de Boer Ian H, Caramori M Luiza, Chan Juliana C N, Heerspink Hiddo J L, Hurst Clint, Khunti Kamlesh, Liew Adrian, Michos Erin D, Navaneethan Sankar D, Olowu Wasiu A, Sadusky Tami, Tandon Nikhil, Tuttle Katherine R, Wanner Christoph, Wilkens Katy G, Zoungas Sophia, Lytvyn Lyubov, Craig Jonathan C, Tunnicliffe David J, Howell Martin, Tonelli Marcello, Cheung Michael, Earley Amy, Rossing Peter
Kidney Research Institute, University of Washington, Seattle, Washington, USA.
University of Minnesota, Minneapolis, Minnesota, USA.
Kidney Int. 2020 Oct;98(4):839-848. doi: 10.1016/j.kint.2020.06.024. Epub 2020 Jul 10.
Improving Global Outcomes (KDIGO) Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease represents the first KDIGO guideline on this subject. The guideline comes at a time when advances in diabetes technology and therapeutics offer new options to manage the large population of patients with diabetes and chronic kidney disease (CKD) at high risk of poor health outcomes. An enlarging base of high-quality evidence from randomized clinical trials is available to evaluate important new treatments offering organ protection, such as sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists. The goal of the new guideline is to provide evidence-based recommendations to optimize the clinical care of people with diabetes and CKD by integrating new options with existing management strategies. In addition, the guideline contains practice points to facilitate implementation when insufficient data are available to make well-justified recommendations or when additional guidance may be useful for clinical application. The guideline covers comprehensive care of patients with diabetes and CKD, glycemic monitoring and targets, lifestyle interventions, antihyperglycemic therapies, and self-management and health systems approaches to management of patients with diabetes and CKD.
改善全球肾脏病预后组织(KDIGO)慢性肾脏病糖尿病管理临床实践指南是KDIGO关于该主题的首个指南。该指南发布之时,糖尿病技术和治疗方法的进步为管理大量有健康不良后果高风险的糖尿病和慢性肾脏病(CKD)患者提供了新选择。来自随机临床试验的高质量证据基础不断扩大,可用于评估提供器官保护的重要新治疗方法,如钠-葡萄糖协同转运蛋白2抑制剂和胰高血糖素样肽1受体激动剂。新指南的目标是通过将新选择与现有管理策略相结合,提供基于证据的建议,以优化糖尿病和CKD患者的临床护理。此外,当缺乏足够数据做出充分合理的建议或额外指导对临床应用可能有用时,该指南包含便于实施的实践要点。该指南涵盖糖尿病和CKD患者的综合护理、血糖监测与目标、生活方式干预、降糖治疗以及糖尿病和CKD患者管理的自我管理和卫生系统方法。