Intensive therapy can preserve kidney function in patients with type 1 diabetes

Maintaining normal blood glucose levels prevents long-term kidney complications

People with type 1 diabetes are at high risk of developing kidney disease, but no therapies are proven to prevent impaired kidney function in these patients.

In the Diabetes Control and Complications Trial (DCCT), Ian de Boer, MD (University of Washington) and his team looked to see if intensive diabetes therapy aimed at reducing blood sugar as close to the normal range as possible might protect type 1 diabetics' kidney function. The study's results were presented during the American Society of Nephrology's Annual Kidney Week.

The researchers randomly assigned 1,441 individuals with type 1 diabetes to this intensive diabetes therapy or to conventional diabetes therapy, aimed at preventing symptoms of high blood sugar. Patients were treated for an average of 6.5 years. Subsequently, 1,375 participants were followed in the observational Epidemiology of Diabetes Interventions and Complications Study (EDIC).

Over an average of 22 years in DCCT/EDIC, intensive therapy was more effective at preserving long-term kidney function in study participants. A total of 24 participants assigned to intensive therapy and 46 assigned to conventional therapy developed impaired kidney function, meaning that intensive diabetes therapy reduced patients' risk by 50%. Of those with impaired kidney function, 8 assigned to intensive therapy and 16 assigned to conventional therapy developed kidney failure.

"This study demonstrates that impaired kidney function can be prevented in type 1 diabetes and reinforces the importance of maintaining good glucose control early in the course of type 1 diabetes to prevent long-term kidney complications," said Dr. de Boer.