| Theme |
Integrated Care -- evolving model in nephrology and dialysis |
| Title |
Comprehensive care for diabetic dialysis patients |
| Author |
Daiji Kawanami |
Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Jikei University School of Medicine |
| Author |
Kazunori Utsunomiya |
Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Jikei University School of Medicine |
| [ Summary ] |
The treatment of diabetes in dialysis patients is challenging because of complicated glucose metabolism. Various factors such as altered pharmacokinetics of antidiabetic agents, reduced renal gluconeogenesis, vitamin D defi ciency, and uremia have been shown to affect glycemic control. The effect of glycemic control on the risk of cardiovascular events and death remains unclear. In addition, appropriate targets for glycemic control in diabetic dialysis patients have not been established. As fi ne adjustment for treatment of diabetes is important, close coordination between diabetologists and physicians who specialize in dialysis is required. |