Help for diabetics with kidney disease

Madam Lyda Bakar Mathilda surrounded by some of those involved in the study (from left) coordinator Nurfaziela Zainal, co-director Dr Loh Ping Tyug, director Prof A. Vathsala, co-director Dr Lim Chee Kong and manager Samantha Ong.
Madam Lyda Bakar Mathilda surrounded by some of those involved in the study (from left) coordinator Nurfaziela Zainal, co-director Dr Loh Ping Tyug, director Prof A. Vathsala, co-director Dr Lim Chee Kong and manager Samantha Ong.PHOTO: TIFFANY GOH FOR THE STRAITS TIMES

Study shows that getting optimal dose of drug could mean higher chance of normal life

For diabetics with early signs of kidney disease, getting the optimal dose of medicine could mean a higher chance of living a normal life later, a new study has found.

Kidney disease, which has few obvious symptoms in its early stages, can eventually lead to incapacitating conditions such as kidney failure, stroke or blindness.

However, initial results from about a third of the study's cohort of 10,500 show that its "optimised" treatment - where patients are given the highest dose of medicine that their body can safely tolerate - slowed the rate at which their kidney functions worsened by 28 per cent. Most of the other patients in the study are still undergoing treatment.

"That is very significant," said Professor A. Vathsala, a senior consultant at the nephrology division of National University Hospital. "We never expected to see such remarkable improvements... in such a short period of time."

Their condition improved in as short a time as a year after treatment was completed.

Researchers also found that the amount of protein in patients' urine, a telltale sign of diabetic kidney disease, was reduced - in some cases, to zero - in half the patients.

The study was a collaboration between the hospital and the National Healthcare Group Polyclinics (NHGP). From October 2011 to March this year, researchers selected - from nearly 100,000 diabetic patients of nine polyclinics - those with early-stage kidney disease for the study.

They were then put on a strict treatment regimen that gradually increased the amount of drugs they take to reduce protein leakage from the damaged kidney into the urine.

This was done gradually, said Dr Lim Chee Kong, deputy director of clinical services at NHGP, as doing it too quickly could cause side effects such as low blood pressure.

Kidney disease is the major source of complications for those with diabetes, and is thought to occur as high blood-sugar levels damage the organ. There are more than 400,000 diabetics here, but a third do not know they have the disease. Earlier this year, Health Minister Gan Kim Yong said his ministry was "declaring war" on diabetes.

One study participant was Madam Lyda Bakar Mathilda, 65, who was diagnosed with diabetes in the 1990s and started showing signs of kidney disease three years ago.

Now, her health markers are within healthy ranges and she has lost around 15kg. "I was a very plump person and I took things very easily," said the retired hotel executive. "But now I cut down on (carbohydrates), have more vegetables and go for walks two times a day."

A version of this article appeared in the print edition of The Straits Times on August 02, 2016, with the headline 'Help for diabetics with kidney disease'. Print Edition | Subscribe