Diabetes and Renal Disease

Patients with long-standing diabetes are at risk of developing diabetes-related complications and diabetic kidney disease is common in this patient population. Diabetes management can be challenging in patients with kidney disease due to the altered pharmacokinetics of diabetes medication in renal impairment. Reduced renal clearance of these medicines can affect glycaemic control and increase the risk of side effects, such as hypoglycaemia. This session will discuss the use of oral antidiabetic agents and insulin in patients with chronic kidney disease, including the management of insulin therapy in dialysis patients. It aims to highlight the advantages, disadvantages and monitoring of the major classes of oral antidiabetic agents, including the SGLT2-inhibitors and to advocate safe use of insulin in this patient group. The session will also aim to raise awareness of new-onset diabetes after transplant (NODAT) and highlight the main treatment for this condition.