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  • 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

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Therapeutics
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

http://dx.doi.org/10.1136/eb-2012-100904

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    Commentary on: Coca SG, Ismail-Beigi F, Haq N, et al. Role of intensive glucose control in development of renal end points in type 2 diabetes mellitus: systematic review and meta-analysis intensive glucose control in type 2 diabetes. Ann Intern Med 2012; 172:761–9.OpenUrlCrossRefWeb of Science

    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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    Footnotes

    • Competing interests S Zoungas has received speaker honoria and travel grants from Servier, MSD, Novartis, Novo Nordisk, Boehringer Ingleheim, Astra Zenica and BMS. She has also served on external advisory boards for MSD, Novo Nordisk and Boerhinger Ingleheim. The authors have no other relevant affiliations or financial involvement with any organisation or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.