|
 |
|
|||||||
|
|||||||||
© 2003 by the American Diabetes Association, Inc.
Pathophysiology/Complications |
Signs of Nephropathy May Occur Early in Young Adults With Diabetes Despite Modern Diabetes Management
Results from the nationwide population-based Diabetes Incidence Study in Sweden (DISS)
1 Department of Medicine, Umeå University Hospital, Umeå, Sweden
2 Department of Endocrinology, Malmö University Hospital, Malmö, Sweden
3 Department of Medicine, Linköping University Hospital, Linköping, Sweden
4 Department of Medicine, Uppsala University Hospital, Uppsala, Sweden
5 Department of Medicine, South Hospital, Stockholm, Sweden
6 Center of Metabolism and Endocrinology, Huddinge University Hospital, Stockholm, Sweden
7 Department of Ophthalmology, Helsingborg Hospital, Helsingborg, Sweden
8 Department of Public Health and Clinical Medicine, Epidemiology, Umeå University, Umeå, Sweden
9 Department of Medicine, Lund University Hospital, Lund, Sweden
Address correspondence and reprint requests to Dr. Maria Svensson, Department of Medicine, Umeå University Hospital, S-90185 Umeå, Sweden. E-mail: maria.svensson{at}medicin.umu.se
OBJECTIVE—To estimate the occurrence of early-onset renal involvement in a nationwide population-based cohort of young adults with diabetes in Sweden and relate the findings to glycemic control, type of diabetes, sex, smoking, and blood pressure.
RESEARCH DESIGN AND METHODS—The Diabetes Incidence Study in Sweden aims to register all incident cases of diabetes in the age-group 15–34 years. In 1987–1988, 806 patients were reported and invited to participate in a follow-up study focusing on microvascular complications. Of them, 469 subjects participated. The assessment was based on questionnaires (n = 469), blood samples (n = 424), urine samples (n = 251) and, when appropriate, medical records (n = 186).
RESULTS—During the follow-up time, median 9 years (range 6–12), 31 of 469 patients (6.6%) with incipient or overt diabetic nephropathy (i.e., micro- or macroalbuminuria) were found, 24 of 426 (5.6%) in type 1 and 7 of 43 (16%) in type 2 diabetic subjects (P = 0.016). Additionally, 24 of 31 patients (77%) had microalbuminuria and 7 (23%) had macroalbuminuria, which mainly occurred in patients with type 2 diabetes. In a Cox regression analysis, high mean HbA1c during the follow-up period and high blood pressure at follow-up increased the risk of developing signs of nephropathy (P = 0.020 and P = 0.003, respectively). Compared with patients with type 1 diabetes, those with type 2 diabetes tended to have an increased risk of renal involvement (P = 0.054) when adjusting for sex, tobacco use, glycemic control, and blood pressure.
CONCLUSIONS—Despite modern treatment and self-monitoring of blood glucose, young adult patients with diabetes may still develop renal involvement during the first 10 years of diabetes duration. Inadequate HbA1c, high blood pressure, and type 2 diabetes appear to be risk markers for early occurrence of diabetic nephropathy.
