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microalbuminuria glycemic control

John M Lachin, Ionut Bebu, Richard M Bergenstal, Rodica Pop-Busui, F John Service, Bernard Zinman, David M Nathan
OBJECTIVE: The Diabetes Control and Complications Trial (DCCT) demonstrated the beneficial effects of intensive versus conventional therapy on the development and progression of microvascular complications of type 1 diabetes. These beneficial effects were almost completely explained by the difference between groups in the levels of HbA1c, which in turn were associated with the risk of these complications. We assessed the association of glucose variability within and between quarterly 7-point glucose profiles with the development and progression of retinopathy, nephropathy, and cardiovascular autonomic neuropathy during the DCCT...
April 12, 2017: Diabetes Care
Cong Ma, Junqin Sheng, Zhiwen Liu, Minghao Guo
1,5-anhydroglucitol (1,5-AG), uric acid and urinary proteins are excreted into the urine with increasing glucosuria. In the present retrospective study we analyzed whether these factors could be used as indicators for type 2 diabetes mellitus (T2DM) glucose control in 6,766 (T2DM) patients. There were 3,988 cases (58.9%) with HbA1c ≤ 6.5%, 853 cases (12.61%) with HbA1c levels ranging from 6.5% to 7% and 1,925 cases (28.5%) with HbA1c > 7%. HbA1c percentages were correlated with age, MA and 1,5-AG serum concentrations (P < 0...
March 10, 2017: Scientific Reports
Nobuyuki Takahashi, Tetsuro Tsujimoto, Daisuke Chujo, Hiroshi Kajio
AIMS/INTRODUCTION: To compare the incidence rate of renal dysfunction between patients with fulminant type 1 diabetes and those with acute-onset type 1 diabetes. MATERIALS AND METHODS: The present retrospective cohort study included patients with fulminant type 1 diabetes and acute-onset type 1 diabetes diagnosed during April 1993 to March 2016 at a national center in Japan. Glycated hemoglobin levels, incidence rates of renal dysfunction defined as an estimated glomerular filtration rate of <60 mL/min/1...
March 7, 2017: Journal of Diabetes Investigation
Jong Wook Choi, Shinje Moon, Eun Jung Jang, Chang Hwa Lee, Joon-Sung Park
Increased glycemic exposure, even below the diagnostic criteria for diabetes mellitus, is crucial in the pathogenesis of diabetic microvascular complications represented by microalbuminuria. Nonetheless, there is limited evidence regarding which single nucleotide polymorphisms (SNPs) are associated with prediabetes and whether genetic predisposition to prediabetes is related to microalbuminuria, especially in the general population. Our objective was to answer these questions. We conducted a genomewide association study (GWAS) separately on two population-based cohorts, Ansung and Ansan, in the Korean Genome and Epidemiology Study (KoGES)...
2017: PloS One
Mona H El-Samahy, Azza A G Tantawy, Amira A M Adly, Nevin M Habeeb, Eman A R Ismail, Gehan M Hamed, Rasha Eladawy
BACKGROUND: Cardiovascular risk in type 1 diabetes mellitus (T1DM) is associated with endothelial dysfunction, inflammation, and altered immunity. CD4(+) CD28(null) T-cells are a subset of long-lived cytotoxic CD4(+) T-lymphocytes with proatherogenic and plaque-destabilizing properties. We hypothesized that the frequency of CD4(+) CD28(null) T-cells may be altered in T1DM and related to vascular complications. AIM: To assess the percentage of CD4(+) CD28(null) T-lymphocytes in children and adolescents with T1DM and their relation to vascular structure and glycemic control...
January 19, 2017: Pediatric Diabetes
Sigal Singer, Nurit Pilpel, Orit Pinhas-Hamiel
BACKGROUND: Gilbert syndrome (GS) is a common hereditary condition, characterized by intermittent unconjugated hyperbilirubinemia. In adults with type 2 diabetes and GS, a markedly lower prevalence of nephropathy was documented, suggesting a beneficial effect of hyperbilirubinemia. We investigated the prevalence of GS among individuals with type 1 diabetes mellitus (T1DM), and the prevalence of microalbuminuria. METHODS: The prevalence of GS was assessed in 401 (204 female) patients with T1DM, median age 21...
January 17, 2017: Pediatric Diabetes
Savas Sipahi, Seyyid Bilal Acikgoz, Ahmed Bilal Genc, Mehmet Yildirim, Yalcin Solak, Ali Tamer
OBJECTIVE: To evaluate the relationship of vitamin D status and vitamin D replacement therapy with glycemic control, serum uric acid (SUA) levels, and microalbuminuria (MAU) in patients with type 2 diabetes (T2DM) and chronic kidney disease (CKD). Subjectsand Methods: A total of 1,463 patients with T2DM and CKD (aged 14-88 years), 927 females and 536 males, were included in this study. The serum data of 25-hydroxyvitamin D, i.e., 25(OH)D, level, SUA, hemoglobin (Hb)A1c, creatinine, estimated glomerular filtration rate, and urine albumin-to-creatinine ratio (UACR) were obtained from the medical records...
