Role of glycemic control and protein restriction in clinical management of diabetic kidney disease.

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
S R Mudaliar, R R Henry

Abstract

To assess the role of control of blood glucose levels and restriction of dietary protein in the management of diabetic nephropathy. We summarize the results of pertinent published studies of glycemic control and modification of protein intake to provide information about strategies that potentially could benefit patients with diabetes and renal dysfunction. Considerable evidence is available to support the contention that improved glycemic control may have beneficial effects on the development and progression of diabetic renal disease. Maximal benefits of improved glycemia occur when instituted before the onset of macroalbuminuria. Once overt diabetic nephropathy is established, improved glycemic control may not be beneficial. Current evidence indicates that a glycosylated hemoglobin level of less than 8.1% should be the glycemic goal. At this level, the risk of developing micro-albuminuria is substantially reduced, and the risk of hypoglycemia is minimized. Most studies have been conducted in type I diabetes, and the results have been extrapolated to type II diabetes. Whether improved glycemic control will be equally beneficial in the nephropathy of type II diabetes has yet to be determined. Although some scientific evidence s...Continue Reading

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Citations

Jul 29, 1998·Journal of Accident & Emergency Medicine·G I QuinP K Plunkett
Jul 29, 1998·Journal of Accident & Emergency Medicine·M M Stark

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