对于为这些患者提供最佳护理是必要的。
