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Diabetic nephropathy, a microvascular complication, usually starts by the development of incipient nephropathy (microalbuminuria), then proteinuria, reduced glomerular filtration rate and finally renal impairment or Chronic Kidney Disease (CKD). CKD if untreated may lead to End Stage Renal Disease (ESRD). Hence, tight glycemic control, and management of hypertension and dyslipidemia is often required to prevent morbidity and mortality. However, this strategy is usually challenging as most of the anti-diabetic therapies need adjustments, modifications or alterations to prevent adverse events and hypoglycemia with CKD. Hence, the aim of the present review is to discuss the up to date existing literature for the management of hyperglycemia with oral agents or insulin among diabetic patients with nephropathy and CKD, while at the same time managing diabetic dyslipidemia and hypertension.

Strategies of Hyperglycemia Management among Patients with Diabetic Nephropathy, Renal Impairment, Hypertension and Lipid Disorders