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Effects of improved glycemic control on microalbuminuria in adolescents with insulin-dependent diabetes mellitus.
Int J Pediatr Nephrol 1986 Jan-Mar; 7(1):31-8IJ

Abstract

The effect of improved glycemic control on microalbuminuria was evaluated longitudinally in 13 adolescents with insulin-dependent diabetes mellitus (IDDM) of 8.4 +/- 0.8 years duration. Glycemic control and microalbuminuria were assessed under three treatment regimens: conventional therapy (Period A); after 6 weeks of intensified conventional therapy (Period B); and at three periods during continuous subcutaneous insulin infusion (CSII) (Period C = 10-14 days, Period D = 2-4 months, and Period E = 6-8 months, of CSII). Although euglycemia was not achieved, there was a decrease in mean 24-hour blood glucose concentrations measured hourly in the hospital, with values averaging 239 mg/dl in Period A, 202 mg/dl in Period B, and 156-184 mg/dl in Periods C to E. This was accompanied by significant reductions in the values for whole blood, and to a lesser extent, in stable glycosylated hemoglobin A1 (GHbA1) (p less than 0.05), but not in creatinine clearance, albumin clearance, or in albumin excretion rate. Significant correlations were found between whole blood GHbA1 levels and albumin clearance in each of Periods B to E and between albumin clearance and albumin excretion in Periods B to D (p less than 0.05) but not in Period A. Our data suggests that the degree of improvement in glycemic control obtained in our adolescent population with IDDM using either intensive conventional therapy or CSII does not reduce the microalbuminuria. If modulation of microalbuminuria is achievable it may require euglycemia or may involve other factors which have a more direct effect on the transit of albumin across the glomerular basement membrane.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

3957559

Citation

Ellis, D, et al. "Effects of Improved Glycemic Control On Microalbuminuria in Adolescents With Insulin-dependent Diabetes Mellitus." The International Journal of Pediatric Nephrology, vol. 7, no. 1, 1986, pp. 31-8.
Ellis D, Avner ED, Kurs-Lasky M, et al. Effects of improved glycemic control on microalbuminuria in adolescents with insulin-dependent diabetes mellitus. Int J Pediatr Nephrol. 1986;7(1):31-8.
Ellis, D., Avner, E. D., Kurs-Lasky, M., Richards, M., & Becker, D. J. (1986). Effects of improved glycemic control on microalbuminuria in adolescents with insulin-dependent diabetes mellitus. The International Journal of Pediatric Nephrology, 7(1), pp. 31-8.
Ellis D, et al. Effects of Improved Glycemic Control On Microalbuminuria in Adolescents With Insulin-dependent Diabetes Mellitus. Int J Pediatr Nephrol. 1986;7(1):31-8. PubMed PMID: 3957559.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of improved glycemic control on microalbuminuria in adolescents with insulin-dependent diabetes mellitus. AU - Ellis,D, AU - Avner,E D, AU - Kurs-Lasky,M, AU - Richards,M, AU - Becker,D J, PY - 1986/1/1/pubmed PY - 1986/1/1/medline PY - 1986/1/1/entrez SP - 31 EP - 8 JF - The International journal of pediatric nephrology JO - Int J Pediatr Nephrol VL - 7 IS - 1 N2 - The effect of improved glycemic control on microalbuminuria was evaluated longitudinally in 13 adolescents with insulin-dependent diabetes mellitus (IDDM) of 8.4 +/- 0.8 years duration. Glycemic control and microalbuminuria were assessed under three treatment regimens: conventional therapy (Period A); after 6 weeks of intensified conventional therapy (Period B); and at three periods during continuous subcutaneous insulin infusion (CSII) (Period C = 10-14 days, Period D = 2-4 months, and Period E = 6-8 months, of CSII). Although euglycemia was not achieved, there was a decrease in mean 24-hour blood glucose concentrations measured hourly in the hospital, with values averaging 239 mg/dl in Period A, 202 mg/dl in Period B, and 156-184 mg/dl in Periods C to E. This was accompanied by significant reductions in the values for whole blood, and to a lesser extent, in stable glycosylated hemoglobin A1 (GHbA1) (p less than 0.05), but not in creatinine clearance, albumin clearance, or in albumin excretion rate. Significant correlations were found between whole blood GHbA1 levels and albumin clearance in each of Periods B to E and between albumin clearance and albumin excretion in Periods B to D (p less than 0.05) but not in Period A. Our data suggests that the degree of improvement in glycemic control obtained in our adolescent population with IDDM using either intensive conventional therapy or CSII does not reduce the microalbuminuria. If modulation of microalbuminuria is achievable it may require euglycemia or may involve other factors which have a more direct effect on the transit of albumin across the glomerular basement membrane. SN - 0391-6510 UR - https://www.unboundmedicine.com/medline/citation/3957559/Effects_of_improved_glycemic_control_on_microalbuminuria_in_adolescents_with_insulin_dependent_diabetes_mellitus_ L2 - http://www.diseaseinfosearch.org/result/2236 DB - PRIME DP - Unbound Medicine ER -