Effects of short-term strict metabolic control on kidney function and extracellular fluid volume in incipient diabetic nephropathy.
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 l-1) and good metabolic control (5 (4-8) mmol l-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) x 10(-6), extracellular fluid volume 13.4 (2.3) vs 14.3 (2.8) l (p less than 0.10). Apart from an increase in extracellular fluid volume during improved metabolic control (12.2 (1.6) vs 13.6 (2.5) l, p less than 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.
Mathiesen
E R
ER
Hvidöre Hospital, Klampenborg, Denmark.
Gall
M A
MA
Hommel
E
E
Skøtt
P
P
Parving
H H
HH
D000328:Adult; D000419:Albuminuria; D001786:Blood Glucose / Q000032:analysis; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000503:physiopathology*; D003928:Diabetic Nephropathies / Q000188:drug therapy / Q000503:physiopathology*; D004334:Drug Administration Schedule; D005110:Extracellular Space / Q000502:physiology*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D007668:Kidney / Q000503:physiopathology*; D008297:Male
D001786:Blood Glucose; D007328:Insulin