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The relationship between long-term glycaemic control and diabetic nephropathy.
Q J Med 1992; 82(297):53-61QJ

Abstract

Urine albumin excretion was studied by two widely accepted methods in 210 patients with insulin-dependent diabetes mellitus and related to the mean of serial glycosylated haemoglobin (HbA1) measurements made every 3 months during the previous 6 years. Microalbuminuria (albumin excretion rate > 20 micrograms/min) was present in 9.5 per cent of patients when defined by a 24-hour collection and 8.1 per cent of patients when defined by a timed overnight urine sample. Those with microalbuminuria, as estimated from a timed overnight urine sample, had a longer duration of diabetes but otherwise did not differ in age, duration of diabetes or arterial blood pressure from patients whose albumin excretion rate was 20 micrograms/min or less irrespective of the method of urine collection. The mean and the most recent HbA1 levels differed significantly between the normal and the microalbuminuric groups when defined by the 24-hour albumin excretion rate (p < 0.001, p < 0.01), but no significant difference between these groups was found when albumin excretion rates were calculated from the timed overnight urine sample. Albumin excretion rate, examined in relation to mean HbA1, increased significantly with worsening glycaemic control whether measured over 24 hours or overnight (p < 0.05, p < 0.01). These findings support an association between glycaemic control and microalbuminuria, but the correlation is weak, dependent on the method of urine collection and is just as good for a relatively short-term as for a long-term measure of average blood glucose.

Authors+Show Affiliations

Sir George E. Clark Metabolic Unit, Royal Victoria Hospital, Belfast, Northern Ireland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

1438668

Citation

McCance, D R., et al. "The Relationship Between Long-term Glycaemic Control and Diabetic Nephropathy." The Quarterly Journal of Medicine, vol. 82, no. 297, 1992, pp. 53-61.
McCance DR, Hadden DR, Atkinson AB, et al. The relationship between long-term glycaemic control and diabetic nephropathy. Q J Med. 1992;82(297):53-61.
McCance, D. R., Hadden, D. R., Atkinson, A. B., Johnston, H., & Kennedy, L. (1992). The relationship between long-term glycaemic control and diabetic nephropathy. The Quarterly Journal of Medicine, 82(297), pp. 53-61.
McCance DR, et al. The Relationship Between Long-term Glycaemic Control and Diabetic Nephropathy. Q J Med. 1992;82(297):53-61. PubMed PMID: 1438668.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The relationship between long-term glycaemic control and diabetic nephropathy. AU - McCance,D R, AU - Hadden,D R, AU - Atkinson,A B, AU - Johnston,H, AU - Kennedy,L, PY - 1992/1/1/pubmed PY - 1992/1/1/medline PY - 1992/1/1/entrez SP - 53 EP - 61 JF - The Quarterly journal of medicine JO - Q. J. Med. VL - 82 IS - 297 N2 - Urine albumin excretion was studied by two widely accepted methods in 210 patients with insulin-dependent diabetes mellitus and related to the mean of serial glycosylated haemoglobin (HbA1) measurements made every 3 months during the previous 6 years. Microalbuminuria (albumin excretion rate > 20 micrograms/min) was present in 9.5 per cent of patients when defined by a 24-hour collection and 8.1 per cent of patients when defined by a timed overnight urine sample. Those with microalbuminuria, as estimated from a timed overnight urine sample, had a longer duration of diabetes but otherwise did not differ in age, duration of diabetes or arterial blood pressure from patients whose albumin excretion rate was 20 micrograms/min or less irrespective of the method of urine collection. The mean and the most recent HbA1 levels differed significantly between the normal and the microalbuminuric groups when defined by the 24-hour albumin excretion rate (p < 0.001, p < 0.01), but no significant difference between these groups was found when albumin excretion rates were calculated from the timed overnight urine sample. Albumin excretion rate, examined in relation to mean HbA1, increased significantly with worsening glycaemic control whether measured over 24 hours or overnight (p < 0.05, p < 0.01). These findings support an association between glycaemic control and microalbuminuria, but the correlation is weak, dependent on the method of urine collection and is just as good for a relatively short-term as for a long-term measure of average blood glucose. SN - 0033-5622 UR - https://www.unboundmedicine.com/medline/citation/1438668/The_relationship_between_long_term_glycaemic_control_and_diabetic_nephropathy_ L2 - https://medlineplus.gov/diabetickidneyproblems.html DB - PRIME DP - Unbound Medicine ER -