The management of patients with type 2 diabetes and chronic kidney disease (CKD) encompasses lifestyle modifications, glycemic control with individualized HbA1c targets, and cardiovascular disease risk reduction. Metformin and sodium-glucose cotransporter-2 inhibitors are first-line agents. Glucagon-like peptide-1 receptor agonists are second-line agents. The use of other antidiabetic agents should consider patient preferences, comorbidities, drug costs, and the risk of hypoglycemia. Renin–angiotensin–aldosterone system inhibitors are strongly recommended for patients with diabetes, hypertension, and albuminuria. Non-steroidal mineralocorticoid receptor antagonists, which pose less risk of hyperkalemia than steroidal agents, are undergoing further evaluation among patients with diabetic kidney disease. Here, we discuss important advancements in the management of patients with type 2 diabetes and CKD. No data are available. This is not a clinical trial.

中文翻译：

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慢性肾病患者 2 型糖尿病的管理

2 型糖尿病和慢性肾病 (CKD) 患者的管理包括生活方式的改变、具有个性化 HbA1c 目标的血糖控制以及降低心血管疾病风险。二甲双胍和钠-葡萄糖协同转运蛋白-2 抑制剂是一线药物。胰高血糖素样肽-1 受体激动剂是二线药物。其他抗糖尿病药物的使用应考虑患者的偏好、合并症、药物成本和低血糖风险。强烈建议糖尿病、高血压和白蛋白尿患者使用肾素-血管紧张素-醛固酮系统抑制剂。非甾体盐皮质激素受体拮抗剂的高钾血症风险低于甾体药物，目前正在糖尿病肾病患者中进行进一步评估。这里，我们讨论了 2 型糖尿病和 CKD 患者管理方面的重要进展。没有可用数据。这不是临床试验。