Diabetes careOct 3, 2022

Managing Diabetes in People with Long-Term Kidney Disease: Guidelines from Diabetes and Kidney Health Experts

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗

Updated Apr 4, 2026

Abstract

The 2022 ADA and KDIGO guidelines recommend comprehensive care for diabetes and chronic kidney disease (CKD) management.

Individuals with diabetes and CKD are at increased risk for kidney failure and cardiovascular disease.
New treatment approaches for diabetes and CKD are supported by recent clinical trials.
The guidelines align on CKD screening, diagnosis, glycemia monitoring, and lifestyle therapies.
Pharmacotherapy should be combined with healthy lifestyle practices to enhance kidney and cardiovascular health.
Specific guidance is provided on the use of various medications, including renin-angiotensin system inhibitors and sodium-glucose cotransporter 2 inhibitors.

Simplified

People with diabetes and chronic kidney disease (CKD) are at high risk for kidney failure, atherosclerotic cardiovascular disease, heart failure, and premature mortality. Recent clinical trials support new approaches to treat diabetes and CKD. The 2022 American Diabetes Association (ADA) Standards of Medical Care in Diabetes and the Kidney Disease: Improving Global Outcomes (KDIGO) 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease each provide evidence-based recommendations for management. A joint group of ADA and KDIGO representatives reviewed and developed a series of consensus statements to guide clinical care from the ADA and KDIGO guidelines. The published guidelines are aligned in the areas of CKD screening and diagnosis, glycemia monitoring, lifestyle therapies, treatment goals, and pharmacologic management. Recommendations include comprehensive care in which pharmacotherapy that is proven to improve kidney and cardiovascular outcomes is layered on a foundation of healthy lifestyle. Consensus statements provide specific guidance on use of renin-angiotensin system inhibitors, metformin, sodium-glucose cotransporter 2 inhibitors, glucagon-like peptide 1 receptor agonists, and a nonsteroidal mineralocorticoid receptor antagonist. These areas of consensus provide clear direction for implementation of care to improve clinical outcomes of people with diabetes and CKD.

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Managing Diabetes in People with Long-Term Kidney Disease: Guidelines from Diabetes and Kidney Health Experts

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