Prevention of deterioration of renal and sensory-nerve function by more intensive management of insulin-dependent diabetic patients. A two-year randomised prospective study.

Journal article

74 insulin-dependent diabetic patients with background retinopathy were randomised to continue with usual diabetic care (group U) or to a more intensive programme (group A) using ultralente insulin as basal cover and soluble insulin at mealtimes. Group A attended the clinic more frequently, received closer dietary supervision, and were taught home blood glucose monitoring. Group A had a significantly lower mean glycosylated haemoglobin level during the study, although the mean level also fell in group U towards the end of year 2. Renal and sensory-nerve function were significantly better preserved in group A than in group U. Significant improvements were also seen in low-density-lipoprotein-cholesterol and whole-blood low-shear viscosity. The rate of progression of retinopathy was similar in both groups. It appears that a modest improvement in diabetic control, obtainable in most clinics, has been associated with a reduction in the progression of diabetic tissue damage.

Authors: Holman, R; Dornan, T; Mayon-White, V; Howard-Williams, J; Orde-Peckar, C

• Publication status: Published
• Journal: Lancet (London, England)
• Volume: 1
• Issue: 8318
• Pages: 204-208
• Publication date: 1983-01-01
• DOI: 10.1016/S0140-6736(83)92586-2
• EISSN: 1474-547X
• ISSN: 0140-6736
• Language: English
• Keywords: Diabetic Nephropathies; Cholesterol, LDL; Cholesterol; Lipoproteins, LDL; Clinical Trials as Topic; Sensory Thresholds; Insulin, Long-Acting; Random Allocation; Humans; Prospective Studies; Blood Glucose; Female; Blood Viscosity; Male; Diabetes Mellitus; Diabetic Neuropathies; Hemoglobin A, Glycosylated; Home Care Services