Prevalence of Diabetic Nephropathy among Type 2 Diabetes Mellitus, and Glycaemic Control Evaluated by Glycaeted Haemoglobin in Diabetic Patients with and without Diabetic Nephropathy

BACKGROUND Increased levels of urinary biomarkers can be detected in type 2 diabetic patients before the onset of significant albuminuria and may be used as an early marker of renal injury in diabetic nephropathy (DN) which would play a significant role for the effective management and treatment approaches in diabetic care. We wanted to evaluate cystatin C and microalbumin as effective early biomarkers in assessing nephropathy in patients with type 2 diabetes mellitus in this study. METHODS A cross-sectional study was conducted among 180 subjects grouped into healthy controls, clinically proven T2DM without nephropathy and type 2 DM with nephropathy comprising 60 participants in each group. Fasting and postprandial blood samples and urine samples were collected and analysed by standard methods. eGFR was calculated using CKD-EPI 2012 equation. IBM - SPSS version 20 was used for statistical analysis. RESULTS Diabetic nephropathy patients had significantly elevated serum cystatin C and microalbumin (2.43 ± 0.59, 700.5 ± 591.8 mg / L, respectively), compared to T2DM (0.98 ± 0.26, 63.7 ± 102.9 mg / L, respectively), and the control study subjects (0.81 ± 0.16, 11.15 ± 8.9 mg / L, respectively). Serum cystatin C showed AUC of 0.994 (95 % CI, 0.986 - 1.00) whereas microalbumin showed 0.944 (95 % CI, 0.907 - 0.981). Serum cystatin C showed a sensitivity of 96.7 % and a specificity of 91.7 % at a cutoff point of 1.34 mg / L whereas at a cut-off point of 138.5 mg / L for microalbumin, the sensitivity and specificity were 90 % and 83.3 % respectively. CONCLUSIONS Serum cystatin C and microalbumin both could be considered as markers for early detection of nephropathy in T2DM patients. The more prominent rise in serum cystatin C values provide an earlier diagnosis of diabetic nephropathy among T2DM patients. KEY WORDS Biomarker, Type 2 Diabetes Mellitus, Cystatin C, Diabetic Nephropathy, Microalbumin

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STUDY OF PREVALENCE AND CLINICAL PROFILE OF NEPHROPATHY AND RETINOPATHY IN TYPE 2 DIABETES PATIENTS AT TERTIARY CARE CENTER, UDAIPUR

10.36106/gjra/0100380 ◽

2021 ◽

pp. 6-8

Author(s):

Yash Salil Patel

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Diabetic Retinopathy ◽

Diabetic Nephropathy ◽

Microvascular Complications ◽

Tertiary Care ◽

Positive Family History ◽

Diabetic Patients

Microvascular complications of Type 2 Diabetes Mellitus (T2DM), (retinopathy and nephropathy) have a similar etiopathogenetic mechanism besides genetic predisposition. Even though these two complications frequently co-exist, their frequency varies. The association of these two signicant complications and their coexistence needs a relook. To study prevalence of retinopathy and nephropathy in Type 2 diabetes mel Aim: litus. Comparison of diabetic retinopathy and nephropathy in Type 2 diabetes mellitus and its correlation of diabetic retinopathy and nephropathy with duration of illness and various risk factors that affects development, progression and severity of diabetic retinopathy and nephropathy. 100 diabetic patients were taken up for study for a period of one year meeti Methodology: ng the criteria for the present study. Detailed history was taken from patient and meticulous examination was done of all patients with special emphasis on renal and ophthalmic symptoms. Clinical data and investigation prole was tabulated. Statistical analysis was done. Among 100 patients, 22 had diabetic retinopathy. Among patients with diab Results & Conclusion: etic retinopathy, 68.18% patients had positive family history. Among 100 patients, 32 had diabetic nephropathy, mean FBS was 207 mg%, PPBS was 317.8 mg% and mean HbA was 9.2%. Among patients with diabetic retinopathy, mean FBS was 211 mg%, PPBS was 324.9 1c mg%, HbA was 9.5%. From this study it is found that diabetic nephropathy starts earlier than retinopathy. In this study 1c hypertension was found to accelerate progression into nephropathy and retinopathy.

