Abstract
The relationship between albuminuria and the control of plasma glucose was chronologically followed up for 8 years in NIDDM patients without hypertension. In patients with normoalbuminuria in the second spotted urine in the morning (urinary albumin index: UAI<15mg/g·creatinine), 5 of 11 patients (45%) whose glycemic control was good (HbA1<9.0% and FPG<140mg/dlthroughout the observation period) and 13 out of 22 patients (59%) with poor control became microalbuminuric (15≤UAI≤200) after 8 years, respectively. Among patients already suffering from microabluminuria, 5 out of 10 patients (50%) with poor control became macroalbuminuric (UAI≥200), excreting more than twice the amount of urinary albumin, though no significant change was observed in the good-control group. The serum levels of laminin P1 in patients with poor control also significantly increased simultaneously. Thus, the development or acceleration of albuminuria in NIDDM resulted from poor glycemic control, independent of hypertension, which indicates the importance of good glycemic control.