Understanding Artificial Pancreas Systems: Results from a 24-Month Trial

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No significant baseline differences were reported between groups in demographic, clinical, body composition, biochemical, renal function, or echocardiographic variables.

At 12 months, microalbuminuria changed 24.10 ± 43.28 in P-G and −43.18 ± 52.13 mg/24 h in PTF-G (< 0.001).

Microalbuminuria decreased in the pentoxifylline group while it increased in placebo at both 6 and 12 months, with clear between-group differences.

At 12 months, eGFRCysCCr changed −6.55 ± 10.18 in P-G and 0.98 ± 8.17 mL/min/1.73 min PTF-G (= 0.008).

Estimated GFR was better preserved with pentoxifylline. The 6-month comparison was not clearly different, but the 12-month comparison favored pentoxifylline.

At 12 months, LVMI changed 20.79 ± 20.06 in P-G and −0.82 ± 25.95 g/min PTF-G (= 0.028).

Left ventricular mass index increased in placebo but stayed roughly stable or slightly decreased with pentoxifylline at 6 and 12 months.

No differences were found between the groups in NT-proBNP concentrations at any of the periods evaluated.

The results excerpt reports no differences between groups in NT-proBNP concentrations at the evaluated time periods.

No serious adverse events (such as deaths, needs of dialysis, cardiovascular events, infections, or hyper or hypoglycemia) were seen.

No serious adverse events were reported in either group, including deaths, dialysis, cardiovascular events, infections, hyperglycemia, or hypoglycemia.

Oral pentoxifylline 1200 mg per day, administered as 400 mg every 8 hours, tested as an add-on to standard CKD therapy.

Positive: 3; Negative: 0; No effect: 2; Mixed: 0

Extracted 5 outcome signals across the study

Renal and cardiac surrogate outcomes mostly favored pentoxifylline, while NT-proBNP and several other variables showed no difference.

↓ Albuminuria at 6 and 12 months compared with placebo

↑ Estimated glomerular filtration rate preservation at 12 months compared with placebo

Mostly intermediate or surrogate outcomes

Microalbuminuria increased in placebo but decreased in the pentoxifylline group at 6 and 12 months.

Estimated GFR declined more in placebo than with pentoxifylline, with the 12-month difference favoring pentoxifylline.

Left ventricular mass index increased in placebo but stayed roughly stable in the pentoxifylline group.

Short- and Middle-Term Nephroprotective and Cardioprotective Effects of Pentoxifylline in Patients with Diabetic Nephropathy: A Randomized Controlled Trial. Med Sci (Basel). 2026;14(1):26. doi:10.3390/medsci14010026

Per-protocol analysis may be less protective against bias than intention-to-treat analysis.

Final analyzed sample was small, with 93 participants.

Outcomes were surrogate kidney and cardiac markers, not dialysis, major cardiovascular events, or mortality.

The trial was conducted in one health system, which may limit generalizability.

In adults with type 2 diabetes and advanced diabetic nephropathy, pentoxifylline lowered albuminuria and helped preserve kidney function and left ventricular mass compared with placebo.

↓ Left ventricular mass index worsening at 6 and 12 months compared with placebo

The Pentoxifylline group received 1200 mg per day, administered orally in three divided doses.

Pentoxifylline group (PTF-G)

The Placebo group received identical tablets containing an inert compound every eight hours.

Placebo group (P-G)

Limited population scope (moderate): Narrow population scope

No post-intervention follow-up (moderate): 0 weeks of follow-up after treatment ended

Relies on surrogate outcomes (moderate): No hard clinical outcomes reported

Pentoxifylline may protect kidney and heart health in diabetic nephropathy

This randomized trial tested pentoxifylline against placebo in adults with type 2 diabetes and advanced diabetic kidney disease. Over 12 months, pentoxifylline improved albuminuria, preserved estimated kidney filtration, and prevented worsening left ventricular mass, with no serious safety signal reported.

This was an exploratory trial using surrogate outcomes.

The study excluded people with recent acute complications, uncontrolled hypertension, and clinical symptoms of heart disease.

Participants continued standard CKD therapy, including ACE inhibitors or ARBs in most cases.

Newer kidney-protective drugs were not available in the institution during the trial.

Pentoxifylline versus placebo in diabetic nephropathy with kidney and cardiac markers.

Intervention	Outcome	Measured Change	Study Effect
Pentoxifylline (Medications)	Albuminuria (Clinical Outcomes)	Decrease	Strong
Pentoxifylline (Medications)	Estimated glomerular filtration rate (Clinical Outcomes)	Increase	Mixed
Pentoxifylline (Medications)	Left ventricular mass index (Metabolic Health)	Decrease	Mixed
Pentoxifylline (Medications)	NT-proBNP (Metabolic Health)	Uncertain	Limited
Pentoxifylline (Medications)	Serious adverse events incidence (Safety)	Uncertain	Limited

Pentoxifylline may protect kidney and heart health in diabetic nephropathy

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