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Kidney Week

Abstract: TH-PO729

Improvement of Glycaemic Control in Patients with Diabetes and CKD through a “One-Stop” Joint Diabetes Kidney Clinic

Session Information

Category: Diabetes

  • 502 Diabetes Mellitus and Obesity: Clinical


  • Patel, Jayna, St HELIER HOSPITAL, LONDON, United Kingdom
  • Sodani, Niyati, St. George's, University of London, London, United Kingdom
  • Wahba, Mona, st Helier Hospital NHS Trust, London, United Kingdom

Diabetic nephropathy is a significant complication of diabetes mellitus and is associated with increased cardiovascular morbidity and mortality. There is substantial evidence to show that optimal glycaemic control has a significant impact on the progression of diabetic nephropathy. There is no consensus regarding the best model for following up patients with diabetes and CKD in the outpatient setting.


We conducted a single centre, retrospective observational analysis of patients that attended a monthly ‘one stop’ joint diabetic and nephrology clinic between 2013 and 2016. This newly established service is run by a consultant nephrologist, endocrinologist and diabetic specialist nurse. Reasons for referral were suboptimal diabetic control, hypoglycaemic episodes in the context of CKD, or where renal function had deteriorated to a point necessitating a change in diabetic medications (e.g. a switch to insulin). They were also referred for further management of weight gain and new onset diabetes after transplantation (NODAT).


A total of 93 patients were reviewed in the clinic. Mean age was 65 years [39-92years]. 57 patients were male and 36 were female. Mean HbA1c of patients at referral was 73 [35-151]. Mean eGFR at referral was 33.6 ml/min [9-90ml/min]. 69.9% of patients were type 2 diabetics and 45% of these patients were switched to an insulin based regimen. 16 patients were started on liraglutide and their mean eGFR at referral was 52.7mls/min [24-90 ml/min]; 13 of these patients were followed up at 1 year and 92% of these patients had lost weight and had a stable eGFR, mean 51.6mls/min [23-90ml/min]. At 1 year follow up, 71% saw an improvement in HbA1c (p<0.05, paired t test).


This study showed that this model of care for patients with diabetes and CKD may be used to help improve diabetic control. Liraglutide, a glucagon-like peptide-1 receptor agonist, seems to be an effective agent to promote weight reduction in patients without causing deterioration in renal function.