Frequency, Degree, and Progression With Time of Proteinuria in Diabetic Patients

Miki, Eishi; Ide, Takehiko; Kuzuya, Tsunehiko; Nakao, Kazuwa

doi:10.1016/s0140-6736(72)91493-6

Cited by 27 publications

(13 citation statements)

References 3 publications

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“…Among 14 prospective studies in patients with established retinal or glomerular lesions [21,22,35,[37][38][39][40][41][42][43][44][45][46][47][48] 4 drew negative conclusions. The UGDP study has just been mentioned [35].…”

Section: Clinical Studiesmentioning

confidence: 99%

“…All other studies have demonstrated that good or very good control slows down the rate of deterioration of established lesions [21,22,37,40,[43][44][45][46][47][48].…”

Section: Clinical Studiesmentioning

confidence: 99%

“…Miki et al have shown that after 6 years of follow up the patients with fair and poor control had a greater frequency of worsening proteinuria than those with good control. The difference was even more marked in the patients with the highest initial fasting blood glucose [45]. Takazakura et al have performed serial renal biopsies in 23 patients.…”

Section: Clinical Studiesmentioning

confidence: 99%

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Relation of diabetic control to development of microvascular complications

Tchobroutsky

1978

Diabetologia

399

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Summary. This review seeks to supply the arguments which support or deny the relationship between the quality of control of blood glucose levels and the course of diabetic microangiopathy. The ideal study is impossible to do in man but most prospective studies suggest that the better the control the slower the rate of progression and severity of lesions. "Scientific" but indirect arguments from biochemical, enzymatic and functional studies have shown that insulin and/or blood glucose control reverse some early diabetic changes that are probably related to the late events. Recent studies suggest that observations on animals that have shown the beneficial effect of treatment are relevant to the problem of diabetic microvascular lesions in man. Heredity influences the development of diabetic microangiopathy in diabetics but retinal and/or glomerular lesions -which are definitely not pathognomonic for diabetes -do not appear in the absence of hyperglycaemia. Muscle capillary basement membrane thickening that seems not to be a specific abnormality was not observed by several investigators in recently diagnosed diabetics. Therefore most of the arguments that have been given to support the point of view that tight control is not justified may be rejected. The opinion of the author is that strict control of diabetes is worthwile in patients with long life expectancy and no psychological, social or cultural handicaps.

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Section: Clinical Studiesmentioning

confidence: 99%

“…All other studies have demonstrated that good or very good control slows down the rate of deterioration of established lesions [21,22,37,40,[43][44][45][46][47][48].…”

Section: Clinical Studiesmentioning

confidence: 99%

Section: Clinical Studiesmentioning

confidence: 99%

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Relation of diabetic control to development of microvascular complications

Tchobroutsky

1978

Diabetologia

399

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“…Renal glomerular basement membrane thickness (RGBMT) of the rats injected with saline increased markedly, whereas RGBMT of the rats treated with elastase remained close to the initial value. In each of the three litter mates, RGBMT after the treatment was significantly thinner in the elastase injected rats than in the saline injected rats.---elastase; glomerular basement membrane ; spontaneously diabetic rat Many investigators suggested that the strict control of hyperglycemia could protect the development of diabetic microangiopathy (Miki et al 1972 ;Tchobroutsky 1978). In addition, hypophysectomy (Ireland et al 1976) and pancreatic transplantation (Mauer et al 1975) have also been attempted for this purpose.…”

mentioning

confidence: 99%

“…---elastase; glomerular basement membrane ; spontaneously diabetic rat Many investigators suggested that the strict control of hyperglycemia could protect the development of diabetic microangiopathy (Miki et al 1972 ;Tchobroutsky 1978). In addition, hypophysectomy (Ireland et al 1976) and pancreatic transplantation (Mauer et al 1975) have also been attempted for this purpose.…”

mentioning

confidence: 99%

Inhibitory effect of pancreatic elastase on thickening of the renal glomerular basement membrane in the spontaneously diabetic rat.

Oikawa

Kakizaki

Gotō

1982

Tohoku J. Exp. Med.

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--Effect of pork pancreatic elastase on thickening of the renal glomerular basement membrane was studied in three litter mates of the spontaneously diabetic rats by electron microscopic morphometry. Intramuscular injection of physiologic saline solution or elastase solution (5 mg/kg body weight/day) was repeated daily for 30 days. Renal cortex specimens were obtained before and after the injection in two litter mates. Renal glomerular basement membrane thickness (RGBMT) of the rats injected with saline increased markedly, whereas RGBMT of the rats treated with elastase remained close to the initial value. In each of the three litter mates, RGBMT after the treatment was significantly thinner in the elastase injected rats than in the saline injected rats.---elastase; glomerular basement membrane ; spontaneously diabetic rat Many investigators suggested that the strict control of hyperglycemia could protect the development of diabetic microangiopathy (Miki et al. 1972 ;Tchobroutsky 1978). In addition, hypophysectomy (Ireland et al. 1976) and pancreatic transplantation (Mauer et al. 1975) have also been attempted for this purpose. However, no direct therapy of the microangiopathy has been reported. The diabetic glomerular lesion, one of the microangiopathies, is characterized by thickening of the glomerular basement membrane and the increase in the amount of basement membrane-like matrix within mesangial regions (osterby 1973), and these changes are known to be induced by the accumulation of certain glycoproteins (Spiro 1963). Pancreatic elastase has a collagenolytic action in liver cirrhosis (Fukuhara 1975). Therefore, the enzyme might have a direct therapeutic effect on the diabetic glomerular lesion.In the present study, we examined the effect of pork pancreatic elastase on the renal glomerular basement membrane thickening of the spontaneously diabetic rat produced from normal Wistar rats by repetition of selective breeding in our laboratory (Goto et al. 1975;Goto and Kakizaki 1981). It has been shown that the renal glomerular basement membrane thickness (RGBMT) increased significantly

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