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 June 14, 2003
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Good News for Diabetics
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(Ivanhoe Newswire) -- The early stages of kidney disease often seen in people with type 1 diabetes can be reversed, shows a new study from the Joslin Diabetes Center in Boston.

That's good news for the roughly 1 million Americans living with type 1 diabetes who are at significantly increased risk of developing end-stage kidney disease requiring either a kidney transplant or dialysis. Statistics show about one out of every three patients with type 1 diabetes develops this condition.

People with type 1 diabetes often suffer from a condition known as microalbuminuria, which is characterized by the leakage of small amounts of proteins from the blood into the urine. Over time, this can lead to kidney disease, with some studies suggesting between a 60-percent and 85-percent risk of progression within six to 14 years. Doctors have traditionally believed the progression could be slowed with treatment, but that it could not be stopped.

In this study, researchers examined nearly 400 patients who had been showing signs of microalbuminuria for two years. All were followed for an additional six years to gauge the progression of the condition and to determine how it was impacted by different treatments. The investigators were surprised to find 58 percent of the group experienced a decline in the leakage of protein over this period, and that it occurred even in those not taking ACE-inhibitors, a drug thought to help treat the condition.

Factors that were associated with a steady improvement included an early diagnosis of microalbuminuria and good control of blood sugar, blood pressure, and, most significantly, cholesterol, a factor known to impact advanced kidney disease, but not previously noted as important in the control of microalbuminuria.

The investigators believe these findings will point the way to more effective treatments for the early stages of kidney disease in type 1 patients. Researchers write, "In the meantime, the study highlights the need for frequent screening and early intervention for microalbuminuria. Once it is identified, the treatment plan should be directed toward improving multiple factors -- blood sugar control, blood pressure control, and cholesterol lowering -- rather than relying on ACE-inhibitor treatment alone."

This article was reported by Ivanhoe.com, who offers Medical Alerts by e-mail every day of the week. To subscribe, go to: http://www.ivanhoe.com/newsalert/.

SOURCE: New England Journal of Medicine, 2003;348:2285-2293

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