Arrest of glomerulopathy in diabetic dogs by improved glycaemic control.

In order to assess the extent to which the progression of diabetic glomerulopathy can be arrested or reversed by improved glycaemic control, glomerular structure has been assessed in dogs randomly divided between a non-diabetic group and three alloxan diabetic groups: dogs assigned to poor glycaemic control for five years (PC), dogs assigned to good glycaemic control for five years (GC), and dogs assigned to poor glycaemic control for 2.5 years followed by good glycaemic control for 2.5 years (P----GC). Glomerular volume, the fractional volume of mesangium as estimated by light microscopy and thickness of glomerular basement membrane as estimated by electron microscopy were significantly greater than normal at 2.5 years of poor glycaemic control, and were even greater at five years. Kidney weight and the frequency of glomerular obliteration were significantly greater than normal at five years of poor control. The development of these renal abnormalities was significantly inhibited if good glycaemic control was begun within the first weeks of diabetes. Good control following 2.5 years of poor control (group P----GC) arrested the progression of the renal abnormalities, but no reversal of the lesions toward normal was apparent.