Diabetes Mellitus Therapy Lowers Kidney Failure Risk

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.

"The DCCT/EDIC study had phenomenal retention throughout its course, with 85 percent of participants completing the EDIC year 16 visit, on average, 22 years after baseline," Dr. de Boer said at a news conference, according to Medscape. Dr. Lawrence Agodoa, director of the Office of Minority Health Research Coordination at the National Institute of Diabetes and Digestive and Kidney Diseases, and director of the chronic kidney disease and end stage renal disease programs at the National Institutes of Health in Bethesda, Maryland, told Medscape that the findings will help to improve patient care. This study was published online Saturday in the New England Journal of Medicine
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