| [ Summary ] |
In Japan, the incidence of diabetes developing to end-stage renal disease (ESRD) has increased, accounting for 41.0 % of patients who required dialysis therapy in 2003. Furthermore,the number of ESRD patients with diabetes has increased, also with cardiovascular morbidity and complicated courses for, this disease. Thus, good glycemic control can decrease cardiovascular and other diabetes-related causes of death, leading to better survival in diabetic patients. However, the altered pharmacokinetics of hypoglycemic agents may complicate the treatment of hyperglycemia in diabetic patients undergoing dialysis therapy, resulting in inadequate glycemic control and adverse events. Therefore, it is important to manage patients receiving insulin therapy by targeting HbA1C levels of less than 8.0 %. Indeed, tight blood glucose control has been shown to reduce mortality rates by decreasing the incidence of death from infection. |