HIPOGLUCEMIAS EN PACIENTES CON ENFERMEDAD RENAL CRÓNICA

Gabriela Medek

Resumen


El control glucémico estricto demostró disminuir la incidencia y progresión de las complicaciones crónicas, con el consecuente incremento del riesgo de hipoglucemias. Actualmente la Asociación Americana de Diabetes clasifica: Nivel 1: alarma de hipoglucemia <70 mg/dl; Nivel 2: hipoglucemia clínicamente significativa <54 mg/dl; Nivel 3: hipoglucemia severa en la cual, sin especificar el valor de glucemia, se requiere la ayuda de terceros o se presentan alteraciones cognitivas. La hipoglucemia suele ser menos frecuente en pacientes con diabetes tipo 2 que en diabetes tipo 1; se relaciona con alta morbilidad y mortalidad, y representa frecuentemente una de las principales barreras para lograr un óptimo control glucémico. Los pacientes con filtrado glomerular (FG) disminuido (<60 ml/min/1,73 m2) frecuentemente presentan menores requerimientos de insulina y disminución de la degradación de la insulina en los tejidos periféricos, los cuales son factores de riesgo para el desarrollo de hipoglucemia severa.


Palabras clave


hipoglucemia, enfermedad renal crónica; morbilidad; mortalidad

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Referencias


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DOI: http://dx.doi.org/10.47196/diab.v51i3.108