ESPE Abstracts

Aim: The work was initiated to study efficacy of prestarium in normoalbuminuric patients with type 1 diabetes mellitus by ACE genotype upon primary diabetic nephropathy (DN) prevention.

Materials and methods: We examined normoalbuminuric 22 patients with type 1 diabetes mellitus aged from 12 to 17 years with DN duration ≧ 10 years divided into two groups by ACE polymorphism, that is, the one with II genotype (n=11) and the one with DD genotype (n=11). Activity of urinary neutral α-glucosidase was measured by rate of glucose production from maltose. PCR was performed by means of GenePackTM PCR Core reagent kit. All patients were prescribed with prestarium in the dose of 2.5 mg/day for 6 months.

Results and discussion: Systolic arterial pressure and diastolic arterial pressure were found reduced by 4.2% and 3.6%, respectively, heart rate decreasing by 6.4%. Pre- and post-therapy blood fibrinolytic activity was 15.3±0.8% and 14.9±0.6%, respectively, fibrinogen concentrations being respectively, 3.02±0.2 g/l and 3.08±0.2 g/l. Total cholesterol was found decreased by 4.4%, HbA1c being reduced by 16.7%. There was 7.1% and 6.8% reduction in proteinuria in the first and second groups of patients, respectively. Glomerular filtration rate and creatinine were found decreased by 9.2% and 4.6% in the 1st group, reducing by 2.2% and 1.2% in the 2nd one. Urinary neutral α-glucosidase in patients with II genotype was registered reduced by 63.6%, confident reduction by 10.5% being found in patients with DD genotype to be 8.5 times higher (P4=0.0001) than the parameter in the 1st group.

Conclusions: In normoalbuminuric diabetic patients with II genotype prestarium facilitated moderate reduction in systolic and diastolic arterial pressure as well as in heart rate. In these patients total cholesterol reduced by 4.4% versus 0.8% in patients with DD genotype. There was 16.7% and 4.7% reduction in HbA1c level, respectively.