open access

Vol 7, No 3 (2018)
ORIGINAL ARTICLES
Published online: 2018-05-21
Get Citation

Comparing the incidence of hypoglycemia episodes in patients with type 2 diabetes and chronic kidney disease treated with insulin or glibenclamide

Mohammad Aghaali, Hossein Saghafi
DOI: 10.5603/DK.2018.0012
·
Clinical Diabetology 2018;7(3):159-163.

open access

Vol 7, No 3 (2018)
ORIGINAL ARTICLES
Published online: 2018-05-21

Abstract

Introduction. Hypoglycemia is one of the side effects of glibenclamide, which is administered orally in people with diabetes. Hypoglycemia may occur easily due to the reduced metabolism of this drug in patients with chronic kidney disease. The aim of this study was to compare the incidence of hypoglycemia in patients with chronic kidney disease who were treated with glibenclamide or insulin.

Material and methods. In this study, 87 patients with type 2 diabetes and in stage 3–4 of chronic kidney disease (CKD) were examined. The patients were divided into two groups of glibenclamide (N = 44) and insulin (N = 43) based on the type of blood glucose-lowering therapy. Next, demographic data, serum creatinine level, number of hypoglycemic episodes over the last year and the amount of consumed drugs were recorded in the checklist. Finally, the data analysis was performed using the SPSS Software.

Results. There was no significant difference between the two groups in terms of age, estimated glomerular filtration rate (eGFR), weight, duration of diabetes and blood glucose control. In addition, it was indicated that 38% of patients in the glibenclamide group and 32% of patients in the insulin group had at least one hypoglycemic episode. Also, in those two groups, there was no significant correlation between doses of the drug and the number of hypoglycemic episodes.

Conclusions. This study showed that there was no significant difference between the patients with chronic kidney disease who were treated with insulin and those patients who were treated with glibenclamide in terms of number of symptomatic hypoglycemic episodes.

Abstract

Introduction. Hypoglycemia is one of the side effects of glibenclamide, which is administered orally in people with diabetes. Hypoglycemia may occur easily due to the reduced metabolism of this drug in patients with chronic kidney disease. The aim of this study was to compare the incidence of hypoglycemia in patients with chronic kidney disease who were treated with glibenclamide or insulin.

Material and methods. In this study, 87 patients with type 2 diabetes and in stage 3–4 of chronic kidney disease (CKD) were examined. The patients were divided into two groups of glibenclamide (N = 44) and insulin (N = 43) based on the type of blood glucose-lowering therapy. Next, demographic data, serum creatinine level, number of hypoglycemic episodes over the last year and the amount of consumed drugs were recorded in the checklist. Finally, the data analysis was performed using the SPSS Software.

Results. There was no significant difference between the two groups in terms of age, estimated glomerular filtration rate (eGFR), weight, duration of diabetes and blood glucose control. In addition, it was indicated that 38% of patients in the glibenclamide group and 32% of patients in the insulin group had at least one hypoglycemic episode. Also, in those two groups, there was no significant correlation between doses of the drug and the number of hypoglycemic episodes.

Conclusions. This study showed that there was no significant difference between the patients with chronic kidney disease who were treated with insulin and those patients who were treated with glibenclamide in terms of number of symptomatic hypoglycemic episodes.

Get Citation

Keywords

glyburide; kidney disease; chronic; insulin; hypoglycemia; diabetes mellitus

About this article
Title

Comparing the incidence of hypoglycemia episodes in patients with type 2 diabetes and chronic kidney disease treated with insulin or glibenclamide

Journal

Clinical Diabetology

Issue

Vol 7, No 3 (2018)

Pages

159-163

Published online

2018-05-21

DOI

10.5603/DK.2018.0012

Bibliographic record

Clinical Diabetology 2018;7(3):159-163.