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P0121KIDNEY BIOPSY FINDINGS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p0121 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Elbis Ahbap Dal ◽

Taner Basturk ◽

Tamer Sakaci ◽

Nuri Baris Hasbal ◽

Mustafa Sevinç ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Diabetic Nephropathy ◽

Renal Insufficiency ◽

Kidney Biopsy ◽

Diabetic Patients ◽

Nephrotic Proteinuria ◽

Nondiabetic Nephropathy

Abstract Background and Aims The aim of the study is to evaluate kidney biopsy findings other than renal diabetic changes in patients with type 2 diabetes mellitus. Method Diabetic patients with kidney biopsy between January 2003 and January 2020 were enrolled to the study. Kidney biopsy was performed to patients with suspicion of kidney disease other than diabetic nephropathy. The suspicious cases were patients without diabetic retinopathy, diabetes mellitus history less than 5 years, creatinine increase faster than expected course and hematuria. Demographic features, biopsy finding were all noted. Results Totally, 135 patients’ data were evaluated in which 54.1% was male. Demographic characteristics of the patients and laboratory data are given in Table 1. Mean age was 55.4±11 years and mean diabetes duration was 6.9±6.3 years. Mean duration of diabetes was 5.3±5.5 years in patients with nondiabetic nephropathy whereas it was 10.2±6.4 and 11.2±7.6 years in patients with diabetic and/or nondiabetic pathologies respectively (p<0.05). Serum creatinine and proteinuria level were lower, and hemoglobin levels were higher in patients with nondiabetic nephropathy (p <0.05).C3 was low in 3.7% of patients. ANA and ANCA positivity were seen in 8.1% and 3.7% of the patients, respectively. Patients without diabetic retinopathy was 81.7% of the total cohort. Biopsy indications were renal insufficiency (8.9%), nephrotic syndrome (24.4%), non-nephrotic proteinuria (16.4%), renal insufficiency with nephrotic range proteinuria (25.9%), renal insufficiency with non-nephrotic proteinuria (24.4%). Mean glomeruli number was 19.3±11.1. Ten patients had macroscopic hematuria in which all resolved with conservative care. Early diabetic changes, diffuse and/or nodular glomerulosclerosis were present in 3.1% and 96.9% of diabetic patients, respectively. Biopsies with diabetic changes with other nondiabetic pathologies were 3% of the biopsies. Isolated nondiabetic nephropathy was found in 23.7% of patients. Pathologic findings other then diabetic changes were as follows in patients without diabetic nephropathy: focal segmental glomerulosclerosis (FSGS) 49.5%, membranous glomerulonephritis 14,1%, Ig A nephropathy 12,1%, membranoproliferative glomerulonephritis 5 %, crescentic glomerulonephritis 4,1%, acute tubular necrosis 4,1%, amyloidosis 3%, tubulointerstitial damage 2%, others 6,1%. Conclusion Biopsy in diabetic patients is beneficial to show both diabetic nephropathy and other kidney pathologies. Kidney biopsy may be performed if there is suspicion of other glomerular pathologies. Focal segmental sclerosis was the most common pathology in our patients without diabetic nephropathy

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Correlation of Pulmonary Function Tests with Anthropometry and Glycaemic Control in Type 2 Diabetes Mellitus-A Cross-sectional Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/47275.14778 ◽

2021 ◽

Author(s):

Aiswarya Roy Karintholil ◽

Akshatha Rao Aroor ◽

Joel Sabu ◽

Joshua Chacko

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Glycaemic Control ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Duration Of Diabetes ◽

Lung Functions ◽

Type 2 Diabetic

Introduction: Diabetic patients are found to have reduced lung functions compared to their controls and their relationship with the duration of diabetes, glycaemic control, and Body Mass Index (BMI) is poorly characterised. Aim: To determine the correlation between the pulmonary function abnormalities with anthropometry, glycaemic control, and duration of diabetes in type 2 diabetic patients. Materials and Methods: A total of 80 type 2 diabetic patients were studied. BMI, Waist Circumference (WC), Waist-Hip Ratio (WHR), Fasting, postprandial blood sugar and glycosylated haemoglobin (HbA1c) were assessed from July to September 2018. Spirometry was done in accordance with the guidelines from the American Thoracic Society (ATS). Reduced pulmonary functions were defined as patients with restrictive (FEV1/FVC≥0.7 and FVC< 80% predicted) or obstructive (FEV1/FVC<0.7) impairment. Statistical analysis was done using ANOVA test and Karl Pearson Correlation coefficient. Results: The mean values of FEV1/FVC (0.8±0.08) and FVC% predicted (60.29±11.39) showed a restrictive pattern. FEF (25-75%) (r=0.241, p=0.031) and PEFR (r=0.245, p=0.029) positively correlated with duration of diabetes. BMI had a negative correlation with FVC% predicted (r=0.239, p=0.033). A negative correlation between FEV1% and Waist Circumference (WC) was observed (r=-0.232, p=0.038). HbA1c negatively correlated to FEV1/FVC (r=-0.227, p=0.043). Conclusion: Patients with type 2 Diabetes Mellitus (DM) were found to have an asymptomatic restrictive pulmonary impairment. Increased duration of diabetes, increased BMI, increased WC was associated with decreased lung functions in diabetics.