2017: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
Margarita Saiz-Satjes, Francisco Javier Martinez-Martin, Alex Roca-Cusachs
AIMS: In AMANDHA trial, the addition of manidipine, but not amlodipine, in diabetic patients with uncontrolled hypertension, microalbuminuria and preserved renal function resulted in a large decrease of urinary albumin excretion (UAE) despite similar blood pressure (BP) reductions. Factors associated with the reduction of UAE were analyzed. METHODS: For this purpose, a multivariable analysis was performed. RESULTS: Although after 6 months of treatment, manidipine and amlodipine decreased BP to a similar extent, reductions of UAE were higher with manidipine...
November 25, 2016: Future Cardiology
Elisabeth R Mathiesen
Among women with diabetes, the worst pregnancy outcome is seen in the subgroup of women with diabetic nephropathy. Development of severe preeclampsia that leads to early preterm delivery is frequent. Predictors and pathophysiological mechanisms for the development of preeclampsia among women with diabetes and observational studies that support antihypertension treatment for pregnant women with microalbuminuria or diabetic nephropathy preventing preeclampsia and early preterm delivery are presented here. Obtaining and maintaining strict glycemic control before and during pregnancy is paramount to prevent preterm delivery...
December 2016: Diabetes Care
Ofri Mosenzon, Gil Leibowitz, Deepak L Bhatt, Avivit Cahn, Boaz Hirshberg, Cheryl Wei, KyungAh Im, Aliza Rozenberg, Ilan Yanuv, Christina Stahre, Kausik K Ray, Nayyar Iqbal, Eugene Braunwald, Benjamin M Scirica, Itamar Raz
OBJECTIVE: Dipeptidyl peptidase 4 inhibitors may have a protective effect in diabetic nephropathy. RESEARCH DESIGN AND METHODS: We studied renal outcomes of 16,492 patients with type 2 diabetes, randomized to saxagliptin versus placebo and followed for a median of 2.1 years in the Saxagliptin Assessment of Vascular Outcomes Recorded in Patients with Diabetes Mellitus-Thrombolysis in Myocardial Infarction 53 (SAVOR-TIMI 53) trial. RESULTS: At baseline, 9,696 (58...
January 2017: Diabetes Care
Nuria Vilarrasa, Miguel Angel Rubio, Inka Miñambres, Lillian Flores, Assumpta Caixàs, Andrea Ciudin, Marta Bueno, Pedro Pablo García-Luna, María D Ballesteros-Pomar, Marisol Ruiz-Adana, Albert Lecube
BACKGROUND: This study aims to describe the long-term outcomes of bariatric surgery in a cohort of patients with type 1 diabetes (T1DM). METHODS: Thirty-two patients with T1DM and initial BMI of 41.3 ± 4.8 kg/m(2) were studied, 18.7 % undergoing duodenal switch (DS), 34.4 % gastric bypass, and 46.9 % sleeve gastrectomy and followed-up after surgery for 4.6 ± 2.6 years. Changes in BMI, HbA1c, insulin requirements, evolution of comorbidities, and microvascular complications were registered annually after surgery...
October 5, 2016: Obesity Surgery
Farah Lizotte, Benoit Denhez, Andréanne Guay, Nicolas Gévry, Anne Marie Côté, Pedro Geraldes
Poor glycemic control profoundly impacts protein expression and cell signaling action that contributes to glycemic memory and irreversible progression of diabetic nephropathy (DN). We have demonstrated that SHP-1 is elevated in podocytes of diabetic mice causing insulin unresponsiveness and DN. Thus, sustained SHP-1 expression caused by hyperglycemia despite systemic glucose normalization could contribute to the glycemic memory effect in DN. Microalbuminuria, GFR, mesangial cell expansion, collagen IV and TGF-β expression were significantly increased in diabetic Ins2(+/C96Y) mice compared to non-diabetic Ins2(+/+) mice and remained elevated despite glucose normalization with insulin implants...
September 1, 2016: Diabetes
Nektaria Papadopoulou-Marketou, George P Chrousos, Christina Kanaka-Gantenbein
Diabetic nephropathy constitutes a devastating complication in patients with type 1 diabetes mellitus, and its diagnosis is traditionally based on microalbuminuria. The aim of this review is to update through the medical literature the suggested early natural course of diabetic nephropathy, the theories behind the pathways of its pathogenesis, and its diagnosis. Poor glycemic control, dyslipidemia, smoking, advanced glycation end products, and environmental and genetic clues play an important role in the development of diabetic nephropathy...
