Type 2 Diabetes and ckd

[Starrstruck]

I'd like to know what is the best diabetes medicine for type 2 diabetes that won't lower kidney function (I do not need insulin) ?and my egfr is 22

[Bassetmommer NKF Ambassador]

That is a difficult question to answer. Depends on your A1c. If you are not on insulin, then it must be still pretty good. The answer about the drugs are two kinds out there. GLp1 inhibitors, and SGLT-2. GLP-1s are often prescribed for DM but not necessarily for CKD. It is often now prescribed for weight loss. I am on one, but my weight loss is nothing great. However, my A1c is quite low to the point I am going to probably have to come down or off pretty soon. SGLT-2 are great for CKD and DM2. My husband is on Farxiga and has done so well that his diabetes is stable, still there with A1c over 6. But his GFR went from 39 to 59 and is going to be discharged from our nephrologist very soon. We are older and a GFR of 59 is pretty good.

But before you get into those level of drugs, exercise is a big help for diabetes. Diet too, but so very difficult at times. Lower carb amounts, eat protein with your carbs and lots of fiber. The thing is, protein is not great for CKD. This is when seeing a renal dietician is best.

What ever you do, it is for life. These drugs are VERY expensive unless you do patient assistance.

[Darlenia]

My hubby, also a T2D, took pills early on and later transitioned to insulin. Oral medications are often preferred by patients and are less expensive and become the first step in treatment. If your diabetes is recent and not the primary cause of your kidney issues, then oral treatment of your diabetes is fine. Bassetmommer has made some good suggestions in that area. If you've had T2D for some time and its the reason for your eGFR value, you may want to consider insulin - the gold standard for mitigating the damage that T2D creates. In the big picture of things, I don't think any diabetes med (oral or insulin) hurts your kidneys, it's generally the other way around. In the meantime, keep a very tight handle on your sugars and carbs through diet and exercise. Wishing you all the success in the world to keep those kidneys functioning!

[userotc]

As you've indicated, most drugs adversely affect kidneys (and/or liver). So the "best medicine" is no medicine, particularly as T2D can be treated naturally with nutrition & lifestyle

[milo_miller]

I dont know your health situation but net carb restriction works very well on diabetes. I lowered my figures from 7.2 to 5 (A1c) in 2 months. I was diabetic for around 15 years. What I have done was just limiting my net carb below 50 gr per day. No sugar and no fructose. I stopped taking my oral diabetes drug.

[Darlenia]

Yes and yes - userotc and miller. It's all about nutrition and lifestyle. My hubby also reversed his diabetes and got off all meds by restricting carbs and exercising a bit more. T2D is a western diet and lifestyle issue.

[metalminded]

Hi! I’m a type 2 and had a kidney transplant 10 years ago. I’ve only been a diabetic the last 2 years.

My kidney isn’t functioning 100% because of being damaged by the BK virus.

I’m taking Ozempic and have not only lost 50+ pounds but my A1C went from being 6.5 to 5.2 and my glucose has been staying between 70-100

I’m thrilled!!

[barbara55109]

When I got ckd I got on insulin. Metformin and glipizide had kept my t2 in control, but are contraindicated if you have ckd. I only take 14 units of night insulin, the slow acting kind, and 20-24 units when I eat once a day. My a1c is 5.6 now. I'm also on wegovy so that helps too. You may want to discuss insulin if your current oral meds are bad for ckd. I'm 60 and have ckd from dehydration. My gfr is around 25 after a low of 7 three years ago. I have my hemo fistula, but at the surprise to everyone my gfr is steady.

[Starrstruck in reply to barbara55109]

My gfr is 22 and my a 1c is 6.7 my doctors do not want to put me on diabetic medicine unless absolutely necessary. I need to watch everything I eat because I have to watch not only sugar and carbs but potassium, sodium and phosphorus as well.I have Tuberous sclerosis complex, that is most likely the reason for my ckd.Have you ever heard of it ? It's a rare disease that affects many organs,the kidneys being a main one

[barbara55109 in reply to Starrstruck]

If you can control the T2 with diet that is great. I just wanted to make sure you weren't on metformin or glipizide!

[Pte82 in reply to Starrstruck]

Starrstruck, I'm new on the block and in my search for answers, like you, I came across today a substance in broccoli called sulforaphane that seems to offer benefits for the conditions you describe. Because of the oxalates in broccoli a supplement may be a better choice. I know little more about it so check with your doctor before using any supplement.

ncbi.nlm.nih.gov/pmc/articl...