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The role of vitamin D deficiency and elevated inflammatory biomarkers as risk factors for the progression of diabetic nephropathy in patients with type 2 diabetes mellitus

Open Chemistry ◽

10.1515/chem-2021-0107 ◽

2021 ◽

Vol 19 (1) ◽

pp. 1183-1192

Author(s):

Ahmad El Askary ◽

Amal F. Gharib ◽

Mazen Almehmadi ◽

Maha Mahfouz Bakhuraysah ◽

Abdulaziz Ali Al Hajjiahmed ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Type 2 Diabetes ◽

Vitamin D ◽

Type 2 Diabetes Mellitus ◽

Diabetic Nephropathy ◽

Vitamin D Deficiency ◽

Diabetic Patients ◽

Tnf Α

Abstract Diabetic nephropathy (DN) is the leading cause of end-stage renal disease worldwide. Albuminuria is the most sensitive marker for the early recognition of DN. Therefore, we aimed to study the risk factors of albuminuria as a marker of DN among diabetic patients. The study included 41 patients with type 2 diabetes mellitus (T2DM), 50 type 2 diabetic nephropathy (T2DN) patients with macroalbuminuria, 43 T2DN patients with microalbuminuria and 38 healthy controls. Logistic regression was used to detect the most significant risk factors for albuminuria. A high statistically significant difference was found between the groups regarding age, sex, body mass index (BMI), diabetes mellitus (DM) duration, glucose, glycated haemoglobin (HbA1c), creatinine, glomerular filtration rate (GFR), lipid profile, tumour necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP), the albumin–creatinine ratio (ACR), vitamin D, total parathyroid hormone (PTH), urea, total calcium and chemerin (p < 0.001). It was found that the duration of DM, BMI, glucose, GFR, total cholesterol (TC), low-density lipoprotein (LDL), TNF-α, IL-6, CRP, ACR, vitamin D, PTH and chemerin are significant albuminuria risk factors in DN. Vitamin D deficiency and associated inflammatory mediators such as chemerin, TNF-α, IL-6 and CRP are the most essential risk factors for albuminuria in T2DM patients.

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Awareness of diabetic nephropathy in patients with type 2 diabetes mellitus: the Indian scenario

Journal of Nephropharmacology ◽

10.15171/npj.2018.20 ◽

2018 ◽

Vol 7 (2) ◽

pp. 90-97 ◽

Cited By ~ 1

Author(s):

Chirag Bansal ◽

Reshma Kaushik ◽

Rajeev Mohan Kaushik

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Diabetic Nephropathy ◽

Diabetic Patients ◽

Patient Awareness ◽

Duration Of Diabetes ◽

Rural And Urban ◽

Control Of Diabetes

Introduction: Diabetic nephropathy is an important complication of diabetes mellitus leading to significant morbidity and mortality. Objectives: To study the awareness of diabetic nephropathy in patients with type 2 diabetes mellitus (T2DM) and the factors influencing patient awareness of diabetic nephropathy. Patients and Methods: Four hundred subjects, aged above 18 years with T2DM as per American Diabetes Association (ADA) criteria, were selected. Patient awareness regarding diabetic nephropathy was assessed as per a prefixed questionnaire. Results: Awareness of basic information concerning diabetes was present in more than 60% of patients. No significant differences were seen between awareness scores of male and female (P = 0.385), rural and urban (P = 0.120) and literate and illiterate (P = 0.567) diabetic patients. Awareness scores were higher in diabetic patients exceeding 50 years of age (P = 0.004) and patients having diabetes for more than10 years (P < 0.0001), controlled diabetes (P = 0.026) and diabetic nephropathy (P < 0.0001). Awareness of diabetic nephropathy was independently associated with duration of diabetes (P = 0.010) and diabetic nephropathy (P = 0.011) but not with age (P = 0.754) and control of diabetes (P = 0.229). Conclusion: A substantial proportion of diabetic patients are still unaware of the basic facts about diabetes and diabetic nephropathy. Awareness of diabetic nephropathy depended upon duration of diabetes and presence of diabetic nephropathy and requires promotion during early stages of diabetes to improve control of diabetes and prevent diabetic nephropathy.

