Kidneys Benefit from Tight Control of Blood Sugar
People with type 1 diabetes who maintain good control of their blood sugar levels may be able to halve their risk for kidney complications.
This is important because the kidney complications of diabetes - whether type 1 or type 2 - can lead to kidney failure.
Researchers at the University of Washington in Seattle wanted to see how good blood sugar control would affect kidney health in people with type 1 diabetes, so they examined data from a long-term study called the Diabetes Control and Complications Trial and its follow-up, the Epidemiology of Diabetes Interventions and Complications.
The initial trial involved more than 1,400 people and ran for 6.5 years in the 1980s. Participants received either intensive diabetes management or conventional diabetes treatment. The follow-up study on 1,375 people collected 16 additional years of data.
During the initial trial, people in the intensive management group had average hemoglobin A1C levels (HbA1C) of 7.3 percent, and the conventional treatment group had an A1C average of 9.1 percent. A1C levels are an indicator of how well blood sugar is under control. During the follow-up study, both groups had A1Cs around 8 percent.
Poor blood sugar control can damage the filtering mechanism of the kidneys, so the researchers in the current study looked at the glomerular filtration rate (GFR), a measure of how well the kidneys function.
The researchers found that 24 people in the intensive therapy group developed an impaired GFR, compared with 46 people in the conventional therapy group.
"That's a risk reduction of 50 percent," says lead author Ian de Boer, M.D.
The risk of kidney failure - also called end-stage renal disease - in the intensive therapy group was also half that of the conventional therapy group: eight people vs. 16.
Dr. de Boer says that the study results, published in a recent issue of the New England Journal of Medicine, emphasize how important it is for people with diabetes to control blood sugar, especially in the first few years after diagnosis.
And, he adds, "the longer you're able to maintain good glucose control, the more benefit you're likely to derive."
Always talk with your health care provider to find out more information.