The majority of cases of chronic kidney disease (CKD) worldwide are driven by the presence of type 2 diabetes (T2D), resulting in an increase in CKD rates over the past few decades. The existence of CKD alongside diabetes is associated with increased burden of cardiovascular disease and increased risk of death. Optimal glycaemic control is essential to prevent progression of CKD, but achieving glycaemic targets in people with CKD and diabetes can be challenging because of increased risk of hypoglycaemia and limitations on glucose-lowering therapeutic options. This review considers the challenges in management of T2D in people with impaired kidney function and assesses evidence for use of basal insulin analogues in people with CKD.

Center for Biomedical Research in Physiopathology of Obesity and Nutrition Instituto de Salud Carlos 3 Madrid Spain

Center for Biomedical Research on Diabetes and Associated Metabolic Diseases Instituto de Salud Carlos 3 Barcelona Spain

Department of Endocrinology and Nutrition CIBERDEM Hospital de la Santa Creu i Sant Pau and Sant Pau Biomedical Research Institute Barcelona Spain

Department of Endocrinology and Nutrition Clínica Universidad de Navarra Pamplona Spain

Diabetes Centre Institute for Clinical and Experimental Medicine Prague Czech Republic

Faculty of Medicine University of Vic Vic Spain

Instituto de Investigación Sanitaria de Navarra Pamplona Spain

Texas Institute for Kidney and Endocrine Disorders Lufkin Texas USA

Trillium Health Partners and Unity Health University of Toronto Toronto Ontario Canada

University of Texas Medical Branch Galveston Texas USA

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