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Diabetes Mellitus, Type 1 > Drug Therapy Author: Maureen D. Passaro, MD; Robert E. Ratner, MD
Editorial changes - 2012-02-07
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Rationale:

  • With a combination of ACE inhibition and intensive BP control, many patients can achieve regression of clinical evidence of diabetic nephropathy.

Evidence:

  • Diabetic nephropathy comprises approximately 35% of all new end-stage renal disease cases in the U.S. (115).
  • Microalbuminuria and proteinuria are predictive of a decline in renal function (116).
  • One study followed 44 patients over 7 years and showed that microalbuminuria predicts the development of diabetic nephropathy. An increased glomerular filtration rate and increased BP may contribute to progression (117).
  • The Angiotensin-Converting Enzyme Inhibition in Diabetic Nephropathy Study showed that with the combination of ACE inhibition and intensive BP control, many patients can achieve regression or apparent remission of clinical evidence of diabetic nephropathy (118).

Comments:

  • None.
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Abd A. Tahrani, MD, MRCP, editorial consultant, received a grant from the UK Novo Nordisk Research Foundation. Maureen D. Passaro, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Robert E. Ratner, MD, is a consultant for Amylin Pharmaceuticals, AstraZeneca, GlaxoSmithKline, Lifescan, Inc., NovoNordisk, Sanofi-Aventis, Takeda, owns stocks in Merck, Johnson & Johnson, Abbott, received grants from Amylin, AstraZeneca, Bayhill Therapeutics, Boehringer Ingelheim, Conjuchem, Inc., Eil Lilly, GlaxoSmithKline, Merck, NovoNordisk, Pfizer, Sanofi-Aventis, Takeda.
Deborah Korenstein, MD, FACP, Co-Editor, PIER, has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Richard B. Lynn, MD, FACP, Co-Editor, PIER, has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.

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