February 2017: Diabetes/metabolism Research and Reviews
John I Anetor, Chukwuemelie Z Uche, Emmanuel B Ayita, Solomon K Adedapo, Jokotade O Adeleye, Gloria O Anetor, Sola K Akinlade
Cadmium (Cd) has recently emerged as a major concern not only in environmental toxicology but also in metabolic diseases such as diabetes mellitus and its complications. Conflicting data aside, these studies have not been examined in a clinical population undergoing management as well as possible modulation by the prominent metabolic antagonist of Cd such as zinc (Zn). This study examined the relationship between cadmium levels, glycemic control, and renal pathology in established type II diabetic patients with focus on populations exposed to modern environmental health hazards (MEHHs)...
2016: Frontiers in Public Health
Soha M Abd El Dayem, Ahmed A Battah, Abo El Magd El Bohy
AIM: To evaluate cardiovascular autonomic neuropathy (CAN) in type 1 Diabetics and to detect its relation to coronary artery calcification. PATIENTS AND METHODS: It is a cross sectional study included 62 diabetics and 30 controls. Clinical, laboratory assessment and 24 Hr holter were done for all patients and controls and coronary artery calcium (CAC) scoring by multisclice CT was done for all patients only. T-test, Mann Whitney U test, and stepwise multiple regression were used for statistical analyses...
December 15, 2015: Open Access Macedonian Journal of Medical Sciences
Soha M Abd El Dayem, Hayam K Nazif, Mona Abd Ei-Kader, Maha El-Tawil
AIM: To study the relation between adiponectin level with glycemic control and complication of diabetes. PATIENTS AND METHODS: The study included 40 female adolescent type 1 diabetic patients and 40 healthy volunteers of the same age and sex. Blood sample was taken for assessment of glycosylated hemoglobin, lipid profile and adiponectine. Urine sample was taken for assessment of albumin/creatinine ratio. RESULTS: Diabetic patients had a significantly higher diastolic blood pressure, triglyceride, total cholesterol, LDL and adiponectin than controls...
December 15, 2015: Open Access Macedonian Journal of Medical Sciences
Mohamed Abo El-Asrar, Nancy Samir Elbarbary, Eman Abdel Rahman Ismail, AlShaimaa Abo Bakr
BACKGROUND: Angiopoietin-2 is a growth factor involved in the pathophysiology of vascular and inflammatory diseases such as arteriosclerosis. Carotid or aortic scans provide noninvasive screening tools for assessment of preclinical atherosclerosis in high-risk children. AIM: We assessed serum angiopoietin-2 in children and adolescents with type 1 diabetes mellitus as a potential marker for vascular complications in relation to glycemic control, inflammation and vascular structure...
July 2016: Angiogenesis
Sunita Neupane, Raju Kumar Dubey, Narayan Gautam, Krishna Kumar Agrawal, Archana Jayan, Sujata Shrestha, Amit Chandra Jha
BACKGROUND: Diabetes mellitus (DM) is a chronic disease characterized by insulin deficiency or peripheral resistance resulting in hyperglycemia. Poor glycemic control leads to diabetic complications. Hyperuricemia has been reported with increased risk of renal insufficiency. The aim of this study was to evaluate the relationship between serum uric acid concentration, degree of urinary albumin excretion (UAE) and glycated hemoglobin (HbA1c) in Type 2 DM (T2DM) patients. MATERIALS AND METHODS: Serum uric acid concentrations, urine microalbumin, and HbA1c were measured in fifty T2DM patients...
March 2016: Nigerian Medical Journal: Journal of the Nigeria Medical Association
Anwar Ali Showail, Medhat Ghoraba
Microalbuminuria is an independent risk factor for cardiovascular and renal out- come in a patient with Type 2 diabetes. The evidence that intensive glycemic control reduces the microvascular complications of diabetes is based almost exclusively on prevention of micro- albuminuria. To evaluate the association between microalbuminuria and glycemic control and other factors in Type 2 diabetes, we studied retrospectively 551 patients with Type 2 diabetes. The patients were divided into two groups: 175 patients with microalbuminuria in the case group and 376 with normal urine albumin-creatinine ratio in the control group...
May 2016: Saudi Journal of Kidney Diseases and Transplantation
Bedowra Zabeen, Maria E Craig, Sohaib A Virk, Alison Pryke, Albert K F Chan, Yoon Hi Cho, Paul Z Benitez-Aguirre, Stephen Hing, Kim C Donaghue
OBJECTIVE: To compare rates of microvascular complications in adolescents with type 1 diabetes treated with continuous subcutaneous insulin infusion (CSII) versus multiple daily injections (MDI). RESEARCH DESIGN AND METHODS: Prospective cohort of 989 patients (aged 12-20 years; diabetes duration >5 years) treated with CSII or MDI for >12 months. Microvascular complications were assessed from 2000-14: early retinopathy (seven-field fundal photography), peripheral nerve function (thermal and vibration threshold testing), autonomic nerve abnormality (heart rate variability analysis of electrocardiogram recordings) and albuminuria (albumin creatinine ratio/timed overnight albumin excretion)...
2016: PloS One
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