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Effects of Short‐term Strict Metabolic Control on Kidney Function and Extracellular Fluid Volume in Incipient Diabetic Nephropathy
Author(s) -
Mathiesen E.R.,
Gall M.A.,
Hommel E.,
Skøtt P.,
Parving H.H.
Publication year - 1989
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.1989.tb01235.x
Subject(s) - medicine , renal function , extracellular fluid , endocrinology , diabetic nephropathy , excretion , nephropathy , interquartile range , albumin , metabolic control analysis , diabetes mellitus , urology , extracellular , chemistry , biochemistry
The effects of strict metabolic control (multiple insulin injections for 1 week) on urinary albumin excretion, glomerular filtration rate and extracellular fluid volume was evaluated in long‐term Type 1 diabetic patients with ( n =9) and without ( n =10) incipient nephropathy. Investigations were carried out in poor (blood glucose 15 (interquartile range, 13–18) mmol I −1 ) and good metabolic control (5 (4–8) mmol I −1 ). In patients with incipient nephropathy glomerular filtration rate was 125 (SD 26) (poor control) vs 125 (20) ml min −1 (good control), urinary albumin excretion 60 (range 37–247) vs 60 (13–359) mg 24 h −1 , fractional albumin clearance 6.1 (0.9–67.6) vs 6.7 (2.1–65.4) x10 −6 , extracellular fluid volume 13.4 (2.3) vs 14.3 (2.8) I ( p <0.10). Apart from an increase in extracellular fluid volume during improved metabolic control (12.2 (1.6) vs 13.6 (2.5) I, p <0.02) all the above mentioned variables remained unchanged in the patients with normal urinary albumin excretion. In conclusion, strict metabolic control for 2–7 days has no effect on urinary albumin excretion and glomerular filtration rate in long‐term Type 1 diabetic patients with or without incipient diabetic nephropathy.