Westberg N G
Acta Endocrinol Suppl (Copenh). 1980;238:85-101.
Already at the time of diagnosis of juvenile onset diabetes mellitus, there are morphological and functional changes in the kidney. The kidneys and the individual glomeruli are considerably enlarged, and the glomerular filtration increased. In experimental diabetes mellitus the metabolism of the glomerular basement membrane is increased. These abnormalities are reversible by meticulous metabolic control. Their relationship to the diabetic glomerulosclerosis that causes uremia twenty to thirty years later is not clear. Carefully analyzed extensive clinical experience confirms that good metabolic control delays the onset of symptomatic diabetic renal disease, as expected from experimental studies. Normalization of even a slightly elevated blood pressure may be important to slow the progression of the renal insufficiency. Better methods for the management of the diabetic state and better education of the patients may be important to postpone the heroic endeavours of renal or pancreatic transplantation or dialysis.
在青少年型糖尿病被诊断出来时，肾脏就已经出现了形态和功能上的变化。肾脏和单个肾小球明显增大，肾小球滤过增加。在实验性糖尿病中，肾小球基底膜的代谢增加。通过精心的代谢控制，这些异常是可逆的。它们与二十到三十年后导致尿毒症的糖尿病肾小球硬化症之间的关系尚不清楚。仔细分析大量临床经验证实，良好的代谢控制会延迟症状性糖尿病肾病的发作，正如实验研究所预期的那样。即使血压稍有升高，使其恢复正常对于减缓肾功能不全的进展可能也很重要。更好地管理糖尿病状态以及更好地对患者进行教育，对于推迟进行肾脏或胰腺移植或透析等重大治疗手段可能很重要。
