Microalbuminuria development in short-term IDDM

Diabetes Res Clin Pract. 1994 May;24(1):15-23. doi: 10.1016/0168-8227(94)90081-7.

Abstract

To assess risk factors associated with microalbuminuria development in short-term evolution insulin-dependent diabetes mellitus (IDDM) we undertake a cross-sectional study with retrospective examination of the 34 patients diagnosed with IDDM between 1982 and 1983 and followed up for at least 7 years in an outpatient endocrinology clinic.

Main measures: (1) At IDDM diagnosis: age, sex, parameters of metabolic control (fasting glycemia, HbA1), islet-cell antibodies, insulin autoantibodies, endogenous insulin secretion (EIS) and HLA type. (2) At 1 year evolution: EIS re-evaluation. (3) From IDDM diagnosis (every 3-4 month): body mass index, insulin schedule and dose, and parameters of metabolic control. (4) At 7-year evolution: 24-h urinary albumin excretion (UAE) and arterial blood pressure measurements on two consecutive outpatient controls. Microalbuminuria was defined as UAE above 30 micrograms/min on the two consecutive measurements. After 7-year follow-up, 8 (23.5%; 95% Cl: 9.3 to 37.7%) patients developed microalbuminuria. Their metabolic control was worse (7 years mean HbA1: 10.7 vs. 9.7%; P = 0.04) and 1 year EIS lower (1.9 vs. 7.6 ng/ml.10 min; P = 0.03) than in normoalbuminuric patients. They also had higher prevalence of 'high-normal' arterial blood pressure (P = 0.03) and diabetic retinopathy (P = 0.01) than normoalbuminuric patients did. Stepwise logistic regression analysis showed that diabetic retinopathy was the only independent and significant risk factor related to microalbuminuria development (P = 0.01). We conclude that in subjects with short-term evolution IDDM, microalbuminuria development was associated with glycemic control, EIS and arterial blood pressure levels, however the strongest association was found with diabetic retinopathy occurrence.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age of Onset
  • Albuminuria / epidemiology*
  • Analysis of Variance
  • Autoantibodies / blood
  • Blood Glucose / metabolism
  • Blood Pressure
  • Child
  • Cholesterol / blood
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / physiopathology
  • Diabetes Mellitus, Type 1 / urine*
  • Female
  • Glycated Hemoglobin A / analysis
  • Histocompatibility Testing
  • Humans
  • Insulin Antibodies / blood
  • Islets of Langerhans / immunology
  • Male
  • Multivariate Analysis
  • Regression Analysis
  • Retrospective Studies
  • Triglycerides / blood

Substances

  • Autoantibodies
  • Blood Glucose
  • Glycated Hemoglobin A
  • Insulin Antibodies
  • Triglycerides
  • islet cell antibody
  • Cholesterol