Glycemic control and prognosis in type I diabetic patients with microalbuminuria.
OBJECTIVE
To investigate the course of microalbuminuria during the 1980s in type I diabetes patients.


METHODS
This was a 10-year follow-up of 109 patients in whom type I diabetes was diagnosed between 1961 and 1980 before 15 years of age and who were initially investigated between 1977 and 1983 after a diabetes duration of > or = 3 years. Microalbuminuria was defined as an albumin excretion rate (AER) of 20-200 micrograms/min in two of three consecutive urine samples.


RESULTS
At the initial investigation, 81 patients had normal AER, 27 had microalbuminuria, and 1 had macroalbuminuria. Between 1989 and 1992, 99 (91%) patients were reinvestigated. Only 5 (19%) of the initially microalbuminuric patients developed macroproteinuria during the 10-year follow-up period, and in 15 (58%) patients, AER decreased to normal. Three (4%) of the normoalbuminuric patients developed microalbuminuria but none macroproteinuria. The initially microalbuminuric patients, in whom AER normalized, improved their glycemic control from 1980-1983 to 1989-1991 (mean +/- SE HbA1c 7.5 +/- 0.2 to 6.6 +/- 0.3%; P = 0.01).


CONCLUSIONS
In the majority of patients with microalbuminuria in whom it is possible to obtain good glycemic control, microalbuminuria will disappear and the risk of developing nephropathy will be markedly reduced.
Bojestig
M
M
Department of Internal Medicine, University Hospital, Linköping, Sweden.
Arnqvist
H J
HJ
Karlberg
B E
BE
Ludvigsson
J
J
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000419:Albuminuria; D001786:Blood Glucose / Q000378:metabolism*; D001794:Blood Pressure; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000652:urine*; D003928:Diabetic Nephropathies / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D012727:Sex Characteristics; D012737:Sex Factors
D001786:Blood Glucose; D006442:Glycated Hemoglobin