THERAPY WITH GLYCOSAMINOGLYCANS LOWERS ALBUMIN EXCRETION RATE IN NON-INSULIN-DEPENDENT DIABETIC-PATIENTS WITH MACROALBUMINURIA

In order to evaluate the efficacy of glycosaminoglycans in diabetic ne phropathy, a preliminary two-step study was performed on micro and mac roalbuminuric Type II non-insulin dependent diabetic (NIDDM) patients. During the first phase, 11 patients (6 with microalbuminuria and 5 wi th macroalbuminuria) were treated with sulodexide 1000 Lipoprotein-lip ase Releasing Units (LRU)/day per os for 2 months; a follow-up period of 4 months was then observed. During the study period several paramet ers related to diabetic state (glycated haemoglobin, glycosuria, fasti ng blood glucose), to kidney function (albumin excretion rate: AER, gl omerular filtration rate: GFR, urinalysis, serum creatinine), to lipid metabolism and to liver function, were evaluated. In the 5 macroalbum inuric patients AER showed a marked decrease after sulodexide therapy, while 4 months after withdrawal of the drug, AER increased in all pat ients. A slight, albeit not significant, AER decrease after sulodexide therapy was also found in microalbuminuric patients. The degree of me tabolic control and blood pressure values did not change during the st udy. GFR and creatinine mean values also remained unmodified. Side eff ects were not observed. During the second phase, 5 Type II diabetic pa tients (3 micro, 2 macro) were treated with sulodexide 600 LRU/d by i. m. route for 21 days. AER was evaluated at both the start and end of t he treatment; a significant decrease was observed in all patients. The se preliminary results support the hypothesis that sulodexide lowers A ER in diabetic patients with overt nephropathy and macroalbuminuria.