A Predictive Study on the Chemical Relationship between Human Kidney Function and Hyperglycemia
Keywords:Blood sugar, Diabetes, kidney disease, Glycemic control, Diabetes complications
Type 2 diabetes mellitus (DM) affects 18-20% of adults over 65 years old globally. Diabetic kidney disease (DKD) is one of the most common and dangerous complications of type 2 DM, impacting about one-third of patients. In addition to the pancreas, liver, intestines, and adipose tissue, the kidneys also play an important role in blood sugar regulation through gluconeogenesis and glucose reabsorption. In this review article, an interdisciplinary group of experts in endocrinology, diabetology, and nephrology discuss the relationship between diabetes and kidney disease. They address diagnosis, challenges with glycemic control, and potential treatments for different stages of DKD. Glucose homeostasis is severely disrupted in DKD patients, putting them at high risk of both hyperglycemia and hypoglycemia. Abnormal high and low blood sugar levels associate with higher morbidity and mortality in this population. Factors increasing hypoglycemia risk include reduced kidney gluconeogenesis, altered metabolic pathways, and decreased insulin clearance. Decreased glucose filtration/excretion and inflammation-induced insulin resistance predispose to hyperglycemia. Careful blood sugar monitoring and control tailored to diabetes patients with kidney disease is required to avoid hypoglycemic and other glucose disorders. Understanding the physiology and pathophysiology of DKD has become essential for all specialties treating diabetic patients. Disseminating this knowledge and evidence will be vital to advance research and improve care for these patients.
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