Declining Incidence of Nephropathy in Insulin-Dependent Diabetes Mellitus

• Published in: The New England journal of medicine Vol. 330; no. 1; pp. 15 - 18
• Main Authors: Bojestig, Mats, Arnqvist, Hans J, Hermansson, Goran, Karlberg, Bengt E, Ludvigsson, Johnny
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 06-01-1994
• Subjects: Adolescent; Adult; Age; Albuminuria - epidemiology; Albuminuria - etiology; Associated diseases and complications; Biological and medical sciences; Catchment Area (Health); Child; Chromatography; Diabetes; Diabetes mellitus; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - epidemiology; Diabetes. Impaired glucose tolerance; Diabetic Nephropathies - epidemiology; Diabetic Nephropathies - etiology; Diabetic nephropathy; Drug dosages; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Female; Glucose; Hemoglobin; Hospitals; Humans; Hyperglycemia - therapy; Incidence; Insulin; Internal medicine; Laboratories; Life Tables; Male; Medical sciences; Medicine; Metabolism; Nephropathy; Patients; Population studies; Sweden - epidemiology; Urine; Sweden; Endocrinopathy; Human; Concomitant disease; Urinary system disease; Lung function; Insulin dependent diabetes; Renal disease; Epidemiology; Public health
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJM199401063300103

Diabetic nephropathy is the most common cause of end-stage renal failure in the Western world
1
. Among patients with insulin-dependent diabetes, those with proteinuria are at greatest risk for early death
2
,
3
. The cumulative incidence of nephropathy among patients with diabetes for 25 years decreased between 1940 and 1950, from 40 percent to 25 to 30 percent, and then remained stable until the 1980s
4
,
5
.
There have been substantial changes in the treatment of diabetes in the past 20 years. Self-monitoring by measurement of urinary glucose and, more recently, blood glucose has become routine; together with better education . . .