EFFECT OF OCTREOTIDE, CAPTOPRIL OR INSULIN ON RENAL CHANGES AND UAE IN LONG-TERM EXPERIMENTAL DIABETES

Renal and glomerular growth is inherent in early human and experimenta l diabetes frequently followed by later increase in urinary albumin ex cretion (UAE). Treatment with angiotensin converting enzyme (ACE) inhi bitors has proven effective in delaying progression of human and exper imental diabetic renal changes, and so has somatostatin analog treatme nt in experimental diabetes. The aim of the present study was to inves tigate three weeks of octreotide and captopril treatment alone or in c ombination following three months of untreated experimental diabetes, and compare the effects to those of insulin treatment. Diabetes induce d significant increases in renal and glomerular growth and urinary alb umin excretion. Octreotide and captopril alone and in combination redu ced renal but not glomerular size, and the combined administration red uced UAE. None of these schedules affected blood glucose levels. Insul in treatment inducing euglycemia significantly reduced renal and glome rular size and UAE. In conclusion, insulin treatment with normalizatio n of the diabetic metabolic derangement nearly normalizes renal and gl omerular growth and UAE after three months of untreated diabetes. The combined treatment of octreotide and captopril was also followed by a significant decrease in renal growth and reduction in UAE compared to placebo treatment without affecting the metabolic control of the diabe tic animals.