Renal Outcomes And Type 2 DM One hundred sixty one symposium Cardio Metabolic

Renal Outcomes And Type 2 DM

F. Hosseinpanah, M.D.

Obesity Research Center Research Institute for Endocrine sciences  Shahid Beheshti University of Medical Sciences October 10^th , 2019 Tehran

Agenda

Clinical scenario

Importance of DKD

Unmet need in management of DKD

Overview of recent CVOTs (SGLT2i,GLP1-IR) ,reporting prespecified renal outcomes

Potential mechanisms of nephroprotection

CREDENCE trial results

Concept of pump, pipes, and filter

Take home messages

Clinical scenario resolution

• A 62 year old male comes to see you for diabetes review. He has had type 2 diabetes for 8 years. He had an acute MI six months ago
•  He is taking MFN 2g /daily , Sitagliptin 100 mg/daily, Atorvastatin 40 mg /daily , ASA 80 mg, Plavix 75 mg /daily, Captopril 50 mg/daily, Metoprolol 50 mg /daily
• BMI = 32 Kg/m²
• BP= 140/88 mmHg
• HbA1c 8.2%, eGFR= 50 ml/min/1.73 m², TG= 155 mg/dl, HDL=41 mg/dl, LDL= 60 mg/dl
• ^{24 uriary albumin excretion= 400 mg}
• ^NPDR
• ^{Echo shows mild-to-moderate LVSD}