PMID: 6402163Feb 19, 1983Paper

Long term correction of hyperglycaemia and progression of renal failure in insulin dependent diabetes

British Medical Journal
G C VibertiH Keen

Abstract

The effect of long term correction of hyperglycaemia on the rate of deterioration of renal function was studied in six insulin dependent diabetics with proteinuria due to diabetic nephropathy. After a planned run in observation period of 10 to 24 months patients entered a programme of continuous subcutaneous insulin infusion for up to 24 months. Glycaemic control was promptly and significantly improved and optimal glycaemic values sustained throughout the study. Blood pressure was maintained stable. A control group of six nephropathic diabetics was studied receiving conventional insulin injection treatment but also with blood pressure control over the same period.Despite greatly improved metabolic control in the infusion treated group no significant change in the rate of decline of glomerular filtration rate could be shown, the plasma creatinine concentrations continued to increase, and the fractional clearance of albumin and IgG rose progressively, indicating progression of glomerular damage. The conventionally treated control group behaved similarly. In a single patient receiving the continuous infusion the rate of decline of the glomerular filtration rate slowed considerably, suggesting that the response to strict diabetic c...Continue Reading

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Citations

Dec 1, 1989·Diabetologia·E R MathiesenT Deckert
Sep 1, 1990·Diabetologia·T S Kern, R L Engerman
Jan 1, 1991·European Journal of Clinical Pharmacology·L Gonzalez-Sicilia de LlamasJ Hernandez Cascales
Apr 15, 1988·Klinische Wochenschrift·R W Schrier, H Holzgreve
Sep 1, 1984·Medical & Biological Engineering & Computing·J C Pickup, D Rothwell
Jul 1, 1990·Acta diabetologica latina·G C Viberti
Jan 1, 1986·Acta diabetologica latina·A LombardoL Motta
Jan 1, 1991·Medical Hypotheses·G Gwinup, A N Elias
Jan 1, 1989·The Journal of Diabetic Complications·O Schmitz
Oct 12, 2000·Diabetes Research and Clinical Practice·C ChangT Y Tai
May 1, 1988·Baillière's Clinical Endocrinology and Metabolism·B M SinghM G Fitzgerald
Dec 22, 1983·The New England Journal of Medicine·M D Siperstein
Jul 12, 1984·The New England Journal of Medicine·C E Mogensen, C K Christensen
Mar 7, 1985·The New England Journal of Medicine·T H Hostetter
Jun 10, 1993·The New England Journal of Medicine·D M Nathan
Jul 27, 2001·Diabetes Technology & Therapeutics·T T AokiJ H Ahn
Aug 1, 1994·Australian and New Zealand Journal of Medicine·R BruceT Cundy
Dec 1, 1990·Diabetic Medicine : a Journal of the British Diabetic Association·M P GordgeG H Neild
Jan 1, 1991·Diabetic Medicine : a Journal of the British Diabetic Association·G C Viberti
Oct 1, 1983·British Medical Journal·A B ShawJ D Lewis-Jackson
Apr 21, 1984·British Medical Journal·J J BendingH Keen
Mar 2, 1985·British Medical Journal·P J Watkins

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