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Diabetes Complications and Management

• Chronic complications of diabetes include retinopathy, neuropathy, and nephropathy. Acute pancreatitis is not a chronic complication.
• Rapid-acting insulin is known for the fastest onset of action compared to other insulin types.
• Glycated Hemoglobin (HbA1c) is the standard test to monitor long-term glucose control in diabetics.
• Pioglitazone is contraindicated for patients with a history of bladder cancer due to safety concerns.
• A hallmark of Type 1 Diabetes is autoimmune destruction of β-cells, which distinguishes it from Type 2 Diabetes characterized by insulin resistance and often obesity.

Metabolic Syndrome and Symptoms of Conditions

• Central obesity is a key feature of metabolic syndrome typically associated with Type 2 Diabetes.
• Fatigue is a common early symptom of chronic kidney disease (CKD), indicating the body's reduced ability to manage waste.
• Potassium binders are utilized in managing hyperkalemia, a common issue in CKD.

Testing and Evaluation in CKD and Diabetes

• The Urine Microalbumin test is frequently used to screen for early diabetic nephropathy.
• Dapagliflozin is less likely to cause hypoglycemia compared to other diabetes medications.
• Thiazide diuretics primarily inhibit sodium reabsorption in the distal convoluted tubule, contributing to fluid management.
• Anemia is a significant complication in end-stage kidney disease (ESKD) that affects overall health.

Drug Safety and Kidney Function

• Sulfonylureas should be used cautiously in elderly patients due to the risk of severe hypoglycemia.
• The kidneys have the primary function of excreting waste products, crucial for maintaining homeostasis.
• The kidneys also regulate blood pressure, underscoring their role in cardiovascular health.
• Erythropoiesis-stimulating agents (ESAs) can pose risks, including an increased likelihood of cardiovascular events.

Markers and Diagnosis

• Serum creatinine serves as an endogenous marker to estimate glomerular filtration rate (GFR), important for assessing kidney function.
• The most reliable method for diagnosing CKD is the measurement of GFR.
• ACE inhibitors are commonly used to reduce proteinuria in CKD, enhancing kidney protection.
• Hyperkalemia is identified as a sign of metabolic acidosis in CKD, indicating electrolyte imbalances.

Key Concepts in CKD Management

• Sodium restriction helps minimize fluid retention and manage blood pressure in CKD patients, preventing further kidney damage.
• Secondary hyperparathyroidism in CKD results from chronic conditions like hypocalcemia and hyperphosphatemia, impacting bone health.
• Renin plays a critical role in the renin-angiotensin-aldosterone system (RAAS), affecting blood pressure and renal function.
• Serum bicarbonate levels are key to assessing the severity of metabolic acidosis in CKD.
• ESAs are crucial in stimulating red blood cell production for patients with anemia associated with CKD, addressing a common complication.