Eight-month correction of hyperglycemia in @entity1723 is associated with a significant and sustained reduction of urinary albumin excretion rates in XXXX with microalbuminuria.

@entity1 @entity644 @entity4051 @entity7617 @entity101 @entity6 @entity177 @entity1723 @entity2263 @entity413
Persistent Albustix-positive @entity644 and subsequent @entity177 are frequently encountered in @entity1723 ( @entity1723 ). Rates of decline of renal function may be modified by treatment of accompanying @entity101 , but studies of the effects of long-term continuous subcutaneous insulin infusion (CSII) on deterioration of renal function provide no statistically significant evidence of benefit of near-normoglycemia. However, short-term studies in @entity1723 subjects with negative Albustix tests but subclinically raised levels of albumin excretion rate (AER) have shown that treatment with CSII significantly reduces this microalbuminuria. The prospective, controlled 8-mo Kroc Collaborative Study therefore offered the opportunity of examining more protracted effects of CSII-induced metabolic correction upon microalbuminuria. Twenty-four-hour urine collections obtained at baseline, 4, and 8 mo were available from 59 Albustix-negative @entity1 . @entity2263 -microglobulin excretion was normal. The 39 normoalbuminuric (AER less than 12 micrograms/min) @entity1 did not differ from the 20 microalbuminuric (AER elevated between 13.2 and 192.6 micrograms/min) with respect to distributions of age, sex, and duration of @entity6 . In both the normoalbuminuric and the microalbuminuric groups studied at 4 and 8 mo, percent glycosylated hemoglobin (% @entity4051 ) and mean blood @entity413 were significantly decreased during CSII compared with baseline values, whereas no change occurred in the group continuing their @entity7617 ( @entity7617 ). AER did not differ between @entity7617 and CSII treatments in the normoalbuminuric group. AER fell significantly in the CSII-treated microalbuminuric @entity1 at 4 (P less than 0.05) and 8 (P less than 0.01) mo but showed no consistent change in the @entity7617 microalbuminuric group.(ABSTRACT TRUNCATED AT 250 WORDS)
