Vuk Vrhovac Institute
University Clinic for Diabetes, Endocrinology and Metabolic Diseases
Medical Faculty, University of Zagreb
Dugi Dol 4a
10000 Zagreb, Croatia
Review
Received: May 15, 1994
Key words: diabetes mellitus, diabetic nephropathy, treatment
The approach to regulation of diabetes in patients with end stage renal disease is reviewed. Specificities regarding glycaemia regulation, intensified education and self-management, appropriate exercise and diet, especially regarding low protein intake is described Gliquidone is recommended for glycaemia regulation in patients with diabetic nephropathy if insulin therapy is not yet necessary. Specificities in insulin treatment, especially intensified blood glucose self monitoring is elaborated The rational step by step approach to insulin treatment starting with one dose of insulin and ending with insulin infusion systems is described Special care regarding the late diabetic complications in patients with end stage renal disease should be guided by an expert team.