Abstract | BACKGROUND: METHODS: A total of 145 CKD subjects (83 men e 62 women) with DM2 treated with oral antidiabetic drugs were included in the study and followed up to 1 year. All patients were randomly assigned 1:1 to either open-label (A) oral bicarbonate to achieve serum bicarbonate levels of 24-28 mmol/L (treatment group) or (B) no treatment (control group). The Homeostatic model assessment (HOMA) index was used to evaluate IR at study inception and conclusion. Parametric and non-parametric tests as well as linear regression were used. RESULTS: At baseline no differences in demographic and clinical characteristics between the two groups was observed. Average dose of bicarbonate in the treatment group was 0.7 ± 0.2 mmol/kg. Treated patients showed a better metabolic control as confirmed by lower insulin levels (13.4 ± 5.2 vs 19.9 ± 6.3; for treated and control subjects respectively; p < 0.001), Homa-IR (5.9[5.0-7.0] vs 6.3[5.3-8.2]; p = 0.01) and need for oral antidiabetic drugs. The serum bicarbonate and HOMA-IR relationship was non-linear and the largest HOMA-IR reduction was noted for serum bicarbonate levels between 24 and 28 mmol/l. Adjustment for confounders, suggests that serum bicarbonate rather than treatment drives the effect on HOMA-IR. CONCLUSIONS: Serum bicarbonate is related to IR and the largest HOMA-IR reduction is noted for serum bicarbonate between 24 and 28 mmol/l. Treatment with bicarbonate influences IR. However, changes in serum bicarbonate explains the effect of treatment on HOMA index. Future efforts are required to validate these results in diabetic and non-diabetic CKD patients. TRIAL REGISTRATION:
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Authors | Antonio Bellasi, Lucia Di Micco, Domenico Santoro, Stefania Marzocco, Emanuele De Simone, Mario Cozzolino, Luca Di Lullo, Pasquale Guastaferro, Biagio Di Iorio, UBI study investigators |
Journal | BMC nephrology
(BMC Nephrol)
Vol. 17
Issue 1
Pg. 158
(10 22 2016)
ISSN: 1471-2369 [Electronic] England |
PMID | 27770799
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Bicarbonates
- Hypoglycemic Agents
- Sodium Bicarbonate
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Topics |
- Acidosis
(blood, drug therapy)
- Aged
- Bicarbonates
(blood)
- Diabetes Mellitus
(blood, drug therapy)
- Female
- Follow-Up Studies
- Humans
- Hypoglycemic Agents
(therapeutic use)
- Insulin Resistance
(physiology)
- Male
- Middle Aged
- Renal Insufficiency, Chronic
(blood, drug therapy)
- Sodium Bicarbonate
(therapeutic use)
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