Retrospective and prospective analysis of chosen factors influencing the development of diabetic nephropathy
Maryna Krawczuk-Rybak, Jadwiga Peczyńska, Mirosława Urban
Med Sci Monit 1998; 4(6): EP1030-1035
The aim of this study was to identify factors preceding and influencing the development of diabetic nephropathy,from normo- to microalbuminuria. Retrospective analysis was carried out on a group of 15 young patients with type I diabetes mellitus (mean age - 16.6 years, SD - 1.34) and persistent microalbuminuria which had appeared at a mean age of 14.9 years, SD - 1.6 (during the period '-3', '-2', '-1' years preceding the appearance of permanent microalbuminuria and at the moment of its manifestation - ' period 0'). We also carried out a prospective evaluation of the following indices nearly two years following the appearance of microalbuminuria (period '+1'): body mass index (BMI), arterial pressure values, daily insulin dosage per body mass (kg), glycemic control (HbA1c) and lipid balance. The control group comprised 13 diabetes mellitus patients with no microangiopathy symptoms (same disease duration time).
Results: 1. The systolic arterial pressure was higher in the studied group in comparison with the control group during microalbuminuric symptoms ('0'), while the diastolic arterial pressure during the period '-3'. Analysis of other periods showed no differences. 2. HbA1c and daily insulin dose values were elevated in all periods of our analysis. 3. We noted no differences in BMI values. 4. Total cholesterol values did not differ, while triglyceride values were found to be elevated during retrospective analysis.
Conclusion: The appearance of microalbuminuria is preceded by long-term incorrect glycemic control, administration of increased insulin doses and a tendency towards higher triglycerides values.
Keywords: Diabetes Mellitus, complications, diabetic nephropathy, dyslipidemia