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Prevalence of microalbuminuria among adults with Type 2 Diabetes mellitus at OOUTH, Sagamu

Annals of Health Research ◽

10.30442/ahr.0401-1-03 ◽

2018 ◽

Vol 4 (1) ◽

pp. 15-21

Author(s):

Adebayo Adetola Amballi ◽

Olatunde Odusan ◽

Omobola Abioye Ogundahunsi ◽

Alfred Ademola Jaiyesimi ◽

Sunday Kolawole Oritogun ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Diabetic Nephropathy ◽

Glycaemic Control ◽

Plasma Glucose ◽

Control Group ◽

Poor Glycaemic Control ◽

Diabetic Population

Background: Diabetes mellitus is a serious global epidemic. The menace of this chronic disease is attributable to its chronic complications which threaten both the world economy and life expectancy, especially in Sub- Saharan Africa. Nephropathy is a complication of Diabetes mellitus and a leading cause of End Stage Renal Disease. Objectives: To determine the prevalence of microalbuminuria as well as the effects of co-morbidities on the pattern of microalbuminuria among adults with Type 2 Diabetes mellitus. Methods: A total of 325 adults with Diabetes mellitus and 100 controls without Diabetes mellitus were studied. The subjects with diabetes were classified into four groups ([i] diabetes only, [ii] diabetes with hypertension, [iii] diabetes with obesity and [iv] diabetes with hypertension and obesity). Urinary protein, microalbuminuria, fasting plasma glucose and Glycated Haemoglobin (HbA1c) were measured using standard methods. Results: The overall prevalence of microalbuminuria was 35.1% in the diabetic population compared to 8.0% in the control group. The prevalence of microalbuminuria in the various diabetic subgroups were as follows: 30.3% (diabetes only), 43.1% (diabetes with hypertension), 37.0% (diabetes with obesity) and 44.6% (diabetes with hypertension and obesity). The fasting plasma glucose and HbA1c were statistically significantly higher in the diabetic population than the control group. This indicated that there is a poor glycaemic control in the diabetic population and hence a possible cause of diabetic nephropathy. Conclusion: The risk of diabetic nephropathy was significant in the study population. The presence of one or more co-morbidities and poor glycaemic control increased the occurrence of diabetic nephropathy.

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Is Uric Acid elevation a random finding or a causative agent of diabetic nephropathy?

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.65.9.1156 ◽

2019 ◽

Vol 65 (9) ◽

pp. 1155-1160 ◽

Cited By ~ 1

Author(s):

Mehmet Zahid Kocak ◽

Gulali Aktas ◽

Tuba T. Duman ◽

Burcin M. Atak ◽

Haluk Savli

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Uric Acid ◽

Diabetic Nephropathy ◽

Study Groups ◽

Diabetic Patients ◽

Study Participants ◽

The Relationship

SUMMARY OBJECTIVE In this study, we aimed to analyze the relationship between serum uric acid (UA) and microalbuminuria as a marker of renal injury in type 2 diabetes mellitus. METHODS A total of 100 patients with type 2 diabetes mellitus were enrolled in the study. Participants were divided into two groups according to the urinary microalbumin/creatinine ratio: diabetic nephropathy and non-nephropathy group. UA and microalbuminuria were compared between the study groups. RESULTS Serum UA levels of diabetic nephropathy patients were significantly higher than those in the non-nephropathy group (UA in patients with diabetic nephropathy groups: 6.3 (1.82) mg/dl, UA in patients of the non-nephropathic group: 4.85 (1.92) mg/dl) (p<0.001). There was a correlation between microalbuminuria and UA (r=0.238). This correlation was statistically significant (p=0.017). CONCLUSION UA levels may be an important predictor of nephropathy in diabetic patients.

