Tight Blood-Sugar Control Shows Mixed Results for Health of Kidneys: Study

TUESDAY, May 29 (HealthDay News) — Intensive control of blood sugar
levels reduces the risk of certain signs of kidney damage among diabetics,
new research indicates.

However, the evidence did not show that intensive control lowers the
risk of actually developing severe kidney disease.

The two signs of kidney damage that the study focused on are conditions
known as microalbuminuria and macroalbuminuria. These are characterized by
excessive levels of protein in the urine, usually resulting from damage to
the filtering units of the kidneys, according to background information in
the study published May 28 in the Archives of Internal
Medicine
.

But, the review of data from seven clinical trials that included more
than 28,000 adult patients did not find conclusive evidence that intensive
blood-sugar control was related to a reduced risk of serious kidney
problems, including kidney failure or death from kidney failure.

“Our analysis demonstrates that, after 163,828 patient-years of
follow-up in the seven studies examined, intensive glycemic [blood sugar]
control lessens albuminuria,” but there’s not enough data to say if that
benefit extends to kidney disease or kidney failure, wrote Dr. Steven
Coca, of Yale University, and colleagues.

This may mean that there’s little point to beginning intensive
blood-sugar control in the mid-stage of type 2 diabetes in an attempt to
prevent kidney failure, they concluded.

However, an expert not involved in the study says the studies included
in this meta-analysis were too short to assess how intensive blood-sugar
control might affect the risk of kidney failure in patients with type 2
diabetes.

“Although implementing intensive therapy is difficult and imposes
burden and expense, all of the primary data continue to support its
long-term benefit,” Dr. David Nathan, of Massachusetts General Hospital,
wrote in an accompanying editorial.

Another expert agreed.

“I feel this [finding] is misleading since most of the studies included
in the analysis had relatively short durations of ‘intensive’ treatment
and also fairly short durations of follow-up,” said Dr. Tracy Breen,
director of diabetes care at North Shore-LIJ Health System in New Hyde
Park, N.Y.

She added that “microvascular complications often take many years to
develop – any analysis that includes trials with less than 10 years of
follow-up may not have the statistical power to show difference in
clinical events.”

More information

The American Diabetes Association has more about tight diabetes control.

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