PURPOSE: This study aimed to identify antidiabetic regimens as well as other factors that associated with glycemic control in T2DM patients with different stages of chronic kidney disease (CKD).

PATIENTS AND METHODS: This retrospective, cross-sectional study involved 242 T2DM inpatients and outpatients with renal complications from January 2009 to March 2014 and was conducted in a tertiary teaching hospital in Malaysia. Glycated hemoglobin (A1C) was used as main parameter to assess patients' glycemic status. Patients were classified to have good (A1C <7%) or poor glycemic control (A1C ≥7%) based on the recommendations of the American Diabetes Association.

RESULTS: Majority of the patients presented with CKD stage 4 (43.4%). Approximately 55.4% of patients were categorized to have poor glycemic control. Insulin (57.9%) was the most commonly prescribed antidiabetic medication, followed by sulfonylureas (43%). Of all antidiabetic regimens, sulfonylureas monotherapy (P<0.001), insulin therapy (P=0.005), and combination of biguanides with insulin (P=0.038) were found to be significantly associated with glycemic control. Other factors including duration of T2DM (P=0.004), comorbidities such as anemia (P=0.024) and retinopathy (P=0.033), concurrent medications such as erythropoietin therapy (P=0.047), α-blockers (P=0.033), and antigouts (P=0.003) were also correlated with A1C.

METHODS: Consecutive subjects who came for a health checkup at a suburban medical facility were recruited for the study. All individuals had clinical assessments, anthropometric measurements, blood tests, and ultrasonography of the liver performed. Those with significant alcohol consumption and history of chronic liver disease were excluded.

RESULTS: Of the 1,621 "health screened" individuals analyzed, 368 (22.7 %) were found to have NAFLD. They comprised Chinese 1,269 (78.3 %), Malay 197 (12.1 %), and Indian 155 (9.6 %). Males and "older" age group ≥45 years had high prevalence rates with the highest in Indian (68.2 %) and Malay (64.7 %) males. Chinese females <45 years had the lowest prevalence of 5.2 %. A significant increase in the prevalence of fatty liver between age <45 years and ≥45 years was seen in female of all three races but in male, this increase was seen only among the Indians. NAFLD was strongly associated with diabetes mellitus, glucose intolerance, body mass index ≥23, low high-density lipoprotein cholesterol, hypertriglyceridemia, and hypertension.