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Prevention of diabetic nephropathy by tight target control in an asian population with type 2 diabetes mellitus: a 4-year prospective analysis.
Arch Intern Med. 2010 Jan 25; 170(2):155-61.AI

Abstract

BACKGROUND

No study to date has evaluated whether multifactorial intervention can prevent diabetic nephropathy in patients with type 2 diabetes mellitus and normoalbuminuria. We evaluated the effect of tightly controlling multiple factors recommended by the American Diabetes Association (ADA) on the development and prevention of diabetic nephropathy in Chinese patients with type 2 diabetes mellitus and normoalbuminuria during a 4(1/2)-year period.

METHODS

A longitudinal cohort study enrolled 1290 patients with type 2 diabetes and normoalbuminuria who received intensified treatment to meet the following ADA recommended goals: hemoglobin A(1c)(HbA(1c)), less than 7%; systolic blood pressure, less than 130 mm Hg; diastolic blood pressure, less than 80 mm Hg; low-density lipoprotein cholesterol, less than 100 mg/dL; triglycerides, less than 150 mg/dL; and high-density lipoprotein cholesterol, greater than 40 mg/dL for men and greater than 50 mg/dL for women.

RESULTS

During the study period, 211 patients (16.4%) developed new-onset microalbuminuria. A significant association was found between the achievement of ADA goals, including HbA(1c) level less than 7% (hazard ratio [HR], 0.729; 95% confidence interval [CI], 0.553-0.906; P = .03), systolic blood pressure less than 130 mm Hg (0.645; 0.491-0.848; P = .002), and high-density lipoprotein cholesterol level greater than 50 mg/dL for women and greater than 40 mg/dL for men (0.715; 0.537-0.951; P = .02) and the development of new-onset microalbuminuria.

CONCLUSIONS

Diabetic nephropathy can be delayed by tight simultaneous achievement of multiple ADA-recommended targets. This multifactorial intervention should be started in patients with diabetes and normoalbuminuria.

Authors+Show Affiliations

Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20101010

Citation

Tu, Shih-Te, et al. "Prevention of Diabetic Nephropathy By Tight Target Control in an Asian Population With Type 2 Diabetes Mellitus: a 4-year Prospective Analysis." Archives of Internal Medicine, vol. 170, no. 2, 2010, pp. 155-61.
Tu ST, Chang SJ, Chen JF, et al. Prevention of diabetic nephropathy by tight target control in an asian population with type 2 diabetes mellitus: a 4-year prospective analysis. Arch Intern Med. 2010;170(2):155-61.
Tu, S. T., Chang, S. J., Chen, J. F., Tien, K. J., Hsiao, J. Y., Chen, H. C., & Hsieh, M. C. (2010). Prevention of diabetic nephropathy by tight target control in an asian population with type 2 diabetes mellitus: a 4-year prospective analysis. Archives of Internal Medicine, 170(2), 155-61. https://doi.org/10.1001/archinternmed.2009.471
Tu ST, et al. Prevention of Diabetic Nephropathy By Tight Target Control in an Asian Population With Type 2 Diabetes Mellitus: a 4-year Prospective Analysis. Arch Intern Med. 2010 Jan 25;170(2):155-61. PubMed PMID: 20101010.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevention of diabetic nephropathy by tight target control in an asian population with type 2 diabetes mellitus: a 4-year prospective analysis. AU - Tu,Shih-Te, AU - Chang,Shun-Jen, AU - Chen,Jung-Fu, AU - Tien,Kai-Jen, AU - Hsiao,Jeng-Yueh, AU - Chen,Hung-Chun, AU - Hsieh,Ming-Chia, PY - 2010/1/27/entrez PY - 2010/1/27/pubmed PY - 2010/2/17/medline SP - 155 EP - 61 JF - Archives of internal medicine JO - Arch Intern Med VL - 170 IS - 2 N2 - BACKGROUND: No study to date has evaluated whether multifactorial intervention can prevent diabetic nephropathy in patients with type 2 diabetes mellitus and normoalbuminuria. We evaluated the effect of tightly controlling multiple factors recommended by the American Diabetes Association (ADA) on the development and prevention of diabetic nephropathy in Chinese patients with type 2 diabetes mellitus and normoalbuminuria during a 4(1/2)-year period. METHODS: A longitudinal cohort study enrolled 1290 patients with type 2 diabetes and normoalbuminuria who received intensified treatment to meet the following ADA recommended goals: hemoglobin A(1c)(HbA(1c)), less than 7%; systolic blood pressure, less than 130 mm Hg; diastolic blood pressure, less than 80 mm Hg; low-density lipoprotein cholesterol, less than 100 mg/dL; triglycerides, less than 150 mg/dL; and high-density lipoprotein cholesterol, greater than 40 mg/dL for men and greater than 50 mg/dL for women. RESULTS: During the study period, 211 patients (16.4%) developed new-onset microalbuminuria. A significant association was found between the achievement of ADA goals, including HbA(1c) level less than 7% (hazard ratio [HR], 0.729; 95% confidence interval [CI], 0.553-0.906; P = .03), systolic blood pressure less than 130 mm Hg (0.645; 0.491-0.848; P = .002), and high-density lipoprotein cholesterol level greater than 50 mg/dL for women and greater than 40 mg/dL for men (0.715; 0.537-0.951; P = .02) and the development of new-onset microalbuminuria. CONCLUSIONS: Diabetic nephropathy can be delayed by tight simultaneous achievement of multiple ADA-recommended targets. This multifactorial intervention should be started in patients with diabetes and normoalbuminuria. SN - 1538-3679 UR - https://www.unboundmedicine.com/medline/citation/20101010/Prevention_of_diabetic_nephropathy_by_tight_target_control_in_an_asian_population_with_type_2_diabetes_mellitus:_a_4_year_prospective_analysis_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/archinternmed.2009.471 DB - PRIME DP - Unbound Medicine ER -