Effect of glycaemic control on glomerular filtration rate in Diabetes Mellitus patients

Background: Glomerular filtration rate (GFR) is a widely accepted parameter in assessing overall renal function. This study sought to assess the effect of glucose lowering on GFR in diabetic patients admitted for short term therapy at Mulago hospital. Methods: This was a descriptive study where consenting patients were consecutively recruited. Glomerular filtration rate was measured using creatinine clearance in 40 type I and II diabetes mellitus patients admitted on the basis of a glucometer reading of RBS ≥ 300mg/dl both at admission and discharge. Data was analyzed using a paired sample t-test and p-value set at 0.05 (95% CI). Results: A total of 40 patients were assessed. Their mean age was 49.8 years. 82.5% of them had type II DM while only 17.5% had type I DM. The average duration of disease was 7 years. GFR was found to decrease from 157.4ml/min on admission to 86.4ml/min at discharge (p=0.001). Random blood sugar levels decreased from 332.2mg/dl on admission to 119.8mg/dl at discharge (p=0.000). Conclusion/Recommendation: Results imply that glycaemic control lowers the GFR in diabetic patients admitted for short term treatment. A reduction in GFR reflects reduction of hyperfiltration, a process that starts diabetic nephropathy. Good glycaemic control will go along way to delay onset of diabetic nephropathy.