Intensive type 1 diabetes mellitus therapy lowers the long-term risk for impaired glomerular filtration rate (GFR), a predictor of end-stage kidney disease, Dr. Ian de Boer, assistant professor of medicine in the division of nephrology at the University of Washington in Seattle, told delegates at Kidney Week 2011: American Society of Nephrology 44th Annual Meeting, Medscape Medical News reports.
The study consisted of an intervention trial, the Diabetes Control and Complications Trial (DCCT), and a follow-up observational trial, the Epidemiology of Diabetes Interventions and Complications (EDIC) study.
DCCT randomly assigned 1,441 individuals with type 1 diabetes to intensive diabetes therapy, with 3 or more insulin injections per day and a target of near-normal glucose concentrations, or to conventional diabetes therapy with 1 or 2 injections per day and a target of preventing hyperglycemic symptoms, for 6.5 years.
Compared with conventional therapy, intensive type 1 diabetes therapy cut the risk for impaired GFR in half over a median follow-up of 22 years, according to the study. However, when the data were adjusted for hemoglobin A1c levels or the albumin excretion rate, the beneficial effect disappeared.




