Intensive therapy and progression to clinical albuminuria in patients with insulin dependent diabetes mellitus and microalbuminuria. Microalbuminuria Collaborative Study Group, United Kingdom
Abstract
To study the effect of intensive therapy of diabetes on the progression to clinical albuminuria in insulin dependent diabetic patients with microalbuminuria. Randomised controlled clinical trial of intensive versus conventional therapy of diabetes for a median of 5 years (range 2-8). Nine hospital based specialist diabetes centres in England and Wales. 70 European insulin dependent diabetic patients aged 17-59 years with microalbuminuria (albumin excretion 30-199 micrograms/min), but without arterial hypertension, recruited from the nine hospital based specialist diabetes centres. Intensive diabetic therapy was allocated to 36 patients (27 men, 9 women) and conventional diabetic therapy to 34 (24 men, 10 women). Development of clinical albuminuria, defined as albumin excretion greater than 200 micrograms/min on at least two consecutive occasions, and rate of change of albumin excretion. Mean glycated haemoglobin concentration, similar at baseline in the two groups (intensive therapy group 10.3% (SEM 1.9%), conventional therapy group 9.8% (1.6%)), fell significantly (by 14%) in the intensive therapy group only. A significant glycaemic separation between the two groups was maintained for up to three years. Progression to clinical...Continue Reading
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