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International Journal of Latest Research in Science and Technology

DOI:10.29111/ijlrst   ISRA Impact Factor:3.35

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OPTIMUM RANGE OF HBA1C FOR PREVENTION OF DIABETIC NEPHROPATHYIN TYPE I AND TYPE II DIABETES MELLITUS

Research Paper Open Access

International Journal of Latest Research in Science and Technology Vol.5 Issue 1, pp 11-15,Year 2016

OPTIMUM RANGE OF HBA1C FOR PREVENTION OF DIABETIC NEPHROPATHYIN TYPE I AND TYPE II DIABETES MELLITUS

Basnet Dojindra, Adhikary Abhijit, Verma Dharmesh

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Received : 19 January 2016; Accepted : 28 January 2016 ; Published : 29 February 2016

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Abstract

Background and Aim:Diabetic nephropathy is one of the most common complications of diabetes mellitus. 30 to 40 % of all type 1 and type 2 diabetic patients develop diabetic nephropathy (1).Various studies have been done to find out relation between glycemic control and development of diabetic nephropathy. Recent studies indicate that an interplay between genetic predisposition and other factors such as hyperglycemia, blood pressure, age, gender, smoking, and ethnicity predispose to nephropathy both in type 1 and type 2 diabetes mellitus. It has also become clear that trace albuminuria (microalbuminuria) provides a unique opportunity to recognize incipient renal involvement early on, particularly in type 1 and less specifically in type 2 diabetes. Increasing evidence indicates that early intervention delays progression of nephropathy. The most important strategies to combat the medical catastrophe of increasing numbers of diabetic patients with end-stage renal failure include (i) prevention of diabetes, (ii) glycemic control to prevent onset of renal involvement and (iii) meticulous antihypertensive treatment to avoid progression of nephropathy. Methods: Literatures published from 1978 to 2015 was identified by searching in the following databases: MEDLINE, MEDLINE ALERT, SCI SEARCH, SOCIAL SCI SEARCH, AMED, EMBASE EMBASE Alert, Elsevier Bio base, Biotechnobase. HbA1c was taken as the sole indicator for glycemic control. References were taken from both the internet and textbooks. Result: Of the 43 literary articles that were reviewed, all the large scale population based studies unanimously favoured keeping the HbA1c levels between 7-8%. Conclusion: It can be safely concluded that keeping the glycemic levels in check brings favourable output for prevention of all the complication of diabetes including Diabetic Nephropathy. Meticulous calculations of population based studies hint that HbA1c levels below 7% is optimum for prevention of Diabetic Nephropathy.