Keywords

glyburide
kidney disease
chronic
insulin
hypoglycemia
diabetes mellitus

Authors

Mohammad Aghaali
Hossein Saghafi

References (28)
  1. Organization WH. Health topic - Diabetes Mellitus, 2015. www.who.int/topics/diabetes_mellitus/en/ (2015).
  2. Cooper L. USRDS. 2001 Annual Data Report. Nephrol News Issues. 2001; 15(10): 31, 34–5, 38 passim.
  3. Mirchi E, Saghafi H, Gharehbeglou M, et al. Association Between 25-Hydroxyvitamin D Level and Inflammatory and Nutritional Factors in Hemodialysis and Peritoneal dialysis Patients in Qom, Iran. Iran J Kidney Dis. 2016; 10(4): 205–212.
  4. Koro CE, Lee BoH, Bowlin SJ. Antidiabetic medication use and prevalence of chronic kidney disease among patients with type 2 diabetes mellitus in the United States. Clin Ther. 2009; 31(11): 2608–2617.
  5. Kajbaf F, Arnouts P, de Broe M, et al. Metformin therapy and kidney disease: a review of guidelines and proposals for metformin withdrawal around the world. Pharmacoepidemiol Drug Saf. 2013; 22(10): 1027–1035.
  6. Guideline development group. Clinical Practice Guideline on management of patients with diabetes and chronic kidney disease stage 3b or higher (eGFR <45 mL/min). Nephrol Dial Transplant. 2015; 30 Suppl 2: ii1–142.
  7. Muller C, Dimitrov Y, Imhoff O, et al. CERRENE, CERRENE study group. Oral antidiabetics use among diabetic type 2 patients with chronic kidney disease. Do nephrologists take account of recommendations? J Diabetes Complications. 2016; 30(4): 675–680.
  8. Penfornis A, Blicklé JF, Fiquet B, et al. How are patients with type 2 diabetes and renal disease monitored and managed? Insights from the observational OREDIA study. Vasc Health Risk Manag. 2014; 10: 341–352.
  9. Lalau JD, Arnouts P, Sharif A, et al. Metformin and other antidiabetic agents in renal failure patients. Kidney Int. 2015; 87(2): 308–322.
  10. Betônico CCR, Titan SMO, Correa-Giannella ML, et al. Management of diabetes mellitus in individuals with chronic kidney disease: therapeutic perspectives and glycemic control. Clinics (Sao Paulo). 2016; 71(1): 47–53.
  11. Solini A, Penno G, Bonora E, et al. Renal Insufficiency and Cardiovascular Events Study Group. Age, renal dysfunction, cardiovascular disease, and antihyperglycemic treatment in type 2 diabetes mellitus: findings from the Renal Insufficiency and Cardiovascular Events Italian Multicenter Study. J Am Geriatr Soc. 2013; 61(8): 1253–1261.
  12. Mak RH, DeFronzo RA. Glucose and insulin metabolism in uremia. Nephron. 1992; 61(4): 377–382.
  13. Rave K, Heise T, Pfützner A, et al. Impact of diabetic nephropathy on pharmacodynamic and Pharmacokinetic properties of insulin in type 1 diabetic patients. Diabetes Care. 2001; 24(5): 886–890.
  14. van Staa T, Abenhaim L, Monette J. Rates of hypoglycemia in users of sulfonylureas. J Clin Epidemiol. 1997; 50(6): 735–741.
  15. Leese GP, Wang J, Broomhall J, et al. DARTS/MEMO Collaboration. Frequency of severe hypoglycemia requiring emergency treatment in type 1 and type 2 diabetes: a population-based study of health service resource use. Diabetes Care. 2003; 26(4): 1176–1180.
  16. Stahl M, Berger W. Higher incidence of severe hypoglycaemia leading to hospital admission in Type 2 diabetic patients treated with long-acting versus short-acting sulphonylureas. Diabet Med. 1999; 16(7): 586–590.
  17. Weir MA, Gomes T, Mamdani M, et al. Impaired renal function modifies the risk of severe hypoglycaemia among users of insulin but not glyburide: a population-based nested case-control study. Nephrol Dial Transplant. 2011; 26(6): 1888–1894.
  18. Holstein A, Hammer C, Hahn M, et al. Severe sulfonylurea-induced hypoglycemia: a problem of uncritical prescription and deficiencies of diabetes care in geriatric patients. Expert Opin Drug Saf. 2010; 9(5): 675–681.
  19. Schloot NC, Haupt A, Schütt M, et al. Risk of severe hypoglycemia in sulfonylurea-treated patients from diabetes centers in Germany/Austria: How big is the problem? Which patients are at risk? Diabetes Metab Res Rev. 2016; 32(3): 316–324.
  20. Greco D, Pisciotta M, Gambina F, et al. Severe hypoglycaemia leading to hospital admission in type 2 diabetic patients aged 80 years or older. Exp Clin Endocrinol Diabetes. 2010; 118(4): 215–219.
  21. van Dalem J, Brouwers MC, Stehouwer CDA, et al. Risk of hypoglycaemia in users of sulphonylureas compared with metformin in relation to renal function and sulphonylurea metabolite group: population based cohort study. BMJ. 2016; 354: i3625.
  22. Gerich JE, Meyer C, Woerle HJ, et al. Renal gluconeogenesis: its importance in human glucose homeostasis. Diabetes Care. 2001; 24(2): 382–391.
  23. Biesenbach G, Raml A, Schmekal B, et al. Decreased insulin requirement in relation to GFR in nephropathic Type 1 and insulin-treated Type 2 diabetic patients. Diabet Med. 2003; 20(8): 642–645.
  24. Snyder RW, Berns JS. Use of insulin and oral hypoglycemic medications in patients with diabetes mellitus and advanced kidney disease. Semin Dial. 2004; 17(5): 365–370.
  25. Bonds DE, Miller ME, Bergenstal RM, et al. The association between symptomatic, severe hypoglycaemia and mortality in type 2 diabetes: retrospective epidemiological analysis of the ACCORD study. BMJ. 2010; 340: b4909.
  26. Seaquist ER, Anderson J, Childs B, et al. Hypoglycemia and diabetes: a report of a workgroup of the American Diabetes Association and the Endocrine Society. Diabetes Care. 2013; 36(5): 1384–1395.
  27. Yun JS, Ko SH. Risk Factors and Adverse Outcomes of Severe Hypoglycemia in Type 2 Diabetes Mellitus. Diabetes Metab J. 2016; 40(6): 423–432.
  28. Pearson JG, Antal EJ, Raehl CL, et al. Pharmacokinetic disposition of 14C-glyburide in patients with varying renal function. Clin Pharmacol Ther. 1986; 39(3): 318–324.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

 

Wydawcą serwisu jest  "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl