Implementation of Guidelines for the Prevention of Diabetic Nephropathy
- Johan Fagerudd, MD, DMSC,
- Carol Forsblom, MD, DMSC,
- Kim Pettersson-Fernholm, MD,
- Per-Henrik Groop, MD, DMSC and
- for the FinnDiane Study Group
- From the Folkhälsan Research Center, University of Helsinki, Helsinki, Finland; and the Department of Medicine, Division of Nephrology, Helsinki University Central Hospital, Helsinki, Finland
- Address correspondence and reprint requests to Per-Henrik Groop, MD, DMSc, Folkhälsan Research Center Biomedicum Helsinki (C318b), P.O. Box 63 FIN-00014, University of Helsinki, Helsinki, Finland. E-mail: per-henrik.groop{at}helsinki.fi
Effective treatment of hyperglycemia, cessation of smoking, and treatment of elevated blood pressure are important means to prevent and retard the progression of diabetic kidney disease in type 1 diabetes (1–4). Guidelines regarding management of these risk factors have become increasingly common, but little is known about how efficiently they are implemented in clinical practice.
The national guidelines for the prevention of diabetic nephropathy published in 1991 by the Finnish Diabetes Association state the following: 1) aim for strict glycemic control (HbA1c 7.0–7.5%); 2) encourage the patient to stop smoking; 3) in patients with elevated albuminuria, initiate antihypertensive therapy with ACE inhibitors as first-line agents if blood pressure exceeds 140/90 mmHg, with the target for treatment <130/80–85 mmHg. The aim of the present study was to examine to what extent these guidelines are implemented in a large cohort of adult type 1 diabetic patients.
RESEARCH DESIGN AND METHODS
The Finnish Diabetic Nephropathy (FinnDiane) study is a nation-wide, prospective, multicenter study initiated in November 1997 with the primary aim to identify genetic and environmental risk factors for diabetic nephropathy in type 1 diabetes (5 …
