One of the most noteworthy milestones reported during 2006 was a reduction in nephropathy (kidney failure) among patients with diabetes. Together, diabetes and high blood pressure account for an astonishing 72% of all new cases of kidney failure. Arguably, one of the most severe complications of diabetes, for nearly 20 years, the rate of annual increases in this particular complication was between 5%-10%.
However, the most encouraging trend in nephropathy was seen in diabetes cases, where the rates for new cases of kidney failure among caucasian patients under age 40 is now the lowest level observed in 20 years! Researchers like to attribute this to improved control of blood glucose and blood pressure, and no doubt this is one of the more important factors. However, the use of anti-hypertensive drugs such as ACE inhibitors to prevent or delay kidney failure is as important, if not moreso, given the abundance of scientific evidence proving the beneficial effects these drugs have on the kidneys. With proper care, fewer than 10% of people with diabetes will develop kidney failure.
This finding is consistent with the finding from the
Quest Diagnostics Health Trends™ Diabetes Report, which in May 2006, reported that
people with diabetes who regularly visit health professionals are actually doing a better job of managing their disease based on 14.3 million test results from 2001-2005 from the nation's largest database of clinical lab results. But its worth mentioning that this trend appears to be largely confined to people who are active participants in their diabetes care.
An ominous threat is looming, notably, the rapid growth of uncontrolled type 2 diabetes, especially among lower-income minorities who often lack access to proper basic care (see my previous blog post on
World Diabetes Day which outlines some of the challenges that the uninsured have, many of whom are employed, when it comes to receiving diabetes care). For example, a meta-analysis of 11 studies that compared HbA1c levels between blacks and whites showed blacks averaged 0.65% higher HbA1c levels than whites according to Julenne Kirk, Pharm.D. his and colleagues as reported in the
September 2006 issue of Diabetes Care. They found that blacks with diabetes have worse control of blood sugar than whites, a factor that may help explain the disease's disparity between African Americans and Caucasians in morbidity and mortality, according to researchers at Wake Forest University. This trend could rapidly erase the recent gains made in new cases of kidney failure among diabetes patients.
Kidney Disease 
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