Diabetes Care, Vol 10, Issue 2 191-194, Copyright © 1987 by American Diabetes Association
Proteinuria in newly diagnosed type II diabetic patients
M Uusitupa, O Siitonen, I Penttila, A Aro and K Pyorala
Urinary excretion of albumin, IgG, and beta 2-microglobulin was examined in
132 (69 men, 63 women) newly diagnosed, middle-aged type II diabetic
patients and in 144 (62 men, 82 women) nondiabetic control subjects. Both
male (N = 57) and female (N = 29) diabetic patients with normal urinary
sediment showed an increased excretion of albumin compared with the
respective nondiabetic subjects, and male diabetic patients also had an
increased IgG excretion. No consistent difference was found in urinary beta
2-microglobulin concentration between the diabetic and nondiabetic
subjects. In all, 19.5% of the diabetic subjects with normal urinary
sediment (12 men, 5 women) showed urinary albumin concentration exceeding
the highest value (35 mg/24 h) found in nondiabetic subjects without renal
disease. The urinary excretion of albumin in the diabetic subjects was not
associated with the presence of hypertension or coronary heart disease or
with the fasting blood glucose or serum insulin levels measured at
diagnosis of diabetes. In male diabetic subjects with urinary albumin
excretion greater than 35 mg/24 h, a reduced creatinine clearance was
found, suggesting the presence of structural damage associated with
diabetic nephropathy. The early increase of urinary albumin excretion in
type II diabetic patients may be mostly functional in nature. However, some
patients may have structural renal damage associated with diabetic
nephropathy present at diagnosis.