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  • 1990-1994  (2)
  • Key words Diabetic glomerulopathy, microalbuminuria, basement membrane thickness, mesangial expansion, mesangial matrix, stereology, hyperglycaemia.  (1)
  • metabolic control  (1)
  • microalbuminuria  (1)
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  • 1990-1994  (2)
Year
Keywords
  • 1
    Electronic Resource
    Electronic Resource
    Improvement of blood glucose control in IDDM patients retards the progression of morphological changes in early diabetic nephropathy (1994)
    Springer
    Diabetologia 37 (1994), S. 483-490 
    Details
    ISSN: 1432-0428
    Keywords: Key words Diabetic glomerulopathy, microalbuminuria, basement membrane thickness, mesangial expansion, mesangial matrix, stereology, hyperglycaemia.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We investigated in a randomized, prospective study the influence of improved blood glucose control during 2–3 years in young insulin-dependent diabetic (IDDM) patients with microalbuminuria, which is indicative of early nephropathy. Patients were randomized either to intensive treatment by continuous subcutaneous insulin infusion (CSII) (n =9) or CT (n =9). Kidney biopsies were taken at baseline and after 26–34 months. End points were structural changes in the glomeruli. Sensitive, quantitative, morphometric methods were used. The blood glucose control improved significantly (p =0.01) during the study in the CSII-group as glycated haemoglobin (HbA1 c) fell from 10.1 % ([95 % CI] 8.9–11.3) to 8.6 % (7.9–9.2), but not in the CT-group, 10.1 % (8.3–11.9) vs 9.7 % (8.7–10.8). Mean HbA1 c during the study period was significantly lower in the CSII-group than in the CT-group, 8.7 % (8.1–9.3) vs 9.9 % (8.5–11.3), p =0.04. Basement membrane thickness (BMT) increased in both groups, most (CT vs CSII, p =0.03) in the CT-group: 140 nm (50–230) vs CSII: 56 nm (27–86). In the CT-group only an increase was seen in matrix/mesangial volume fraction (p =0.006) and matrix star volume (p =0.04). Furthermore, a positive correlation between mean HbA1 c during the study and change from baseline in BMT (r =0.70, p =0.001) and matrix/glomerular volume fraction (r =0.33, p =0.09, NS) was demonstrated. Albumin excretion rate correlated significantly to BMT and most of the matrix parameters. The present study shows that during a period of only 2.5 years, a close relationship between the level of mean blood glucose and progression of glomerular morphological changes in early diabetic nephropathy can be demonstrated. [Diabetologia (1994) 37: 483–490]
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001250050136
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Glomerular charge selectivity and the influence of improved blood glucose control in Type 1 (insulin-dependent) diabetic patients with microalbuminuria (1992)
    Springer
    Diabetologia 35 (1992), S. 1165-1169 
    Details
    ISSN: 1432-0428
    Keywords: Type 1 (insulin-dependent) diabetes mellitus ; nephropathy ; microalbuminuria ; continuous subcutaneous insulin infusion ; metabolic control ; glomerular charge selectivity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We first compared glomerular charge selectivity index in two matched groups of Type 1 (insulin-dependent) diabetic patients with micro and normoalbuminuria respectively, and secondly, investigated prospectively in a randomized clinical trial, the influence of improved metabolic control on selectivity index in diabetic patients with microalbuminuria. In Study 1, 27 patients with microalbuminuria (albumin excretion 〉-15 μg/min in at least two out of three overnight urine samples) were matched (age, diabetes duration, mean 1-year HbA1c, gender) with normoalbuminuria patients (n=24), and in Study 2, 23 microalbuminuric patients were randomly allocated to either intensive (continuous subcutaneous insulin infusion) or conventional treatment. Glomerular charge selectivity index was measured as IgG/IgG4 selectivity index, i.e. total IgG/IgG4 clearance ratio in timed overnight urine samples. The microalbuminuric patients had a significantly reduced selectivity index compared to the normoalbuminuric patients: 1.20 (0.92–1.40) vs 1.68 (1.22–2.21), median and 95% confidence interval (p〈0.01). In Study 2, the HbA1c improved in the intensive-treatment group compared to the conventional-treatment group: at 2, 6 and 12 months the difference in mean percentage HbA1c between the groups was 1.1, 1.2 and 1.4, respectively (p〈0.01). A sharp 50% increment in IgG/IgG4 selectivity index was seen in the intensive-treatment group during the first 6 months (p〈0.05 compared to the conventional group). We conclude that adolescents and young adults in an early stage of diabetic nephropathy have reduced glomerular charge selectivity, which may be improved by reducing the mean blood glucose level.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00401371
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
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