Retrospective analysis on the effect of Reverse Diabetes2 Now on kidney function in patients with type 2 diabetes with impaired kidney function.

IF 3.3 Q2 NUTRITION & DIETETICS
Nathalie Wilmsen, Hanno Pijl, Willem Geerlings, Gerjan Navis
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Abstract

Objective: Type 2 diabetes is one of the main causes of kidney damage. Recent intervention studies suggest that the progression of type 2 diabetes can be halted, or even brought into remission by lifestyle interventions. In a pragmatic trial, the Reverse Diabetes2 Now programme (RD2N, NL: Keer Diabetes2 Om), a multicomponent lifestyle intervention, reduced the need for bloodglucose lowering medications up to 24 months.

Research design and methods: Here, we retrospectively investigate the effect of RD2N on markers of kidney function in patients selected for impaired kidney function at baseline (eGFR <70 mL/min/1.73 m2 (n=45). Baseline data were retrieved from the intervention database and follow-up data on renal markers were collected from routine medical records. Wilcoxon non-parametric tests were used to assess changes over 6 and 12 months.

Results: After 6 months median eGFR increased significantly from 62.0 (IQR 55.5-65.0) to 69.0 (IQR 55.0-76.5) mL/min/1.73 m2 (p=0.002). Median albumin/creatinine ratio (n=26) remained within the normal range (<3 mg/mmol). The effect on eGFR was similar after exclusion of patients in whom medication was changed (median eGFR 62.0 ((IQR 59.5-66.0) to 69.0 (IQR 60.0-77.0) mL/min/1.73 m2, p=0.006, n=29), suggesting that the effect on eGFR is not related to medication changes. At 12 months, eGFR was not significantly changed (n=22, median eGFR 63.5 mL/min/1.73 m2 (IQR 58.5-71.0), p=0.067).

Conclusions: The retrospective nature of this study and the despite guidelines limited availability of renal markers in routine type 2 diabetes care are limiting. Nevertheless, these data support a favourable effect of RD2N on renal function. Further research, with proper documentation of renal function, urinary protein excretion and dietary intake, is needed to substantiate these results, ideally in a large-scale prospective cohort study.

Abstract Image

Abstract Image

2型糖尿病合并肾功能损害患者应用逆转糖尿病2 Now对肾功能影响的回顾性分析
目的:2型糖尿病是肾脏损害的主要原因之一。最近的干预研究表明,生活方式干预可以阻止2型糖尿病的进展,甚至使其得到缓解。在一项实用的试验中,逆转糖尿病计划(RD2N, NL: Keer Diabetes2 Om),一种多组分生活方式干预,减少了长达24个月的降糖药物需求。研究设计和方法:在这里,我们回顾性研究了RD2N对基线肾功能受损患者的肾功能标志物(eGFR 2 (n=45))的影响。基线数据从干预数据库中检索,肾脏标志物的随访数据从常规病历中收集。使用Wilcoxon非参数检验评估6个月和12个月的变化。结果:6个月后,中位eGFR从62.0 (IQR 55.5-65.0)显著上升至69.0 (IQR 55.0-76.5) mL/min/1.73 m2 (p=0.002)。白蛋白/肌酐比值中位数(n=26)保持在正常范围内(2,p=0.006, n=29),提示对eGFR的影响与药物变化无关。12个月时,eGFR无显著变化(n=22,中位eGFR 63.5 mL/min/1.73 m2 (IQR 58.5-71.0), p=0.067)。结论:本研究的回顾性性质和尽管指南限制了肾脏标志物在常规2型糖尿病护理中的可用性是有限的。然而,这些数据支持RD2N对肾功能的有利影响。需要进一步的研究,包括肾功能、尿蛋白排泄和饮食摄入的适当记录,来证实这些结果,最好是进行大规模的前瞻性队列研究。
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来源期刊
BMJ Nutrition, Prevention and Health
BMJ Nutrition, Prevention and Health Nursing-Nutrition and Dietetics
CiteScore
5.80
自引率
0.00%
发文量
34
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