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Guideline/Fact Sheet
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Sodium-Glucose Cotransporter-2 Inhibitor for Renal Function Preservation in Patients with Type 2 Diabetes Mellitus: A Korean Diabetes Association and Korean Society of Nephrology Consensus Statement
Tae Jung Oh, Ju-Young Moon, Kyu Yeon Hur, Seung Hyun Ko, Hyun Jung Kim, Taehee Kim, Dong Won Lee, Min Kyong Moon, The Committee of Clinical Practice Guideline, Korean Diabetes Association and Committee of the Cooperative Studies, Korean Society of Nephrology
Diabetes Metab J. 2020;44(4):489-497.   Published online August 21, 2020
  • 8,100 View
  • 169 Download
  • 2 Web of Science
  • 3 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   

Diabetes is a leading cause of end-stage renal disease. Therefore, prevention of renal dysfunction is an important treatment goal in the management of diabetes. The data of landmark cardiovascular outcome trials of sodium-glucose cotransporter-2 (SGLT2) inhibitor showed profound reno-protective effects. The Korean Diabetes Association and the Korean Society of Nephrology reviewed clinical trials and performed meta-analysis to assess the effects of SGLT2 inhibitors on the preservation of estimated glomerular filtration rate (eGFR). We limited the data of SGLT2 inhibitors which can be prescribed in Korea. Both eGFR value and its change from the baseline were significantly more preserved in the SGLT2 inhibitor treatment group compared to the control group after 156 weeks. However, some known adverse events were increased in SGLT2 inhibitor treatment, such as genital infection, diabetic ketoacidosis, and volume depletion. We recommend the long-term use SGLT2 inhibitor in patients with type 2 diabetes mellitus (T2DM) for attenuation of renal function decline. However, we cannot generalize our recommendation due to lack of long-term clinical trials testing reno-protective effects of every SGLT2 inhibitor in a broad range of patients with T2DM. This recommendation can be revised and updated after publication of several large-scale renal outcome trials.


Citations to this article as recorded by  
  • Real-World Treatment Patterns according to Clinical Practice Guidelines in Patients with Type 2 Diabetes Mellitus and Established Cardiovascular Disease in Korea: Multicenter, Retrospective, Observational Study
    Ye Seul Yang, Nam Hoon Kim, Jong Ha Baek, Seung-Hyun Ko, Jang Won Son, Seung-Hwan Lee, Sang Youl Rhee, Soo-Kyung Kim, Tae Seo Sohn, Ji Eun Jun, In-Kyung Jeong, Chong Hwa Kim, Keeho Song, Eun-Jung Rhee, Junghyun Noh, Kyu Yeon Hur
    Diabetes & Metabolism Journal.2024; 48(2): 279.     CrossRef
  • Renoprotective Mechanism of Sodium-Glucose Cotransporter 2 Inhibitors: Focusing on Renal Hemodynamics
    Nam Hoon Kim, Nan Hee Kim
    Diabetes & Metabolism Journal.2022; 46(4): 543.     CrossRef
  • Real-World Prescription Patterns and Barriers Related to the Use of Sodium-Glucose Cotransporter 2 Inhibitors among Korean Patients with Type 2 Diabetes Mellitus and Cardiovascular Disease
    Jong Ha Baek, Ye Seul Yang, Seung-Hyun Ko, Kyung Do Han, Jae Hyeon Kim, Min Kyong Moon, Jong Suk Park, Byung-Wan Lee, Tae Jung Oh, Suk Chon, Jong Han Choi, Kyu Yeon Hur
    Diabetes & Metabolism Journal.2022; 46(5): 701.     CrossRef
Guideline/Fact Sheet
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Metformin Treatment for Patients with Diabetes and Chronic Kidney Disease: A Korean Diabetes Association and Korean Society of Nephrology Consensus Statement
Kyu Yeon Hur, Mee Kyoung Kim, Seung Hyun Ko, Miyeun Han, Dong Won Lee, Hyuk-Sang Kwon
Diabetes Metab J. 2020;44(1):3-10.   Published online February 21, 2020
  • 9,891 View
  • 351 Download
  • 14 Web of Science
  • 13 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   

The safety of metformin use for patients with type 2 diabetes mellitus (T2DM) and advanced kidney disease is controversial, and more recent guidelines have suggested that metformin be used cautiously in this group until more definitive evidence concerning its safety is available. The Korean Diabetes Association and the Korean Society of Nephrology have agreed on consensus statements concerning metformin use for patients with T2DM and renal dysfunction, particularly when these patients undergo imaging studies using iodinated contrast media (ICM). Metformin can be used safely when the estimated glomerular filtration rate (eGFR) is ≥45 mL/min/1.73 m2. If the eGFR is between 30 and 44 mL/min/1.73 m2, metformin treatment should not be started. If metformin is already in use, a daily dose of ≤1,000 mg is recommended. Metformin is contraindicated when the eGFR is <30 mL/min/1.73 m2. Renal function should be evaluated prior to any ICM-related procedures. During procedures involving intravenous administration of ICM, metformin should be discontinued starting the day of the procedures and up to 48 hours post-procedures if the eGFR is <60 mL/min/1.73 m2.


