Kidney disease has been recognized as a complication of type 2 diabetes mellitus (T2DM) since the 1950s, developing in approximately 35% of patients with T2DM and affecting as many as 50% of patients with diabetes of more than 20 years' duration. The prevalence of diabetic kidney disease (DKD) in the United States increased from 1988 to 2008 in proportion to the prevalence of diabetes. Among adults with diabetes, the prevalence of DKD has remained stable despite increased use of antihyperglycemic agents and renin-angiotensin-aldosterone system (RAAS) inhibitors.
Newer glucose-lowering agents appear to have glucose-independent effects on diabetic nephropathy and its progression. This virtual patient case will provide an overview of the relationship between T2DM, hypertension, and cardiorenal syndrome, review the evidence based algorithms for the treatment of patients with T2DM, and provide an overview of effects of anti-hyperglycemic agents, particularly GLP-1 RAs and SGLT2 inhibitors, on cardiorenal disease. Following this virtual patient case, clinicians will have increased awareness on how to effectively manage patients with T2DM and DKD based on the benefits and risks of SGLT2 inhibitors and GLP-1 RAs.