Abbreviations: CSII, continuous subcutaneous insulin infusion • DISS, Diabetes Incidence Study in Sweden
CiteULike 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
This article has been cited by other articles:
|
|
 |
|
  C. S. Samuel, T. D. Hewitson, Y. Zhang, and D. J. Kelly Relaxin Ameliorates Fibrosis in Experimental Diabetic Cardiomyopathy Endocrinology, July 1, 2008; 149(7): 3286 - 3293. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J P H Shield, E Crowne, and J Morgan Is there a place for bariatric surgery in treating childhood obesity? Arch. Dis. Child., May 1, 2008; 93(5): 369 - 372. [Full Text] [PDF]
|
|
|
|
 |
|
 V. Ninichuk, S. Clauss, O. Kulkarni, H. Schmid, S. Segerer, E. Radomska, D. Eulberg, K. Buchner, N. Selve, S. Klussmann, et al. Late Onset of Ccl2 Blockade with the Spiegelmer mNOX-E36-3'PEG Prevents Glomerulosclerosis and Improves Glomerular Filtration Rate in db/db Mice Am. J. Pathol., March 1, 2008; 172(3): 628 - 637. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Weissberg-Benchell, H. Wolpert, and B. J. Anderson Transitioning From Pediatric to Adult Care: A new approach to the post-adolescent young person with type 1 diabetes Diabetes Care, October 1, 2007; 30(10): 2441 - 2446. [Full Text] [PDF]
|
|
|
|
|
|
L. Haines, K. C. Wan, R. Lynn, T. G. Barrett, and J. P.H. Shield Rising Incidence of Type 2 Diabetes in Children in the U.K. Diabetes Care, May 1, 2007; 30(5): 1097 - 1101. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Saito, H. Sone, K. Kawai, S. Tanaka, S. Kodama, M. Shu, E. Suzuki, K. Kondo, S. Yamamoto, H. Shimano, et al. Risk Imparted by Various Parameters of Smoking in Japanese Men With Type 2 Diabetes on Their Development of Microalbuminuria: Analysis from the Tsukuba Kawai Diabetes Registry Diabetes Care, May 1, 2007; 30(5): 1286 - 1288. [Full Text] [PDF]
|
|
|
|
|
|
V. Ninichuk, A. G. Khandoga, S. Segerer, P. Loetscher, A. Schlapbach, L. Revesz, R. Feifel, A. Khandoga, F. Krombach, P. J. Nelson, et al. The Role of Interstitial Macrophages in Nephropathy of Type 2 Diabetic db/db Mice Am. J. Pathol., April 1, 2007; 170(4): 1267 - 1276. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. B. Petitti, G. Imperatore, S. L. Palla, S. R. Daniels, L. M. Dolan, A. K. Kershnar, S. Marcovina, D. J. Pettitt, C. Pihoker, and for the SEARCH for Diabetes in Youth Study Group Serum Lipids and Glucose Control: The SEARCH for Diabetes in Youth Study Arch Pediatr Adolesc Med, February 1, 2007; 161(2): 159 - 165. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. L. Stone, M. E. Craig, A. K. Chan, J. W. Lee, C. F. Verge, and K. C. Donaghue Natural History and Risk Factors for Microalbuminuria in Adolescents With Type 1 Diabetes: A longitudinal study. Diabetes Care, September 1, 2006; 29(9): 2072 - 2077. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. C. Eppens, M. E. Craig, J. Cusumano, S. Hing, A. K.F. Chan, N. J. Howard, M. Silink, and K. C. Donaghue Prevalence of Diabetes Complications in Adolescents With Type 2 Compared With Type 1 Diabetes. Diabetes Care, June 1, 2006; 29(6): 1300 - 1306. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. C.W. Tang, J. C.K. Leung, L. Y.Y. Chan, A. W.L. Tsang, and K. N. Lai Activation of Tubular Epithelial Cells in Diabetic Nephropathy and the Role of the Peroxisome Proliferator-Activated Receptor-{gamma} Agonist J. Am. Soc. Nephrol., June 1, 2006; 17(6): 1633 - 1643. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Y. Chow, D. J. Nikolic-Paterson, E. Ozols, R. C. Atkins, and G. H. Tesch Intercellular Adhesion Molecule-1 Deficiency Is Protective against Nephropathy in Type 2 Diabetic db/db Mice J. Am. Soc. Nephrol., June 1, 2005; 16(6): 1711 - 1722. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Y. Chow, D. J. Nikolic-Paterson, R. C. Atkins, and G. H. Tesch Macrophages in streptozotocin-induced diabetic nephropathy: potential role in renal fibrosis Nephrol. Dial. Transplant., December 1, 2004; 19(12): 2987 - 2996. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J R Porter and T G Barrett Acquired non-type 1 diabetes in childhood: subtypes, diagnosis, and management Arch. Dis. Child., December 1, 2004; 89(12): 1138 - 1144. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Svensson, J. W. Eriksson, and G. Dahlquist Early Glycemic Control, Age at Onset, and Development of Microvascular Complications in Childhood-Onset Type 1 Diabetes: A population-based study in northern Sweden Diabetes Care, April 1, 2004; 27(4): 955 - 962. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| Diabetes | Diabetes Care | Clinical Diabetes | Diabetes Spectrum |