Intensive insulin therapy reduces the urinary intercellular adhesion molecule-1 excretion in patients with Type 2 diabetes mellitus

Objective: To observe the change of urinary intercellular adhesion molecule-1 (ICAM-1) excretion in the patients with Type 2 diabetes mellitus (T2DM) compared to normal control group, and to investigate the effect and significance of insulin intensive therapy on the urinary ICAM-1 excretion. Method: We examined the urinary ICAM-1 and creatinine (Cr) of random urine in 20 patients with T2DM and 20 normal subjects using enzyme-linked immunosorbent assay. All diabetics were given intensive insulin therapy for 2 weeks, urinary ICAM-1 and Cr was examined once again at the end of observation. Results: Compared with the normal control group, not only the fasting blood glucose (FBG), post-prandial 2-h blood glucose (P2hBG), and glycosylated hemoglobin (HbA(1c)), but also the urinary ICAM-1 to urinary Cr ratio in patients with T2DM increased significantly (p<0.01). The urinary ICAM-1/urinary Cr ratio of diabetics had a positive correlation with FBG (r=0.51, P<0.01), P2hBG (r=0.496, p<0.01), and HbA(1c) (r=0.478, p<0.05), respectively. After 2 weeks of intensive insulin therapy in Type 2 diabetics, both the level of blood glucose and the level of urinary ICAM-1/urinary Cr ratio had a remarkable decrease compared with the basal values (p<0.01). Conclusion: Intensive insulin therapy is capable of alleviating the enhanced local inflammation reaction of renal tissue under hyperglycemia state with the reduction of urinary ICAM-1 excretion. (J. Endocrinol. Invest. 32: 877-880, 2009) (C) 2009, Editrice Kurtis