Key Words   
Diabetes, Diabetic Nephropathy, Hyperglycemia, Blood sugar, End Stage Renal Disease (ESR
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References
  1. Andreas Schroeder, Marc Heiderhoff, Johannes Kobberling (2005), Determination of albuminuria in the urine of diabetics for prevention and control of nephropathy, GMS Health Technology Assessment volume. ISSN 1861-8863.
  2. Timothy C Evans, Peter Capell. Diabetic Nephropathy. Clinical diabetes, vol. 18, No.1, 2000.
  3. Diabetes Atlas. 5th edition http://www.idf.org/diabetesatlas.Brancati FL, Whelton PK, Randall BL, Neaton JD, Stamler J, Klag MJRisk of End Stage Renal Disease (ESRD) in diabetes mellitus, a prospective cohort study of men screened for Multiple Risk Factor Interventional Trial (MRFIT). JAMA, 1997; 278 (23) : 2069-74.
  4. Lawrence g. Hunsicker, (2004), Emerging trends for prevention and treatment of nephropathy: Blokade of the RAAS and BP control, Supplement to Journal of Managed Care Pharmacy (JMCP), September 2004,, Volume 10, No.5, S-a.
  5. Roger A. Rodby , Pharmacoeconomic Challenges in the Management of Diabetic Nephropathy, Supplement to Journal of Managed Care Pharmacy (JMCP), September 2004 , Volume 10, No.5, S-a.
  6. Zhuo L, Zou G, Li. W, et al. Prevalance of Diabetic Nephropapathy complicating non renal disease among Chinese patients with type2 diabetes mellitus, Eur J Med Res 2013 feb 22, 18:4, 1186/2047.
  7. Masakazu Haneda, Kazunori Utsunomiya, Daisuke Koya, et.al. A New Classification of Diabetic Nephropathy 2014: a report from Joint Committee on Diabetic Nephropathy, Journal of Diabetes Investigation Vol.6 No.2 March 2015.
  8. Kevin McLaughlin and Alan G. Jardine, Clinical management of diabetic nephropathy, Diabetes Obesity and Metabolism, 1, 1999, 307-315.
  9. Cohen MP, Ziyadeh FN. Role of Amadori-modified nonenzymatically glycated serum proteins in the pathogenesis of diabetic nephropathy. J Am Soc Nephrol 1996; 7: 183-190.
  10. Soulis T, Cooper M, Vranes D, Bucala R, Jerums G. The effects of aminoguanidine in preventing experimental diabetic nephropathy are related to duration of treatment. Kidney Int 1996; 50: 627-634.
  11. Goldfarb S, Ziyadeh FN, Kern EF, Simmons DA. Effects of polyol-pathway inhibition and dietary myo-inositol on glomerular hemodynamic function in experimental diabetes mellitus in rats. Diabetes 1991; 40: 465-471.
  12. Koya D, King GI. Protein kinase C activation and development of diabetic complications. Diabetes 1998; 47: 859-866.
  13. Ishii H, Jirousek MR, Koya D et al. Amelioration of vascular dysfunction in diabetic rats by an oral PKC beta inhibitor. Science 1996; 272: 728-731.
  14. Susane Schmidt, Abdullah Ismail, Eberhard Ritz. Diabetic Glomerulopathy: Pathogenesis and Management. Saudi Journal of Kidney Disease and Transplantation 2000; 11(3): 405-413.
  15. Seaquist ER, Goetz FC, Rich S, Barbosa, J. Familial clustering of diabetic kidney disease. Evidence for genetic susceptibility to diabetic nephropathy. N Engl J Med 1989; 320: 1161-5.
  16. Pettitt DJ, Saad MF, Bennett PH, Nelson RG, Knowler WC. Familial predisposition to renal disease in two generations of Pima Indians with type 2(non-insulin-dependent) diabetes mellitus. Diabetologia 1990; 33:438-43.
  17. Eto M, Saito M, Okada M, et al: Apolipoprotein E genetic polymorphism,remnant lipoproteins, and nephropathy in type 2 diabetic patients. Am J KidneyDis 40:243–251, 2002.
  18. Soedamah-Muthu SS, Colhoun HM, Taskinen MR, et al. Differences in HDL cholesterol: apoA-I + apoA-II ratio and apoE phenotype with albuminuric status in type 1 diabetic patients. Diabetologia 43:1353–1359, 2000.
  19. Hsieh MC, Lin SR, Yang YC, et al: Increased frequency of apolipoprotein E2 allele in type 2 diabetic patients with nephropathy in Taiwan. J Nephrol 15:368–373, 2002.
  20. Hung-Chun Chen, Jinn-Yuh Guh, Jer-Ming Chang, Min-Chia Hsieh, Shyi-Jang Shin, and Yung-Hsiung Lai. Role of Lipid control in diabetic nephropathy. Kidney International, Vol. 67, Supplement 94 (2005).
  21. Katia lopez- Revuelta, Patricia Pena Galdo, Ramona Stanescu, Leticia Parejo, Caemen Guerrero, Elia Perez-Fernandez. Silent Diabetic Nephropathy. World Journal of Nephrology, 2014 February 6; 3 (1): 6-15.
  22. Romano Nosadini, Giancarlo Tonolo. Relationship between Blood glucose control, pathogenesis and progression of diabetic nephropathy. Journal of American society of Nephrology 15: S1-S5, 2004.
