ada2 Flashcards
What is the primary end point of the Finerenone in Reducing Cardiovascular Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial?
The primary end point was reduced cardiovascular outcome.
What is the recommended use of SGLT2 inhibitors in individuals with type 2 diabetes and diabetic kidney disease?
Use of an SGLT2 inhibitor is recommended to reduce CKD progression and cardiovascular events.
Describe the two different classes of MRAs.
There are two different classes of MRAs, steroidal and nonsteroidal.
What is the risk associated with MRAs in diabetic kidney disease?
The risk of hyperkalemia is associated with MRAs in diabetic kidney disease.
What is the mean albuminuria in people with an eGFR of 20 mL/min/1.73 m²?
The mean albuminuria was 852 mg/g (interquartile range 446-1,634 mg/g).
How did finerenone compare with placebo in reducing cardiovascular outcome?
Finerenone had a lower hazard ratio (HR 0.82) compared to placebo in reducing cardiovascular outcome.
What percentage of the study group experienced hyperkalemia-related discontinuation?
2.3% of the study group experienced hyperkalemia-related discontinuation.
What are ongoing clinical trials focusing on?
Ongoing clinical trials are focusing on CKD and cardiovascular outcomes in people with diabetes.
What is the purpose of the FIDELITY analysis?
To evaluate the efficacy and safety of finerenone in individuals with chronic kidney disease.
Describe the findings of the FIDELITY analysis.
The analysis showed a 14% reduction in composite cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, and hospitalization for individuals with chronic kidney disease.
How does finerenone compare to the placebo group in terms of hyperkalemia incidence?
There was a higher incidence of hyperkalemia in the finerenone group compared to the placebo group.
Define chronic kidney disease (CKD).
A condition characterized by the gradual loss of kidney function over time.
What should healthcare professionals educate their patients about regarding CKD?
They should educate their patients about the progressive nature of CKD, the kidney preservation benefits of proactive treatment of blood pressure and blood glucose, and the potential need for renal replacement therapy.
Describe the relationship between diabetes and nephropathy.
Diabetes is a risk factor for the development of nephropathy, a condition characterized by kidney damage and impaired kidney function.
What is the purpose of the randomized clinical trial mentioned in the content?
The purpose of the randomized clinical trial was to evaluate the effects of blood-pressure lowering and glucose control in patients with type 2 diabetes.
Define acute kidney injury.
Acute kidney injury refers to a sudden and temporary loss of kidney function, often caused by a decrease in blood flow to the kidneys or direct damage to the kidneys.
How do SGLT2 inhibitors impact the risk of acute kidney injury in patients?
A propensity-matched analysis showed that SGLT2 inhibitors may increase the risk of acute kidney injury in patients with diabetes.
Describe the findings of the EMPA-REG OUTCOME study.
The EMPA-REG OUTCOME study found that empagliflozin, an SGLT2 inhibitor, reduced the risk of cardiovascular events and progression of kidney disease in patients with type 2 diabetes.
Describe the CREDENCE study.
The CREDENCE study investigated the effects of Canagliflozin on cardiovascular and renal outcomes in type 2 diabetes mellitus and chronic kidney disease stages 3A, 3B, or 4.
What are the potential benefits of SGLT2 inhibitors in diabetic kidney disease?
SGLT2 inhibitors, such as Canagliflozin, may reduce inflammation, fibrosis biomarkers, and hypertension, leading to improved kidney function in diabetic kidney disease.
Define chronic kidney disease.
Chronic kidney disease refers to the gradual loss of kidney function over time, often caused by conditions like diabetes or high blood pressure.
How do SGLT2 inhibitors work in diabetes?
SGLT2 inhibitors, like Canagliflozin, work by blocking the reabsorption of glucose in the kidneys, leading to increased glucose excretion in the urine and lower blood sugar levels.
Describe the effects of Canagliflozin on intrarenal angiotensinogen augmentation.
Canagliflozin prevents intrarenal angiotensinogen augmentation, which can help reduce kidney injury and hypertension in a mouse model of type 2 diabetes mellitus.
Describe the effects of Canagliflozin on intrarenal angiotensinogen augmentation.
