Individuals with diabetes should be treated to meet a target systolic BP of 20 mg/mmol, on maximally tolerated, or maximally prescribed doses of RAASis, should be recommended an SGLT2i to delay progression of CKD and progression to dialysis, and to reduce likelihood of cardiovascular events [57,58,75,76] [Grade A, Level 1A]
However, because higher insulin concentrations are required to suppress gluconeogenesis than to inhibit glycogenolysis (i.e., the breakdown of glycogen), or increase glycogen synthesis, gluconeogenically derived glucose-6-phosphate can be diverted into hepatic glycogen even during mild hyperinsulinemia [87,123]
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