【摘 要】
：
Diabetes is a leading cause of chronic kidney disease (CKD).We ask if CKD progression is preventable by glycemic control with intensive insulin treatment.Data was obtained from 46 diabetic patients (2
【机 构】
：
Mandal Diabetes Research Foundation Northeast Florida USA
【出 处】
：
2013百奥泰波兰重大疾病临床峰会
论文部分内容阅读
Diabetes is a leading cause of chronic kidney disease (CKD).We ask if CKD progression is preventable by glycemic control with intensive insulin treatment.Data was obtained from 46 diabetic patients (28 F, 18 M), mean age 62.2 (39-86) years, followed for an average of 14.2 (1.5 to 1 t5) months.Diabetes was diagnosed by 2-h postprandial (2hPP) glucose of > 11.1 mmol/L and treated with Glargine insulin after breakfast and dinner and regular insulin by finger-stick glucose 2-hPP and bedtime.Hypertension (BP) was treated without reninangiotensin inhibitors.Glucose, serum creatinine (Scr), estimated glomerular filtration rate (eGFR),and glycosylated hemoglobin (HbA1c), and BP were compared between first and last visits (paired two-tailed t-test.p < 0.05 was significant).Patients were divided by 2hPP glucose of < or > 11.1mmol/L.In all patients, fasting glucose was significantly lower at the last versus first visit (8.4 +0.6 vs.10.3 +0.7mmol/L), associated with a significantly reduced Scr (100.3 + 5.2 vs.110.9 +7.8 μmol/L).CKD staging in all groups between visits was unchanged.<11.1 mmol/L group had a significant reduction of HbA1c (9.14+0.52 vs.7.60+0.45%).Renal function in the < 11.1 mmol/L group at the last visit improved from CKD stage 2 to 1.Diastolic BP in all patients group was significantly lower at the last visit (77.0+ 1.5 vs.81.6+0.9 mmHg).Overall, this paradigm of therapy is effective in preventing progression of diabetes related CKD.
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