Renal protection in diabetes: Role of glycemic control

Paola Fioretto, Marino Bruseghin, Ilaria Berto, Pietro Gallina, Enzo Manzato, Michele Mussap

Research output: Contribution to journalArticle

72 Citations (Scopus)

Abstract

Diabetes is the most common cause of ESRD in Western countries. This article describes the impact of glycemic control in the various stages of the disease and considers the impact of tight glycemic control on the development and progression of diabetic nephropathy (DN). The Diabetes Control and Complications Trial and the United Kingdom Prospective Diabetic Study have demonstrated in type 1 and type 2 diabetes that intensive glycemic control significantly reduces the risk for development of microalbuminuria. Although observational studies suggest an impact of glycemia also on the progression of DN, fewer data are available on the impact of improved metabolic control in secondary prevention. The long-term follow-up of the patients who participated in the Diabetes Control and Complications Trial (Epidemiology of Diabetes Interventions and Complications Study) demonstrated a sustained effect of previous tight glycemic control on both development and progression of DN. Finally, long-term normoglycemia, achieved by pancreas transplantation, is able not only to prevent the development of early diabetic glomerulopathy in kidney transplant recipients but also to halt progression and induce regression of the established diabetic renal lesions in nonuremic patients. Taken together, these studies strongly demonstrate that improvement in glucose control is the most important therapeutic approach in primary prevention. Tight glycemic control also is important in slowing progression of DN, and if blood glucose is normalized, then regression of DN can be achieved. Therefore, a target of glycated hemoglobin levels

Original languageEnglish
JournalJournal of the American Society of Nephrology
Volume17
Issue numberSUPPL. 2
DOIs
Publication statusPublished - Apr 2006

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Diabetic Nephropathies
Kidney
Diabetes Complications
Pancreas Transplantation
Glycosylated Hemoglobin A
Primary Prevention
Secondary Prevention
Type 1 Diabetes Mellitus
Type 2 Diabetes Mellitus
Chronic Kidney Failure
Observational Studies
Blood Glucose
Epidemiology
Prospective Studies
Glucose

ASJC Scopus subject areas

  • Nephrology

Cite this

Fioretto, P., Bruseghin, M., Berto, I., Gallina, P., Manzato, E., & Mussap, M. (2006). Renal protection in diabetes: Role of glycemic control. Journal of the American Society of Nephrology, 17(SUPPL. 2). https://doi.org/10.1681/ASN.2005121343

Renal protection in diabetes : Role of glycemic control. / Fioretto, Paola; Bruseghin, Marino; Berto, Ilaria; Gallina, Pietro; Manzato, Enzo; Mussap, Michele.

In: Journal of the American Society of Nephrology, Vol. 17, No. SUPPL. 2, 04.2006.

Research output: Contribution to journalArticle

Fioretto, P, Bruseghin, M, Berto, I, Gallina, P, Manzato, E & Mussap, M 2006, 'Renal protection in diabetes: Role of glycemic control', Journal of the American Society of Nephrology, vol. 17, no. SUPPL. 2. https://doi.org/10.1681/ASN.2005121343
Fioretto P, Bruseghin M, Berto I, Gallina P, Manzato E, Mussap M. Renal protection in diabetes: Role of glycemic control. Journal of the American Society of Nephrology. 2006 Apr;17(SUPPL. 2). https://doi.org/10.1681/ASN.2005121343
Fioretto, Paola ; Bruseghin, Marino ; Berto, Ilaria ; Gallina, Pietro ; Manzato, Enzo ; Mussap, Michele. / Renal protection in diabetes : Role of glycemic control. In: Journal of the American Society of Nephrology. 2006 ; Vol. 17, No. SUPPL. 2.
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