Summary
A prospective and randomized clinical trial of an inception cohort of diabetic kidney recipients to test the hypothesis that maximized metabolic control of diabetes prevents or delays diabetic nephropathy in the renal allografts was initiated approximately three years ago. Notwithstanding the fact that all our diabetic patients were on prednisone and therefore metabolically unstable, we achieved and maintained a clear difference between the standard control (group A) and the maximized control patients (group B). At 13 months of study, the mean fasting blood glucose mg% (A: 242±22, B: 130±9, p<0.001), nonfasting blood glucose (A: 276±40, B: 135±10, p<0.001), 24 hour urine glucose (A: 85±16, B: 5±1, p<0.001), and glycosylated hemoglobin % (A: 13±0.9, B: 10±0.8, p<0.01) were all clearly and statistically significantly higher for the group A patients. These results show the feasibility of such a trial using the tools available today to treat diabetes.
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References
Barbosa J., Menth L., Eaton J., Sutherland D., Freier E., Najarian J.: Long-term, ambulatory subcutaneous insulin infusion vs. multiple daily injections in brittle diabetics — Diabetes Care4, 269, 1981.
Barbosa J., Menth L., Schumacher G., Johnson S., Najarian J.: Feasibility of blood glucose self-monitoring in unstable insulin-dependent diabetes — Diabetes Care3, 155, 1980.
Cahill G., Etzwiler D., Freinkel N.: ‘Control’ and diabetes — New Engl. J. Med.294, 1004, 1976.
Ingelfinger F.: Debates on diabetes — New Engl. J. Med.296, 1228, 1977.
Mauer S. M., Barbosa J., Vernier R. L., Najarian J. S., Goetz F. C.: Development of diabetic vascular lesions in normal kidneys transplanted into patients with diabetes mellitus — New Engl. J. Med.295, 916, 1976.
Ross H., Rifkin H.: Metabolic control and vascular disease in diabetes mellitus. In:Podolsky S. (Ed.): Clinical diabetes: modern management. Appleton-Century-Crofts, New York, 1980; p. 565.
Spierstein M.D., Foster D. W., Knowles H. C., Levine R., Madison L. L., Roth J.: Control of blood glucose and diabetic vascular disease — New Engl. J. Med.296, 1060, 1977.
Svendsen P. Aa., Christiansen J. S., Welinder B., Nerup J.: Fast glycosylation of hemoglobin — Lanceti, 603, 1979.
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Barbosa, J., Connett, J., Fryd, D. et al. The Minnesota diabetes complications clinical trial the first three years. Acta diabet. lat 20, 164–171 (1983). https://doi.org/10.1007/BF02624917
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DOI: https://doi.org/10.1007/BF02624917