Insulinoterapia como último recurso de tratamiento en pacientes con diabetes mellitus tipo 2 y enfermedad renal crónica

Abstract

The existence of Type 2 diabetes mellitus and CKD is a reality that is becoming an increasing problem, so the application of insulin therapy as a viable solution has become more common nowadays. That is why the objective of the present review is to study the literature on treatments for type 2 diabetes mellitus and CKD with emphasis on insulin therapy as a last resort. For this purpose, the methodology is carried out through a bibliographic research in several sources with scientific rigor in books, indexed articles, congress proceedings and doctoral theses. The sources correspond to academic search engines such as Dialnet, Scielo, Latindex, Directory of Open Access, Proquest, Scopus, SciFinder, among others. The selection of the study sample is made based on a screening of articles with a high level of scientific evidence. The results reveal several ways of functioning of insulin therapy applicable to different patients, mainly linked to the study and treatment of beta cells. In addition, connections were found between treatment and cultural and psychosocial issues in patients. In addition, type 2 diabetes mellitus is linked to chronic kidney disease due to the similarities in the causes that provoke both conditions, specifically the deficiency of insulin production in the body due to the increase or malfunction of beta cells. The implementation of insulin therapy is currently the most feasible option for the treatment of chronic kidney disease and type 2 diabetes mellitus, due to its effects on beta cells, decrease in glucagon, connections with genetic regulators such as miRNA and Akt-induced phosphorylation processes and a significant reduction in HbAlC levels.