title: [Efect of short term glycemic control on microalbuminuria and glomerular filtration rate in type 2 diabetic patients with poor glycemic control].
abstract: BACKGROUND
  The intensive glucose control significantly reduces the risk of microvascular complications, including nephropathy.
  
  
  OBJECTIVE
  We assess the impact of glycemic control through calculation of weekly mean glycemia (WMG) and glycemic variability (GV) on 24 hours ambulatory blood pressure (ABPM), urinary albumin excretion (UAE) and glomerular filtration rate (GFR).
  
  
  METHODS
  53 patients with type 2 diabetes mellitus (DM2) were randomly divided into two groups to receive conventional or intensive treatment, which included weekly visits for medication adjustments and implementation of an educational plan for six weeks.
  
  
  RESULTS
  We observed glycemic control (WMG < 150 mg/dL and VG < 50) in 75% (n = 21) of the patients on the intervention treatment (IT) (n = 28), and in 24% (n = 6) of the ones on the conventional treatment (CT) (n = 25) (p < 0.001). Considering patients of the two groups, 14 out of the 27 patients who achieved glycemic control showed initial mean systolic blood pressure (SBP) > 120 mmHg which was reduced from 138.4 ± 10.1 to 127.8 ± 11.6 mmHg (p = 0.023) at the end of week six. Reductions in SBP and diastolic BP (DBP) during wakefulness and sleep did not occur in the group (n = 17) without glycemic control and with SBP > 120 mmHg. Initially, 15 patients had GFR > 120 mL/min, and after six weeks, only the subgroup that achieved glycemic control (n = 7) showed a reduction of 137.2 ± 16 to 122.2 ± 25.2 mL/min (p = 0.02). At the beginning of the study, another fifteen patients presented with microalbuminuria. After six weeks, regardless of whether they achieved glycemic control or not, there was reduction in UAE, from 63.0 ± 43.1 to 24.8 ± 19.5 mg/g creatinine (p = 0.02).
  
  
  CONCLUSIONS
  Thus short term glycemic control resulted in reductions of BP, GFR and the UAE in patients with DM2, which are beneficial for renal protection.
authors.affiliation: Universidade Federal de São Paulo, Rua Leandro Dupret 365, Vila Clementino, São Paulo, SP, Brazil. clarissabaia@yahoo.com.br
authors.forename: Clarissa Baia Bargas
authors.initials: CB
authors.lastname: Uezima
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Zanella
authors.forename: Anita
authors.initials: A
authors.lastname: Sachs
authors.forename: Augusto
authors.initials: A
authors.lastname: Pimazzoni Netto
authors.forename: Patrícia Lins
authors.initials: PL
authors.lastname: Zach
mesh_terms: D000419:Albuminuria / Q000209:etiology / Q000517:prevention & control*; D001786:Blood Glucose / Q000032:analysis*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D001786:Blood Glucose