Pediatric Diabetes

 The effect of 12 weeks carnosine supplementation on renal functional integrity and oxidative stress in pediatric patients with diabetic nephropathy: a randomized placebo-controlled trial
 
Background and Objectives Oxidative stress is a significant contributor to the pathogenesis of diabetic nephropathy. Carnosine is a natural radical oxygen species scavenger. We investigated the effect of carnosine as an adjuvant therapy on urinary albumin excretion (UAE), the tubular damage marker alpha 1-microglobulin (A1M), and oxidative stress in pediatric patients with type 1 diabetes and nephropathy. Methods This randomized placebo-controlled trial included 90 patients with diabetic nephropathy, despite oral angiotensin-converting enzyme inhibitors (ACE-Is), who were randomly assigned to receive either 12 weeks of carnosine 1?g/day (n?=?45), or matching placebo (n?=?45). Both groups were followed-up with assessment of hemoglobin A1c (HbA1c), UAE, A1M, total antioxidant capacity (TAC) and malondialdhyde (MDA). Results Baseline clinical and laboratory parameters were consistent between carnosine and placebo groups (P?>?.05). After 12 weeks, carnosine treatment resulted in significant decrease of HbA1c (8.2?±?2.1% vs 7.4?±?1.3%), UAE (91.7 vs 38.5?mg/g creatinine), A1M (16.5?±?6.8?mg/L vs 9.3?±?6.6?mg/L), MDA levels (25.5?±?8.1 vs 18.2?±?7.7?nmol/mL) while TAC levels were increased compared with baseline levels (P?