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Blood sugar control might not protect kidneys from type 2 diabetes

Kathleen Blanchard's picture
Keeping blood sugars low with medication might not protect diabetic kidneys.

If you’re diabetic and keeping your sugars well under control, your kidneys may still be at risk for damage. That’s the conclusion of researchers from Yale University who found in a study review that intensive blood sugar control with Type 2 diabetes may not improve patient outcomes.

Intensive blood sugar control may not be the best approach

The study, led by Steven G. Coca of Yale, included a review of seven randomized clinical trials that included 28,065 adult patients who were monitored for two to 15 years.

The study authors found that taking higher doses of medications to control glucose for people with type 2 diabetes did not definitely improve the risk of kidney failure or death from kidney disease.

But the finding doesn’t mean controlling blood sugar levels and keeping HgA1c levels in check should be ignored.

"After pooling the results from the follow-up data in the seven studies examined, our analysis shows that intensive glycemic control may improve some things about the kidney that we measure, but did not affect patients' outcomes," said Coca in a media release.

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What the study may mean for patients is another approach for ensuring the kidneys are protected from the disease, such as blood pressure medication. Other ways to ensure your blood pressure stays lower is by limiting salt, engaging in regular physical activity and maintaining a healthy weight.

The National Kidney and Urologic Diseases Information Clearinghouse also recommends consuming a moderate protein diet; guided by a nutritionist.

Speak with your doctor about medications that can help and make sure your health care provider screens your kidneys regularly for diabetic nephropathy with a urine test that measures GFR or glomerular filtration rate. Check your urine regularly for the presence of protein, either at home or at the doctor's office. Protein in the urine can signal kidney damage.

Researchers have assumed intensive glucose management offers protection to the kidneys from damage caused by diabetes. The study review shows keeping blood sugars low may not be the best approach for protecting the kidneys from harm associated with type 2 diabetes.

Arch Intern Med. Vol. 172, No. 10
May 28, 2012

American Diabetes Association
Kidney Damage