scholarly journals Association of diabetic retinopathy and diabetic macular oedema with renal function in southern Chinese patients with type 2 diabetes mellitus: a single-centre observational study

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e031194 ◽  
Author(s):  
Xuenan Zhuang ◽  
Dan Cao ◽  
Dawei Yang ◽  
Yunkao Zeng ◽  
Honghua Yu ◽  
...  

Background and objectivesThe association of diabetic retinopathy (DR) and diabetic macular oedema (DME) with renal function in southern Chinese patients with diabetes is poorly understood. So we aimed to study the correlation between stage of DR and DME with stage of estimated glomerular filtration rate (eGFR) and stage of urine albumin-to-creatinine ratio (UACR), and to explore the systemic risk factors for DR and DME.Design and settingThis single-centre retrospective observational study was conducted from December 2017 to November 2018.Participants413 southern Chinese patients with type 2 diabetes mellitus.Outcome measuresThe correlations between stage of DR and DME with stage of eGFR/UACR were assessed by Spearman’s or χ² analyses and represented with histograms. Risk factors associated with the occurrence of DR and DME were performed by logistic regression and represented with nomograms.ResultsStage of DR had a positive correlation with stage of eGFR (r=0.264, p<0.001) and stage of UACR (r=0.542, p<0.001). With the stage of eGFR/UACR being more severe, the prevalence of DME became higher as well (both p<0.001). The risk factors for DR were DM duration (OR 1.072; 95% CI 1.032 to 1.114; p<0.001), stage of UACR (OR 2.001; 95% CI 1.567 to 2.555; p<0.001) and low-density lipoprotein (LDL) (OR 1.301; 95% CI 1.139 to 1.485; p<0.001), while risk factors for DME were stage of UACR (OR 2.308; 95% CI 1.815 to 2.934; p<0.001) and LDL (OR 1.460; 95% CI 1.123 to 1.875; p=0.008).ConclusionsAmong southern Chinese patients, stage of DR and DME were positively correlated with renal function, while stage of UACR performed a better relevance than stage of eGFR.

2004 ◽  
Vol 21 (10) ◽  
pp. 1096-1101 ◽  
Author(s):  
M. J. Naushahi ◽  
W. J. C. de Grauw ◽  
A. J. Avery ◽  
W. H. E. M. van Gerwen ◽  
E. H. van de Lisdonk ◽  
...  

2019 ◽  
Author(s):  
yongwen zhang ◽  
Huanhuan Han ◽  
Lanfang Chu

Abstract Background: The goals of the present study were to quantify incidence rate of hypoglycemia, in-vestigate risk factors for hypoglycemia in patients with type 2 diabetes mellitus (T2DM) and suggest preventive measures. Methods: This study was a retrospective cohort, multicenter, non-interventional study of hypogly-cemic events, used previously acquired data from 10,359 patients with T2DM, who were treated between March 2015 and March 2018. Two aspects of our research were investigated: (i) retrospec-tive study to assess the incidence of hypoglycemia during hospitalization; and (ii) to determine the relationship between hypoglycemia and risk factors such as age, HbA1c, complications, duration of DM, insulin and/or SU use, and cognitive impairment. Results: Overall, 9,993 patients were included in the full analysis set, 376 patients were identified hypoglycemia in the database. Demographic characteristics of patients with T2DM were similar between hypoglycemia and non-hypoglycemia groups, significant differences were not observed between the groups, except for cognitive impairment (p =0.037). The most common cause of hypo-glycemia was drug overdose/misuse (34.2%), irregular diet (21.3%), and excessive physical activity (13.8%). Most of the hypoglycemic episodes occurred before and after lunch (39.4% between 10:00 and 13:00). Retrospective rates (events per patient per month [PPPM]) of overall, severe, and noc-turnal hypoglycemia were 3.83 events PPPM (95% CI 1.90–5.80), 1.17 events PPPM (95% CI 0.78-1.56), and 0.07 events PPPM (95% CI 0.05-0.09). Multivariate model analysis showed that the use of SU (OR=3.162, p = 0.040) and insulin (OR= 2.414, p = 0.017) were associated with hypo-glycemic events. Logistic regression analysis of the variables revealed that significant positive as-sociation of the frequency of overall and severe hypoglycemia with age (beta=0.855, p=0.018; be-ta=1.343, p=0.015) and duration of DM (beta=1.248, p=0.025; beta=0.947, p=0.014). Conclusions: The present study shows that advanced age, duration of DM, cognitive dysfunction, and insulin and/or SU use are the main causes of hypoglycemia in Chinese patients with T2DM. Education on hypoglycemia, appropriate use of antidiabetic drugs and avoidance of related risk factors are essential for patients with DM.


2017 ◽  
Vol Volume 12 ◽  
pp. 1661-1672 ◽  
Author(s):  
Mei Guo ◽  
Jian-Ying Niu ◽  
Xian-Wu Ye ◽  
Xiao-Jie Han ◽  
Ying Zha ◽  
...  

2013 ◽  
Vol 12 (5) ◽  
pp. 16-21
Author(s):  
A. V. Markova ◽  
Yu. G. Schwartz

Aim. To assess the association between the 12-month dynamics of cardiovascular risk factors (CVD RFs), progressing chronic kidney disease (CKD), and individual baseline clinical and laboratory parameters in patients with arterial hypertension (AH) and Type 2 diabetes mellitus (DM-2) who received active antidiabetic treatment.Material and methods. In total, 122 patients with AH and DM-2 underwent the laboratory assessment of blood and urine samples at baseline and 12 months later, in order to evaluate the levels and dynamics of CVD RFs and CKD severity.Results. After 12 months of continuous therapy with antihypertensive and oral antidiabetic medications and statins, the carbohydrate metabolism parameters significantly improved. However, creatinine clearance decreased significantly (by 7,52%). The direction of renal function parameter changes was determined by the baseline CKD stage. Progressing CKD was also associated with obesity (O), atrial fibrillation (AF), and myocardial infarction (MI) in medical history. In patients with or without O, the albumin-creatinine ratio decreased by 59,8% and 34%, respectively. In participants with or without AF, microalbuminuria increased by 321% and decreased by 53,5%, respectively. In patients with MI in medical history, urine levels of creatinine decreased by 33,6%, while in the other patients, they increased by 5,4%. O was associated with a reduction in total cholesterol (TCH) by 5,5%, while in non-obese patients, TCH levels did not change substantially.Conclusion. In most patients with AH and DM-2, adequate glycemia control, standard antihypertensive treatment, and statin therapy for 12 months were associated with minimal changes in CVD RFs and with a significant deterioration in renal function. The latter was predicted by the CKD stage at baseline, O, MI in medical history, and AF. 


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