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Systematic review with meta-analysis
Intensive glucose control in patients with type 2 diabetes is associated with a reduction in albuminuria and may be associated with reduced end-stage renal disease
  1. Clement Lo,
  2. Sophia Zoungas
  1. School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  1. Correspondence to: Professor Sophia Zoungas
    School of Public Health and Preventive Medicine, Monash University, 43–51 Kanooka Grove, Melbourne, Victoria 3168, Australia;sophia.zoungas{at}monash.edu

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Context

Diabetic nephropathy is the commonest cause of end-stage renal disease (ESRD)1 making the prevention of its onset and progression, critically important. While epidemiological studies have linked hyperglycaemia to diabetic nephropathy, randomised controlled trials (RCTs) to date have reported the beneficial effects of intensive glycaemic control on early stages of nephropathy, that is, albuminuria levels but not ESRD. On the basis of this evidence, guidelines have recommended a glycated haemoglobin (HbA1c) of <7% to prevent renal outcomes. This systematic review specifically examines whether intensive glycaemic control improves a range of early and advanced renal outcomes in patients with type 2 diabetes (T2DM).

Methods

RCTs meeting the pre-specified inclusion criteria (randomisation of patients with T2DM to intensive or …

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