Efficacy and Safety of Oral Antidiabetic Drugs in Type 2 Diabetes Mellitus with Chronic Kidney Disease

• Main Authors: Retta C Sihotang, Rizka Ramadhani, Dicky L Tahapary
• Format: Article
• Language: Indonesian
• Published: Department of Internal Medicine, Faculty of Medicine Universitas Indonesia-Cipto Mangunkusumo Hospital 2018-09-01
• Series: Jurnal Penyakit Dalam Indonesia
• Subjects: Chronic kidney disease; Efficacy; Oral antidiabetic; Safety; Sulfonylurea
• Online Access: http://jurnalpenyakitdalam.ui.ac.id/index.php/jpdi/article/view/202/164

Selection of oral antidiabetic drugs (OAD) in patients with type 2 diabetes mellitus (T2DM) with chronic kidney disease (CKD) is very important because most OAD is secreted through the kidneys so dose adjustment is required. In Indonesia, short acting sulfonylureas (SU) are commonly used for the management of T2DM with CKD. This review article aimed to compare the effectiveness and safety of certain SU types with other OAD in T2DM with CKD. Sulfonylureas, tiazolidindion (TZD), DPP-IV-inhibitor, and SGLT-2-inhibitor were evaluated. Short acting sulfonylureas (glycazides and glipizids) and SGLT-2-inhibitor (empaglifozin and canaglifozin) may inhibit the progression of CKD in T2DM. On the contrary, pioglitazone and sitagliptin are associated with higher progression of CKD, while linagliptin has a neutral effect on deterioration of CKD. However, sitagliptin and linagliptin have lower risk of causing hypoglycemia than short acting SU. In conclusion, short acting SU can still be the primary choice for the blood glucose management in T2DM with CKD in Indonesia.