Management of Diabetes Mellitus in Patients With CKD: Core Curriculum 2022.

The most common cause of kidney failure in the United States and across the world is diabetes mellitus (DM). Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in persons with diabetes, and chronic kidney disease (CKD) further increases overall CVD risk. It is important to individualize glycemic targets for patients to maintain glucose levels that will reduce the development and progression of complications while avoiding hypoglycemia.

Electronic Health Record-Based Strategy to Promote Medication Adherence Among Patients With Diabetes: Longitudinal Observational Study.

Background: Poor medication adherence is common; however, few mechanisms exist in clinical practice to monitor how patients take medications in outpatient settings.

Objective: This study aimed to pilot test the Electronic Medication Complete Communication (EMC) strategy, a low-cost, sustainable approach that uses functionalities within the electronic health record to promote outpatient medication adherence and safety.

Methods: The EMC strategy was implemented in 2 academic practices for 14 higher-risk diabetes medications.

Management of diabetes mellitus in patients with chronic kidney disease.

Glycemic control is essential to delay or prevent the onset of diabetic kidney disease. There are a number of glucose-lowering medications available but only a fraction of them can be used safely in chronic kidney disease and many of them need an adjustment in dosing. The ideal target hemoglobin A1c is approximately 7 % but this target is adjusted based on the needs of the patient.

Acute kidney injury and bisphosphonate use in cancer: a report from the research on adverse drug events and reports (RADAR) project.

Purpose: To determine whether acute kidney injury (AKI) is identified within the US Food and Drug Administration's Adverse Events and Reporting System (FDA AERS) as an adverse event resulting from bisphosphonate (BP) use in cancer therapy.

Methods: A search of the FDA AERS records from January 1998 through June 2009 was performed; search terms were "renal problems" and all drug names for BPs. The search resulted in 2,091 reports.

Bisphosphonates and nonhealing femoral fractures: analysis of the FDA Adverse Event Reporting System (FAERS) and international safety efforts: a systematic review from the Research on Adverse Drug Events And Reports (RADAR) project.

Background: In the United States, hip fracture rates have declined by 30% coincident with bisphosphonate use. However, bisphosphonates are associated with sporadic cases of atypical femoral fracture. Atypical femoral fractures are usually atraumatic, may be bilateral, are occasionally preceded by prodromal thigh pain, and may have delayed fracture-healing.

Primary hyperaldosteronism: challenges in subtype classification.

Background: Primary hyperaldosteronism (PA) is a serious and potentially debilitating disease. Detailed guidelines have been written to guide endocrinologists in establishing the diagnosis of PA as well as in subtype classification of PA. The objective of this case report is to present a case where subtype classification of PA was challenging and repeated imaging of the adrenal glands helped establish the diagnosis in a patient with initial normal adrenal glands on CT and MRI images.

Addressing secondary prevention of osteoporosis in fracture care: follow-up to "own the bone".

The majority of the 1.8 million individuals who sustain a fracture annually in the United States have osteopenia or osteoporosis, yet <15% of these patients subsequently receive treatment for osteoporosis. A prospective cohort study was conducted to assess the effect of two different interventions on the rate of osteoporosis treatment in patients with a fragility fracture.

Diabetes, cardiovascular risk and nephropathy.

Diabetic patients with chronic kidney disease are at high risk for cardiovascular disease (CVD). All aspects of risk reduction should be rigorously applied to such patients. Statins should be used with reduction of low-density lipoprotein cholesterol levels, and blood pressure management is important.

Optimizing insulin therapy in patients with type 1 and type 2 diabetes mellitus: optimal dosing and timing in the outpatient setting.

Management of type 1 and type 2 diabetes is continually evolving, and among these evolving therapies is administration of insulin in its various forms. The insulin regimen needs to be tailored to each individual, not only to maximize compliance and glycemic control but also to minimize hypoglycemia and weight gain.

Optimizing insulin therapy in patients with type 1 and type 2 diabetes mellitus: optimal dosing and timing in the outpatient setting.

Management of type 1 and type 2 diabetes is continually evolving, and among these evolving therapies is administration of insulin in its various forms. The insulin regimen needs to be tailored to each individual, not only to maximize compliance and glycemic control but also to minimize hypoglycemia and weight gain.