Citations to this article as recorded by  
  • Distribution and elimination kinetics of midazolam and metabolites after post-resuscitation care: a prospective observational study
    Wonjoon Jeong, Jung Sunwoo, Yeonho You, Jung Soo Park, Jin Hong Min, Yong Nam In, Hong Joon Ahn, So Young Jeon, Jang Hee Hong, Ji Hye Song, Hyein Kang, My Tuyen Thi Nguyen, Jaehan Kim, Changshin Kang
    Scientific Reports.2024;[Epub]     CrossRef
  • Prediction of glycosylated hemoglobin level in patients with cardiovascular diseases and type 2 diabetes mellitus with respect to anti-diabetic medication
    Alisher Ikramov, Shakhnoza Mukhtarova, Raisa Trigulova, Dilnoza Alimova, Saodat Abdullaeva
    Frontiers in Endocrinology.2024;[Epub]     CrossRef
  • Determinants of vitamin B12 deficiency in patients with type-2 diabetes mellitus — A primary-care retrospective cohort study
    Andrew Kien Han Wee, Rehena Sultana
    BMC Primary Care.2023;[Epub]     CrossRef
  • Risk factors for post-contrast acute kidney injury in patients sequentially administered iodine- and gadolinium-based contrast media on the same visit to the emergency department: a retrospective study
    Changshin Kang, Soo Hyun Han, Jung Soo Park, Dae Eun Choi
    Kidney Research and Clinical Practice.2023; 42(3): 358.     CrossRef
  • Guideline for the diagnosis and treatment of diabetes mellitus in patients with transfusion-dependent thalassemia
    Mohammad E. Khamseh, Mojtaba Malek, Nahid Hashemi-madani, Fariba Ghassemi, Neda Rahimian, Amir Ziaee, Mohammad Reza Foroughi-Gilvaee, Pooya Faranoush, Negin Sadighnia, Ali Elahinia, Mohammad Reza Rezvany, Mohammad Faranoush
    Iranian Journal of Blood and Cancer.2023; 15(4): 293.     CrossRef
  • Continuous use of metformin in patients receiving contrast medium: what is the evidence? A systematic review and meta-analysis
    Ting-Wan Kao, Kuo-Hua Lee, Wing P. Chan, Kang-Chih Fan, Che-Wei Liu, Yu-Chen Huang
    European Radiology.2022; 32(5): 3045.     CrossRef
  • Glucagon-Like Peptide-1 Receptor Agonists in Type 2 Diabetes Mellitus and Cardiovascular Disease: The Past, Present, and Future
    Filipe Ferrari, Rafael S. Scheffel, Vítor M. Martins, Raul D. Santos, Ricardo Stein
    American Journal of Cardiovascular Drugs.2022; 22(4): 363.     CrossRef
  • Comparative Efficacy of Lobeglitazone Versus Pioglitazone on Albuminuria in Patients with Type 2 Diabetes Mellitus
    Kyung-Soo Kim, Sangmo Hong, Hong-Yup Ahn, Cheol-Young Park
    Diabetes Therapy.2021; 12(1): 171.     CrossRef
  • Treatment Patterns of Type 2 Diabetes Assessed Using a Common Data Model Based on Electronic Health Records of 2000–2019
    Kyung Ae Lee, Heung Yong Jin, Yu Ji Kim, Yong-Jin Im, Eun-Young Kim, Tae Sun Park
    Journal of Korean Medical Science.2021;[Epub]     CrossRef
  • Albuminuria Is Associated with Steatosis Burden in Patients with Type 2 Diabetes Mellitus and Nonalcoholic Fatty Liver Disease (Diabetes Metab J 2021;45:698-707)
    Eugene Han, Hye Soon Kim
    Diabetes & Metabolism Journal.2021; 45(6): 972.     CrossRef
  • KRCP's past and future path
    Tae-Hyun Yoo
    Kidney Research and Clinical Practice.2020; 39(3): 233.     CrossRef
  • Metformin Use and Risk of All-Cause Mortality and Cardiovascular Events in Patients With Chronic Kidney Disease—A Systematic Review and Meta-Analysis
    Yao Hu, Min Lei, Guibao Ke, Xin Huang, Xuan Peng, Lihui Zhong, Ping Fu
    Frontiers in Endocrinology.2020;[Epub]     CrossRef
  • Pharmacotherapy for patients with diabetes mellitus
    Joon Ho Moon, Soo Lim
    Journal of the Korean Medical Association.2020; 63(12): 766.     CrossRef

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