  23. Mogensen CE. Microalbuminiria predicts clinical proteinuria and early mortality in maturity-onset diabetes. N Engl J Med 1986; 310: 356-360.
  24. Ziyadeh FN. The extracellular Matrix (ECM) in diabetic nephropathy. Am J Kidney Disease 1993; 22: 736-44
  25. Tae Sun Park. How much glycemic control is needed to prevent progression of diabetic nephropathy? Journal of Diabetes Investigation, Volume 3, Issue 5, October 2012
  26. Shurraw S, Hemmelgarn B, Lin M, et al. Association between glycemic control and adverse outcomes in people with diabetes mellitus and chronic kidney disease. Arch Intern Med 2011; 171: 1920–1927.
  27. Oh SW, Kim YC, Koo HS, et al. Glycated hemoglobin and the incidence of end-stage renal disease in diabetics. Nephrol Dial Transplant 2011; 26: 2238–2244.
  28. Ole Torffvit, Carl- David Agardh. The impact of metabolic and blood pressure control on incidence and progression of nephropathy, A 10- year study of 385 type 2 diabetic patients. Journal of Diabetes and Its Complications 15 (2001) 307-313.
  29. Warram JH, Scott LJ, Hanna LS, Wantman M, Cohen SE, Laffel LM, Ryan L, Krolewski AS: Progression of microabuminuria to proteinuria in type 1 diabetes: Nonlinear relationship with hyperglycemia. Diabetes 49: 94–100, 2000.
  30. Nosadini R, Velussi M, Brocco E, Bruseghin M, Abaterusso C, Saller A, Dalla Vestra M, Carraro A, Bortoloso E, Sambataro M,Barzon I, Frigato F, Muollo B, Chiesura-Corona M, Pacini G, Baggio B, Piarulli F, Sfriso A, Fioretto P: Course of renal function in type 2 diabetic patients with abnormalities of albumin excretion rate. Diabetes 49: 476–484, 2000
  31. Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, Cull CA, Hadden D, Turner RC, Holman RR: Association of glycemia with micro and macrovascular complications of type 2 diabetes: Prospective observational studies. Br Med J 321: 405–412, 2000.
  32. Reichard P, Nilsson B-Y, Rosenqvist U. The effect of long-term intensified insulin treatment on the development of microvascularcomplications of diabetes mellitus N Engl J Med 1993; 329: 304-309.
  33. Dahl-Jorgensen It, Bjoro T, Kierulf P, Sandvik L, Bangstad HJ,Hanssen KF. Long term glycemic control and kidney function in insulin-dependent diabetes mellitus. Kidney Int 1992; 41: 920-923.
  34. Feldt-Rasmussen B, Mathiesen ER, Jensen T, Lauritzen T, Deckert T. Effect of improved metabolic control on loss of kidney function in insulin-dependent diabetic patients Diabetologia 1991; 34: 164-170.
  35. Ming-Chia Hsieh, Yi-Ting Hsieh, Tzu-Jung Cho, Jung-Fu Chen, Shi-Dou Lin, Hung-Chun Chen and Shih-Te Tu. Remission of diabetic nephropathy in type 2 diabetic Asian population: role of tight glucose and blood pressure control. Eur J Clin Invest 2011; 41 (8): 870-878.
  36. Lewis EJ, Hunsicker LG, Bain RP, Rohde RD, for the Collaborative Study Group. The effect of angiotensin converting enzyme inhibition on diabetic nephropathy. New Engl J Med 1993; 329: 1456-1462.
  37. Chase HP, Jackson WE, Hoops SL, Cockerham RS, Archer PG, O’Brien D. Glucose control and renal and retinal complications of insulin-dependent diabetes. J Am Med Assoc 1989; 261: 1155-1160.
  38. The Diabetes Control, Complication Research Group. Effect of intensive therapy on the development and progression of diabetic nephropathy in the Diabetic Control and Complication Trial. Kidney Int 1995; 7: 1703-1720.
  39. Martin H. de Borst, Gerjan Navis. Risk of strict glycemic control in diabetic nephropathy. Nature Reviews Nephrology, vol.2 Jan 2015.
  40. Ohkubo Y, Kishikawa H, Araki E. Intensive insulin therapy prevents the progression of diabetic microvascular complications in Japanese patients with non-insulin-dependent diabetes mellitus: a randomized prospective 6-year study. Diabetes Res Clin Pract 1995; 28:103-17.
  41. Intensive blood glucose control with sulfhonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study Group. Lancet 1998; 352:837-53.
  42. Committee for Statistical Surveys, Japanese Society for Dialysis Therapy (JSDT). Current state of dialysis therapy in Japan, 2013 illustrated. Available at: http://docs.jsdt.or.jp/ overview/index.html.

 

To cite this article

Basnet Dojindra, Adhikary Abhijit, Verma Dharmesh , " Optimum Range Of Hba1c For Prevention Of Diabetic Nephropathyin Type I And Type Ii Diabetes Mellitus ", International Journal of Latest Research in Science and Technology . Vol. 5, Issue 1, pp 11-15 , 2016

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