Glycaemic Control after Metformin Discontinuation in Diabetic Patients with a Declining Renal Function
Metformin is contraindicated in diabetic patients with declining renal function. This study examined the glycaemic control in diabetic patients with chronic kidney disease when metformin was discontinued. This was a retrospective study. We screened 2032 diabetic patients who attended the Diabetes Cl...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Journal of Diabetes Research |
| Online Access: | http://dx.doi.org/10.1155/2017/2769819 |
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| _version_ | 1832566648638275584 |
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| author | Theresa Leyco Davin Ryanputra Ray Peh Alexphil Ponce Chin Meng Khoo |
| author_facet | Theresa Leyco Davin Ryanputra Ray Peh Alexphil Ponce Chin Meng Khoo |
| author_sort | Theresa Leyco |
| collection | DOAJ |
| description | Metformin is contraindicated in diabetic patients with declining renal function. This study examined the glycaemic control in diabetic patients with chronic kidney disease when metformin was discontinued. This was a retrospective study. We screened 2032 diabetic patients who attended the Diabetes Clinic at a tertiary hospital between 1 September 2014 and 30 September 2015. We analyzed the data on 69 patients whom metformin was discontinued due to declining renal function and had a complete 6-month follow-up. There was no significant difference in the HbA1c and body weight at 6-month follow-up compared to baseline after metformin discontinuation. The eGFR was significantly lower at 6-month follow-up compared to baseline. Upon metformin discontinuation, the majority of patients had their diabetes medication uptitrated (in particular insulin or sulphonylurea). Patients with an improved glycaemia at 6-month follow-up had further declined in eGFR compared to patients with worsened glycaemia. 17% of the study patients experienced hypoglycaemia. Upon metformin discontinuation, glycaemic control could be optimised with uptitration but should be balanced against the risk of hypoglycaemia. Further improvement in the glycaemic control might indicate further deterioration in the renal function. |
| format | Article |
| id | doaj-art-e24a167d5e2f4adabae3a276618cc12d |
| institution | Kabale University |
| issn | 2314-6745 2314-6753 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes Research |
| spelling | doaj-art-e24a167d5e2f4adabae3a276618cc12d2025-02-03T01:03:36ZengWileyJournal of Diabetes Research2314-67452314-67532017-01-01201710.1155/2017/27698192769819Glycaemic Control after Metformin Discontinuation in Diabetic Patients with a Declining Renal FunctionTheresa Leyco0Davin Ryanputra1Ray Peh2Alexphil Ponce3Chin Meng Khoo4Department of Medicine, National University Hospital, SingaporeYong Loo Lin School of Medicine, National University of Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, SingaporeHigher Education Department, Centre for International Education, Cebu, PhilippinesDepartment of Medicine, National University Hospital, SingaporeMetformin is contraindicated in diabetic patients with declining renal function. This study examined the glycaemic control in diabetic patients with chronic kidney disease when metformin was discontinued. This was a retrospective study. We screened 2032 diabetic patients who attended the Diabetes Clinic at a tertiary hospital between 1 September 2014 and 30 September 2015. We analyzed the data on 69 patients whom metformin was discontinued due to declining renal function and had a complete 6-month follow-up. There was no significant difference in the HbA1c and body weight at 6-month follow-up compared to baseline after metformin discontinuation. The eGFR was significantly lower at 6-month follow-up compared to baseline. Upon metformin discontinuation, the majority of patients had their diabetes medication uptitrated (in particular insulin or sulphonylurea). Patients with an improved glycaemia at 6-month follow-up had further declined in eGFR compared to patients with worsened glycaemia. 17% of the study patients experienced hypoglycaemia. Upon metformin discontinuation, glycaemic control could be optimised with uptitration but should be balanced against the risk of hypoglycaemia. Further improvement in the glycaemic control might indicate further deterioration in the renal function.http://dx.doi.org/10.1155/2017/2769819 |
| spellingShingle | Theresa Leyco Davin Ryanputra Ray Peh Alexphil Ponce Chin Meng Khoo Glycaemic Control after Metformin Discontinuation in Diabetic Patients with a Declining Renal Function Journal of Diabetes Research |
| title | Glycaemic Control after Metformin Discontinuation in Diabetic Patients with a Declining Renal Function |
| title_full | Glycaemic Control after Metformin Discontinuation in Diabetic Patients with a Declining Renal Function |
| title_fullStr | Glycaemic Control after Metformin Discontinuation in Diabetic Patients with a Declining Renal Function |
| title_full_unstemmed | Glycaemic Control after Metformin Discontinuation in Diabetic Patients with a Declining Renal Function |
| title_short | Glycaemic Control after Metformin Discontinuation in Diabetic Patients with a Declining Renal Function |
| title_sort | glycaemic control after metformin discontinuation in diabetic patients with a declining renal function |
| url | http://dx.doi.org/10.1155/2017/2769819 |
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