Adamíková Alena
Vnitr Lek. 2015 Feb;61(2):147-50.
The main cause of renal failure is diabetic nephropathy which affects 20-40 % of diabetic patients. Diabetics with altered renal function have restricted therapeutic options due to the risk of accumulation of oral antidiabetic drugs and of their metabolites at a reduced glomerular filtration rate. Good metabolic control is very important during the early phases of nephropathy for reducing the risk of progression and in the stage of renal failure reduces the risk of progression of atherosclerosis and improves life prognosis. Metabolism of insulin is changed during renal failure, clearance of insulin is prolonged, the risk of hypoglycemia increases. Short-acting insulin analogues have faster absorption and long-acting analogues have a lower risk of hypoglycemia. Thus they can positively affect glycemic control of patients with diabetes and impaired renal function.
肾衰竭的主要原因是糖尿病肾病，它影响20%至40%的糖尿病患者。肾功能改变的糖尿病患者由于口服降糖药及其代谢产物在肾小球滤过率降低时蓄积的风险，其治疗选择受到限制。在肾病早期，良好的代谢控制对于降低病情进展风险非常重要，而在肾衰竭阶段则可降低动脉粥样硬化进展风险并改善生活预后。肾衰竭期间胰岛素代谢发生改变，胰岛素清除时间延长，低血糖风险增加。短效胰岛素类似物吸收更快，长效类似物低血糖风险更低。因此，它们可对糖尿病和肾功能受损患者的血糖控制产生积极影响。
