Usama A Sharaf El Din1 *, Mona M Salem2 and Dina O Abdulazim3
1Department of Internal Medicine, Nephrology Unit, Cairo University, Egypt 2Department of Internal Medicine and Endocrinology, Cairo University, Egypt 3Department of Rheumatology and Rehabilitation, Cairo University, EgyptFulltext PDF
In the last two decades, a dramatic shift in the paradigm of management of Type 2 Diabetes Mellitus (T2DM) has been settled. Reduction of diabetic complications became the primary target instead of focusing on the mere glycemic control. The tight blood sugar control among Type 1 Diabetes Mellitus (T1DM) and T2DM patients aimed at avoidance of long-term complications of this disease. In spite of the significant influence of this approach on the incidence of these complications, the outcome is still not satisfactory. The frequent failure to achieve tight blood sugar control and the lack of hypoglycemic agents that are capable to combat the underlying pathogenic mechanisms of diabetic complications underlie this unsatisfactory outcome. These drawbacks are overcome in the newly introduced hypoglycemic agents. These agents were initially introduced to better control blood sugar in T2DM. However, accumulating evidence proved their possible favorable effects in T1DM and T2DM.
In this review, we are going to discuss these mechanisms and highlight the therapeutic value of the early use of these agents to prevent the development of diabetic nephropathy
Type 1 diabetes; Type 2 diabetes; Diabetic nephropathy; Microvascular complications; Macrovascular complications; DPP4Is; SGLT2Is; Nrf2 agonists
Sharaf El Din UA, Salem MM, Abdulazim DO. Time to Prevent the Development of Diabetic Nephropathy in Both Type 1 and Type 2 Diabetic Patients. J Clin Nephrol Kidney Dis. 2019; 4(1):1023..