Intensive diabetes therapy to control blood glucose halves the risk of kidney problems later in life, shows study.
The Diabetes Control and Complications Trial (DCCT) and Epidemiology of Diabetes Interventions and Complications (EDIC) Research Group said that compared to conventional therapy, near-normal control of blood glucose beginning soon after diagnosis of type 1 diabetes and continuing an average six and a half years reduced by half the long-term risk of developing kidney disease,
The risk of kidney failure was also halved, but the difference was not statistically significant, perhaps due to the relatively small total number of patients who reached that stage of the disease.
Participants entered the DCCT on average six years after onset of diabetes when complications of diabetes were absent or very mild. Half aimed for near-normal glucose control (intensive therapy) and the others received what was then standard glucose control.
After an average 22-year follow-up, 24 in the intensive group developed significantly reduced kidney function and 8 progressed to kidney failure requiring dialysis or transplantation. On conventional therapy, 46 developed kidney disease, with kidney failure in 16.
"Achieving near-normal glucose levels in type 1 diabetes can be challenging. But our study provides strong evidence that reinforces the benefits of reaching the goal as early as possible to slow or prevent kidney disease and other complications," said first author Ian H. de Boer, M.D., a kidney specialist at the University of Washington, Seattle.
The finding was published online in the New England Journal of Medicine Nov. 12 to coincide with presentation at a scientific meeting.