Читать книгу Recent Advances in Dialysis Therapy in Japan - Группа авторов - Страница 88

The basic principle of insulin therapy in dialysis patients is the same as in diabetes patients with normal kidney function. Basal supported oral therapy (BOT) is a combination therapy of basal insulin supplementation and oral hypoglycemic agents in type 2 diabetes patients who have relatively preserved insulin secretory ability. Several studies have reported that this therapy is effective [15–18]. To our knowledge, there are no reports on the effectiveness and safety of BOT in dialysis patients, but it is considered a promising therapeutic method when oral hypoglycemic agents alone cannot provide adequate glycemic control. Plasma insulin levels decrease during hemodialysis in patients receiving insulin treatment because insulin is adsorbed to the dialyzer [19, 20]. Therefore, for cases of hyperglycemia after hemodialysis, additional administration of insulin may be necessary to compensate for insulin deficiency.