From St. Petersburg, Russia:
What pharmacological methods or other programmes of prophylaxis of diabetic kidney disease and also of lower limbs and retina do exist, if a child (11 year) has been ill with an insulin dependent sugar diabetes since 8 years without any signs of diabetic kidney disease but with accompanying secondary pyelonephritis?
Small blood vessel pathology in the eyes and kidneys are very uncommon under the age of sixteen unless a child has been in very poor control indeed. The same is true of large blood vessel problems, which in any case do not appear until a later stage. Certainly the first step in prevention is to ensure the highest possible degree of control of blood sugars. The best source of help with this would be your diabetic care team; but with your good English you might like to download Understanding Insulin-Dependent Diabetes by H. Peter Chase, M.D.
After the age of 16 it is wise to monitor urine for the loss of small amounts of albumin, so-called microalbuminuria, and if this is sustained present practise is to start one of a group of drugs called angiotensin converting enzyme inhibitors. You will need to discuss this with the doctor.
Finally there is some evidence, that is still not firmly established, that the 'antioxidant' group of vitamins like vitamin C and E may have some prophylactic role. But good control in the early years should still be the main goal.
Original posting 8 Jul 1998
Posted to Research: Other
Last Updated: Tuesday April 06, 2010 15:08:58
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