Prevention of deterioration of renal and sensory-nerve function by more intensive management of insulin-dependent diabetic patients. A two-year randomised prospective study.
74 insulin-dependent diabetic patients with background retinopathy were randomised to continue with usual diabetic care (group U) or to a more intensive programme (group A) using ultralente insulin as basal cover and soluble insulin at mealtimes. Group A attended the clinic more frequently, received closer dietary supervision, and were taught home blood glucose monitoring. Group A had a significantly lower mean glycosylated haemoglobin level during the study, although the mean level also fell in group U towards the end of year 2. Renal and sensory-nerve function were significantly better preserved in group A than in group U. Significant improvements were also seen in low-density-lipoprotein-cholesterol and whole-blood low-shear viscosity. The rate of progression of retinopathy was similar in both groups. It appears that a modest improvement in diabetic control, obtainable in most clinics, has been associated with a reduction in the progression of diabetic tissue damage.
D001786:Blood Glucose / Q000032:analysis*; D001809:Blood Viscosity; D002784:Cholesterol / Q000097:blood; D008078:Cholesterol, LDL; D002986:Clinical Trials as Topic; D003920:Diabetes Mellitus / Q000178:diet therapy* / Q000188:drug therapy*; D003928:Diabetic Nephropathies / Q000517:prevention & control*; D003929:Diabetic Neuropathies / Q000503:physiopathology / Q000517:prevention & control*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006699:Home Care Services; D006801:Humans; D049528:Insulin, Long-Acting / Q000627:therapeutic use*; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D011446:Prospective Studies; D011897:Random Allocation; D012684:Sensory Thresholds
D001786:Blood Glucose; D002784:Cholesterol; D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin; D049528:Insulin, Long-Acting; D008077:Lipoproteins, LDL