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Medicinski pregled 2005 Volume 58, Issue 11-12, Pages: 572-575
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Effect of glycemic control on microalbuminuria and arterial blood pressure in patients with type 1 diabetes

Vasović Olga, Zamaklar Miroslava, Lalić Katarina, Milošević Dragoslav, Žikić Ljiljana, Popović Ljiljana

Introduction Diabetic nephropathy is the leading cause of hypertension in type 1 diabetes. Microalbuminuria is usually the first manifestation of renal disease and antedate hypertension. The aim of this study was to investigate relationships between glycemic control, hypertension and microalbuminuria in type 1 diabetics. Material and methods We studied 27 type 1 diabetics, 18 male and 9 female, aged 18-50 years, with a duration of diabetes <20 years. Glycemic control was assessed using glycosylated hemoglobin (HbAlc) measurements, fructosamine and lipid analysis. 24-h urinary albumin excretion rate was evaluated by radioimmunoassay. Patients with persistent urinary albumin excretion rate 30-300 nig/24 h were defined as microalbuminuric (Group A -41% patients) and lower than that, as normoalbuminuric (Group B -59%). We examined them twice: first in poor glycemic control and then in good glycemic control. Results We found significant differences (Student's t-test) between groups in regard to microalbuminuria (p<0.01), diabetes duration (p<0.05), systolic blood pressure (BP) and diastolic BP (p<0.05). Systolic BP (p<0.01), diastolic BP (p<0.01) and microalbuminuria (p=0,05) positively correlated (Spearman's rho) with poor glycemic control in Group A. In both groups there was a significant improvement in glycemic control and regression in systolic and diastolic BP (p<0.01), but only Group B showed significant reduction in urinary albumin excretion rate (p<0.0l). Discussion and conclusion In this study, type 1 diabetics showed regression in systolic and diastolic hypertension with improvements of glycemic control regardless of presence of microalbuminuria, but only normoalbuminuric showed significant reduction in urinary albumin excretion rate.

Keywords: diabetes melliius, insulin-dependent: hypertension, albuminuria, blood glucose, hemoglobin A, glycosylated, fructosamine

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