Highlights in Diabetes and Metabolism From ASN 2022

Carol Wysham, MD


November 29, 2022

Dr Carol Wysham, of the University of Washington School of Medicine in Spokane, reports on key studies looking at glucose-lowering therapies in adults with type 2 diabetes, as presented at the 2022 annual meeting of the American Society of Nephrology.

Dr Wysham first highlights a real-world study evaluating the long-term use of empagliflozin compared with dipeptidyl peptidase-4 (DPP-4) inhibitors. The researchers used the estimated glomerular filtration rate (eGFR) slope as their predictive value for clinical kidney benefit. They found that long-term use of empagliflozin was associated with less impairment of kidney function than DPP-4 inhibitors.

Next, Dr Wysham discusses a study testing the safety of SGLT2 inhibitors in patients with both chronic kidney disease and type 2 diabetes. Researchers found that in this patient population undergoing routine care, use of SGLT2 inhibitors was associated with an increased risk for nonvertebral fractures, lower-limb amputations, and genital infections.

Next, Dr Wysham examines a report pooling data from the SUSTAIN 6 and PIONEER 6 studies to determine whether semaglutide improves the eGFR slope. Researchers found that across the A1c and blood pressure subgroups, semaglutide reduced eGFR compared with placebo.

Finally, Dr Wysham discusses an analysis using data from the Framingham Heart Study to determine whether a demonstrable link could be established between kidney disease and mild cognitive impairment. Researchers reported that patients with albuminuria had an increased risk for brain infarctions.


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