Alleviating the Burden in Treating Type 1 Diabetes and Chronic Kidney Disease

(Family Features) While diabetes gets a lot of attention, people with Type 1 Diabetes (T1D) are frequently overlooked when drug companies develop new medications. “People with T1D and chronic kidney disease, or CKD, face significantly higher risks of morbidity and mortality if they are unable to control their blood sugar levels,” said Steve Edelman, MD, an endocrinologist and the founder and director of Taking Control Of Your Diabetes, a not-for-profit organization dedicated to educating and motivating people living with diabetes. “They are challenged to do this relying solely on insulin, which is extremely difficult and is the principal therapy for people with T1D.” An estimated 1.7 million adult Americans have T1D, with approximately 21%, or 360,000, also affected by CKD, according to the CDC National Diabetes Statistics Report 2024. Without effective glycemic control (managing blood sugar) and other important preventative measures, patients with T1D are at a 10 times higher risk of cardiovascular disease, a six-fold greater risk of progression to end-stage kidney disease, a four times greater risk of heart failure and a 2-5 times greater risk of all-cause mortality. Consider this information to better understand the challenges and risks of complications these patients face. Challenges with Current Treatments Impact Patients’ Ability to Reach Glycemic Goals Diabetes management aims to reduce the risks of cardiovascular disease, kidney failure, retinopathy, neuropathy and other complications, in part by improving glycemic control while minimizing the risk of hypoglycemia. Currently, Americans with T1D have limited therapeutic options, relying almost exclusively on insulin. There are no oral agents to improve glycemia in adults with T1D. Despite advances in insulin therapy and glucose monitoring, most people with T1D do not meet glycemic control target levels with insulin alone. One measure of glycemic control is a number known as A1C, which is a measure of glucose control over the past 2-3 months. The goal is to help patients achieve the guideline-recommended target of an A1C below 7% and improve their time-in-range, which represents an established metric that translates into clinically meaningful benefits for patients. Reaching Glycemic Goals Are Key to Reducing Risk of Further Complications By achieving glycemic control, kidney function can be stabilized, long-term disease progression mitigated and the morbidity and mortality that the cardiorenal burden puts on patients with T1D and CKD reduced. Today, it is estimated only 23% of people with T1D achieve an A1C of less than 7%, according to research from the American Diabetes Association, and about 50% have an A1C greater than 8%. Patients who do not achieve A1C targets remain at significantly greater risk of complications associated with their condition. “Relying solely on insulin can negatively affect a patient’s glucose control and quality of life,” said Dr. Edelman. “Doctors and patients need an oral agent to improve glycemic control in people with T1D and CKD. Therefore, we need therapeutic options that improve glycemic control and reduce their risk of kidney disease progression and cardiovascular comorbidities.” Visit TCOYD.org to learn more about living with T1D and advocating for additional therapeutic options.   Photos courtesy of Getty Images