Doctors Lisa and Sara talk to Consultant Nephrologist Dr Darren Green about patients with Type 2 Diabetes who also have Chronic Kidney Disease and Heart Failure. 

We go through a hypothetical case to illustrate some of the finer points of management that can commonly get missed or might not be appreciated. A really detailed talk full of useful practice enhancing tips for this complex group of patients. 

Disclaimer: This episode was supported by Greater Manchester NHS who received support from Boehringer. 

You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)

Resources:

• Dr Kevin Fernando counselling diabetic patients starting an SGLT2 Inhibitors like Dapagliflozin or Empagliflozin: https://www.youtube.com/watch?v=pc99SdtlsyU


• Diabetes UK counselling sheets on SGLT2 inhibitors: https://www.diabetes.org.uk/about-diabetes/looking-after-diabetes/treatments/tablets-and-medication/sglt2-inhibitors


• Kidney Care UK Patient Booklets: https://kidneycareuk.org/get-support/free-resources/patient-information-booklets/


• Pumping Marvellous Heart Failure Charity with patient resources: https://pumpingmarvellous.org/


• International Society for Nephrology Toolkit for Initiating or Changing RAASi - Renin Angiotensin Aldosterone System Inhibitors (like ACEis such as Lisinopril or Ramipril, or ARBs like Candesartan on Losartan): https://www.theisn.org/initiatives/toolkits/raasi-toolkit/


• Royal College of General Practitioners Acute Renal Failure Toolkit: https://elearning.rcgp.org.uk/course/info.php?id=899


• CONFIDENCE trial: Finerenone with Empagliflozin in Chronic Kidney Disease and Type 2 Diabetes | New England Journal of Medicine: https://www.nejm.org/doi/full/10.1056/NEJMoa2410659


• ATLAS trial: Efficacy and safety of high-dose lisinopril in chronic heart failure patients at high cardiovascular risk, including those with diabetes mellitus: https://pubmed.ncbi.nlm.nih.gov/11071803/


• Metformin lactic acidosis Metformin in Patients With Type 2 Diabetes and Kidney Disease: A Systematic Review: https://jamanetwork.com/journals/jama/article-abstract/2084896


• UK AKI Summit report UKKA AKI Summit Report + Recommendations: https://share.google/7uw1GPQ5sV2riJtiV


• RCGP AKI follow up  post discharge recommendations: https://bjgpopen.org/content/early/2020/06/15/bjgpopen20X101054/tab-figures-data?versioned=true

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This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

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