Among the commonly used drugs in the department of nephrology, some drugs can affect the secretion and function of human insulin, thus causing hyperglycemia, mainly including the following categories:
Hydrocortisone, prednisone, methylprednisolone, dexamethasone. Hormone drugs can play a role in reducing urinary protein and controlling the progression of nephropathy through anti-inflammatory and immune suppression. On the other hand, hormones can also increase insulin resistance, reduce insulin production, up-regulate glucagon and adrenaline, and increase body weight, leading to elevated blood sugar.
In the department of nephrology, the commonly used calcineurin inhibitors are cyclosporine and tacrolimus, which have powerful immunosuppressive effect and are powerful weapons for reducing urinary protein and anti-rejection of transplantation. But be aware that calcineurin inhibitors can reduce insulin secretion and raise blood sugar.
Tacrolimus is more common than cyclosporin-induced hyperglycemia, possibly because cyclosporin-bound proteins are more distributed in the heart, liver, and kidney, while tacrolimus-bound proteins are more distributed in pancreatic beta cells.
Target rapamycin inhibitors
Sirolimus is an inhibitor of the target of rapamycin that can be used to fight rejection in kidney transplant patients. It can reduce insulin secretion, increase insulin resistance, and cause blood sugar to rise.
Barliximab can be used in kidney transplant patients to fight rejection, enhance islet autoimmunity, and raise blood sugar.
Represents the drug hydrochlorothiazide, is a class of diuretic and antihypertensive drugs, often in combination with Pril/sartan drugs, in lowering blood pressure at the same time, play a diuretic role. Thiazide diuretics can increase insulin resistance and decrease insulin secretion, thereby raising blood sugar.
Beta blockers are another class of blood pressure drugs, including metoprolol, bisoprolol, and labeolol, which are often used in patients with kidney disease to lower blood pressure, lower heart rate, and ease heart failure. At the same time, beta blockers increase insulin resistance and decrease insulin secretion, which increases blood sugar.
Statins (3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors), including simvastatin, atorvastatin, etc., are A class of widely used lipid-lowering drugs, which can reduce LDL cholesterol and have A certain effect on reducing triglyceride. They are commonly used in patients with nephrotic syndrome and hyperlipemia. Statins can increase insulin resistance and reduce insulin production, which can raise blood sugar.
Steroid-induced diabetes is common in patients with proteinuria, and post-transplant diabetes may occur in patients with kidney transplantation who take anti-rejection drugs. When using these drugs, the risk of hyperglycemia should be taken into account, especially in patients with diabetes themselves.