Canagliflozin prevents intrarenal angiotensinogen augmentation, which can help reduce kidney injury and hypertension in a mouse model of type 2 diabetes mellitus.
Describe chronic kidney disease.
Chronic kidney disease refers to the gradual loss of kidney function over time, leading to the accumulation of waste and fluid in the body. It is typically caused by conditions like diabetes or high blood pressure and can progress to end-stage renal disease, requiring dialysis or kidney transplantation.
What is the role of angiotensin receptor blockers in chronic kidney disease?
Angiotensin receptor blockers (ARBs) are medications that help to lower blood pressure and reduce proteinuria in patients with chronic kidney disease. They work by blocking the action of angiotensin II, a hormone that constricts blood vessels and increases blood pressure.
How does diabetes contribute to chronic kidney disease?
Diabetes is a leading cause of chronic kidney disease. High blood sugar levels over time can damage the blood vessels in the kidneys, impairing their ability to filter waste and fluid from the body. This can eventually lead to kidney failure if not properly managed.
Define proteinuria.
Proteinuria is a condition characterized by the presence of excess protein in the urine. It is often a sign of kidney damage or dysfunction, as the kidneys normally filter out waste products while retaining essential proteins in the bloodstream. Proteinuria can be an indicator of chronic kidney disease.
What is the purpose of the ADA Standards of Care in Diabetes?
To provide clinical practice recommendations and tools for evaluating quality of care in diabetes.
Describe diabetic retinopathy.
Diabetic retinopathy is a vascular complication of diabetes that can lead to blindness.
What are the recommendations for optimizing glycemic control in diabetic retinopathy?
Optimize glycemic control to reduce the risk or slow the progression of diabetic retinopathy.
How does the prevalence of diabetic retinopathy relate to diabetes duration and glycemic control?
The prevalence of diabetic retinopathy is strongly related to both the duration of diabetes and the level of glycemic control.
What are the recommended intervals for monitoring retinopathy status in pregnant women with diabetes?
Retinopathy status should be monitored every trimester and for 1 year postpartum.
What can retinal photography enhance in terms of efficiency and cost reduction?
Retinal photography may enhance efficiency and reduce costs when the expertise of ophthalmologists can be used for complex examinations and therapy.
Describe the association between rapid reductions in A1C and retinopathy worsening.
Rapid reductions in A1C, such as those using GLP-1 RAs, can be associated with initial worsening of retinopathy.
What is the recommended screening approach for diabetic retinopathy?
Diabetic retinopathy screening should be performed using validated approaches and methodologies.
When should adults with type 1 diabetes have their initial dilated and comprehensive eye examination?
Adults with type 1 diabetes should have an initial dilated and comprehensive eye examination within 5 years after the onset of diabetes.
What is the alternative to traditional screening approaches for diabetic retinopathy?
Artificial intelligence systems authorized for use by the U.S. FDA represent an alternative to traditional screening approaches.
How can prompt diagnosis of diabetic retinopathy benefit patients?
Prompt diagnosis allows triage of patients and timely intervention that may prevent vision loss.
Describe the screening recommendation for people with type 2 diabetes.
People with type 2 diabetes should have an initial dilated and comprehensive eye examination at the time of the diabetes diagnosis.
What is the importance of screening youth with type 1 or type 2 diabetes for diabetic retinopathy?
Youth with type 1 or type 2 diabetes are also at risk for complications and need to be screened for diabetic retinopathy.
What are the common complications of diabetes?
Retinopathy, neuropathy, and foot care.
Describe the prevalence of any diabetic retinopathy and PDR in early pregnancy.
The prevalence of any diabetic retinopathy and PDR in early pregnancy was 52.3% and 6.1%, respectively.
What is the alternative treatment to traditional panretinal laser photocoagulation for diabetic retinopathy?
Intravitreous injections of anti-vascular endothelial growth factor (anti-VEGF) are a reasonable alternative.
How can macular focal/grid laser photocoagulation be effective in treating diabetic macular edema?
Macular focal/grid laser photocoagulation has been shown to be effective in treating eyes with clinically significant macular edema from diabetes.
What is the association between intensive glycemic management and retinopathy?
Rapid implementation of intensive glycemic management in the setting of retinopathy is associated with early worsening of retinopathy.