TY - JOUR

T1 - Chronic kidney disease in type 1 diabetes

T2 - translation of novel type 2 diabetes therapeutics to individuals with type 1 diabetes

AU - Sridhar, Vikas S.

AU - Limonte, Christine P.

AU - Groop, Per Henrik

AU - Heerspink, Hiddo J.L.

AU - Pratley, Richard E.

AU - Rossing, Peter

AU - Skyler, Jay S.

AU - Cherney, David Z.I.

N1 - Publisher Copyright: © 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

PY - 2024

Y1 - 2024

N2 - Current management of chronic kidney disease (CKD) in type 1 diabetes centres on glycaemic control, renin–angiotensin system inhibition and optimisation of risk factors including blood pressure, lipids and body weight. While these therapeutic approaches have significantly improved outcomes among people with type 1 diabetes and CKD, this population remains at substantial elevated risk for adverse kidney and cardiovascular events, with limited improvements over the last few decades. The significant burden of CKD and CVD in type 1 diabetes populations highlights the need to identify novel therapies with the potential for heart and kidney protection. Over the last decade, sodium–glucose cotransporter-2 inhibitors, glucagon-like peptide 1 receptor agonists and non-steroidal mineralocorticoid receptor antagonists have emerged as potent kidney-protective and/or cardioprotective agents in type 2 diabetes. The consistent, substantial kidney and cardiovascular benefits of these agents has led to their incorporation into professional guidelines as foundational care for type 2 diabetes. Furthermore, introduction of these agents into clinical practice has been accompanied by a shift in the focus of diabetes care from a ‘glucose-centric’ to a ‘cardiorenal risk-centric’ approach. In this review, we evaluate the potential translation of novel type 2 diabetes therapeutics to individuals with type 1 diabetes with the lens of preventing the development and progression of CKD. Graphical Abstract: [Figure not available: see fulltext.].

AB - Current management of chronic kidney disease (CKD) in type 1 diabetes centres on glycaemic control, renin–angiotensin system inhibition and optimisation of risk factors including blood pressure, lipids and body weight. While these therapeutic approaches have significantly improved outcomes among people with type 1 diabetes and CKD, this population remains at substantial elevated risk for adverse kidney and cardiovascular events, with limited improvements over the last few decades. The significant burden of CKD and CVD in type 1 diabetes populations highlights the need to identify novel therapies with the potential for heart and kidney protection. Over the last decade, sodium–glucose cotransporter-2 inhibitors, glucagon-like peptide 1 receptor agonists and non-steroidal mineralocorticoid receptor antagonists have emerged as potent kidney-protective and/or cardioprotective agents in type 2 diabetes. The consistent, substantial kidney and cardiovascular benefits of these agents has led to their incorporation into professional guidelines as foundational care for type 2 diabetes. Furthermore, introduction of these agents into clinical practice has been accompanied by a shift in the focus of diabetes care from a ‘glucose-centric’ to a ‘cardiorenal risk-centric’ approach. In this review, we evaluate the potential translation of novel type 2 diabetes therapeutics to individuals with type 1 diabetes with the lens of preventing the development and progression of CKD. Graphical Abstract: [Figure not available: see fulltext.].

KW - Cardiorenal

KW - Chronic kidney disease

KW - Glucagon-like peptide 1 receptor agonist

KW - Mechanisms

KW - Review

KW - Sodium–glucose cotransporter-2 inhibitor

KW - Therapeutics

KW - Type 1 diabetes

U2 - 10.1007/s00125-023-06015-1

DO - 10.1007/s00125-023-06015-1

M3 - Review

C2 - 37801140

AN - SCOPUS:85173759235

VL - 67

SP - 3

EP - 18

JO - Diabetologia

JF - Diabetologia

SN - 0012-186X

IS - 1

ER -