| Theme |
The consideration of polypharmacy in dialysis patients |
| Title |
Antihypoglycemic medication in patients with diabetes undergoing dialysis |
| Author |
Noriko Yoshida |
Diabetes Center, Tokyo Women's Medical University School of Medicine |
| Author |
Naofumi Yoshida |
Diabetes Center, Tokyo Women's Medical University School of Medicine |
| Author |
Tetsuya Babazono |
Diabetes Center, Tokyo Women's Medical University School of Medicine |
| [ Summary ] |
Intensive insulin therapy is essential for patients with type 1 diabetes, regardless of whether they have chronic kidney disease. In patients with type 2 diabetes and end-stage renal disease who are undergoing dialysis, single or multiple hypoglycemic agents are selected from oral and injectable preparations. Seven oral drugs and 5 glucagon-like peptide (GLP)-1 receptor agonists are currently in the market in Japan.However, in patients on dialysis, oral drug options are limited to α-glucosidase inhibitors, fast-acting insulin secretagogues, and dipeptidyl peptidase 4 inhibitors ; whereas, GLP-1 receptor agonist choicesare limited to liraglutide, lixisenatide, and dulaglutide. The use of multiple hypoglycemic drugs or treatment with hypoglycemic drugs combined with medications that may cause hypoglycemia as a side effect may be associated with the risk of polypharmacy. |