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Microalbumin Status in Relation to Glycated Haemoglobin and Duration of Type 2 Diabetes Mellitus

Annals of Clinical Chemistry and Laboratory Medicine ◽

10.3126/acclm.v1i1.12310 ◽

2015 ◽

Vol 1 (1) ◽

pp. 21-24 ◽

Cited By ~ 1

Author(s):

Kumananda Acharya ◽

Sangita Regmi ◽

Alina Shri Sapkota ◽

Mithileshwer Raut ◽

Bharat Jha

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Diabetic Nephropathy ◽

Hba1c Level ◽

Diabetic Patients ◽

Endocrine Disorders ◽

Duration Of Diabetes ◽

Study Results

BACKGROUND: Diabetes mellitus (DM) is one of the most common endocrine disorders, characterized by hyperglycemia. Diabetic nephropathy is a consequence of long- standing diabetes and urinary microalbumin (Uma) status predicts progression to diabetic nephropathy. This study was conducted to know the status of Uma in relation to duration of diabetes and HbA1c level in patients with Type 2 diabetes mellitus (T2DM). METHODS: This prospective cross-sectional descriptive study was conducted from July 1, 2014 to January 15, 2015 at TUTH, Kathmandu. Ninety-six known T2DM patients with age 35– 83 years were included in the study. EDTA venous blood and spot urine sample were collected for analysis of HbA1c and Uma respectively. Only those patients having HbA1c concentration ≥ 6.3% and duration of diabetes ≥ 6 months were included under the study. RESULTS: Overall prevalence of microalbuminuria (MAU) was 39.6 %. MAU had a highly significant correlation with duration of diabetes (r =0.471, p<0.05). Present study has shown positive correlation of MAU with HbA1c level, although statistically insignificant (r=0.245, p>0.05). CONCLUSIONS: Prolonged exposure to hyperglycemia-induced advanced glycosylation end products accumulations contributes for the development of MAU. So, duration of diabetes mellitus is main contributing factor for the development of MAU rather than HbA1c level alone. Screening for MAU to prevent renal impairment and measuring HbA1c level on a regular basis for good glycemic control are important in diabetic patients. DOI: http://dx.doi.org/10.3126/acclm.v1i1.12310 Ann. Clin. Chem. & Lab. Med. 1(1) 2015: 21-24

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Prevalence of NAFLD and Its Correlation with Diabetic Nephropathy in Type 2 Diabetes Mellitus Patients

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2021/173 ◽

2021 ◽

Vol 10 (11) ◽

pp. 809-812

Author(s):

Simran Kaur ◽

Sushma Laxmareddygari ◽

Nitin Gupta ◽

Akshith Rajgupta Tabjula ◽

Yavatesh Joshi ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Diabetic Nephropathy ◽

Fatty Liver ◽

Demographic Data ◽

Significant Risk ◽

Diabetic Patients ◽

Alcoholic Fatty Liver

BACKGROUND Diabetes mellitus (DM) is a disease related to abnormality in metabolism of carbohydrates which is characterised by hyperglycemia that results from relative or absolute defect in insulin secretion, varying degrees of insulin resistance or both. Various researches have established the link between type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD). The present study was done for assessing the prevalence of NAFLD and its association with diabetic nephropathy in patients with type 2 diabetes mellitus. METHODS 75 patients of type 2 diabetes were included in this study. Clinical details and demographic data of all the patients were obtained. Samples were obtained from all the patients and all the routine investigations were carried out. Ultrasonography (USG) abdomen was performed in all patients after 12 hours fasting. Microsoft Excel was used for recording the results and were analysed by Statistical Package for the Social Sciences (SPSS) software. Level of significance was evaluated using chisquare test. RESULTS NAFLD was present in 57 patients. Therefore, the overall prevalence of NAFLD was see 76 %. The overall prevalence of diabetic nephropathy was 42 percent among diabetic patients. Out of 31 patients with diabetic nephropathy, NAFLD was present in 25 patients. Significant results were obtained while assessing the association of NAFLD with diabetic nephropathy in T2DM patients. CONCLUSIONS NAFLD was found to be a significant risk factor for the development of diabetic nephropathy in patients having type 2 diabetes mellitus. KEY WORDS Non-Alcoholic Fatty Liver, Diabetic Nephropathy, Type 2 Diabetes Mellitus, Nonalcoholic Steatohepatitis

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