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Diabetic nephropathy treatment

2017-01-19 10:13

Diabetic nephropathy  treatment

(a) medical treatment

1 diabetes treatment:

(1) diet therapy: early diabetic nephropathy is currently advocated in the intake of protein restriction (0.8g/kg.d). The edema and renal insufficiency patients, in addition to limit sodium intake in the diet, the intake of protein should take fewer principle (0.6g/kg.d), when necessary, may be appropriate to lose amino acids in the insulin and plasma. Which may be appropriate to increase the carbohydrate intake to ensure sufficient heat. Fat should use vegetable oil.

(2) drug therapy: oral hypoglycemic agents

1 sulfonylurea (SUs) mechanism: promoting insulin secretion

Applicable scope: no acute complications of type 2 diabetes mellitus (T2DM) on behalf of the drug: generation of tolbutamide, the two generation of gliclazide, glipizide

Non sulfonylurea is mainly used to control postprandial hyperglycemia

Representative drugs: repaglinide and nateglinide, etc.

2 biguanide mechanism A. to improve the uptake and utilization of glucose in tissues; B. through inhibition of gluconeogenesis and glycogenolysis, decreased hepatic glucose output is too high; C. decreased the fat oxidation rate of D.; improve the operation ability of glucose; insulin sensitivity of E., reduce the insulin resistance.

3 glucosidase inhibitor (AGI) mechanism: inhibition of starch, dextrin and disaccharides (such as sucrose) in intestinal absorption.

Representative drugs: acarbose, voglibose

4 the mechanism of insulin sensitizing agent: increase the sensitivity of glucose to insulin, reduce insulin resistance

On behalf of the drug: Rosiglitazone, pioglitazone

5 insulin

Indications: type a.1 diabetes mellitus patients with B. complications of C. perioperative D. pregnancy and delivery E. oral glucose lowering drugs can not be controlled type 2 diabetes mellitus F. pancreatic resection


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