Premium
Low risk of overt nephropathy after 24 yr of childhood‐onset type 1 diabetes mellitus (T1DM) in Norway
Author(s) -
Skrivarhaug Torild,
Bangstad HansJacob,
Stene Lars C,
Sandvik Leiv,
Hanssen Kristian F,
Joner Geir
Publication year - 2006
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/j.1399-5448.2006.00204.x
Subject(s) - medicine , type 1 diabetes , type 2 diabetes mellitus , nephropathy , pediatrics , diabetes mellitus , diabetic nephropathy , endocrinology
Aim: To estimate the risk of diabetic nephropathy and associated risk factors in a nationwide cohort of childhood‐onset type 1 diabetes mellitus (T1DM) and 19–30 yr of diabetes duration. Methods: Patients diagnosed with childhood‐onset T1DM (<15 yr) from 1973 through 1982, who previously (1989–1990) participated in a clinical examination to assess diabetic complications, were invited for a new examination in 2002–2003. Of 355 eligible patients, 299 participated (84.2%), and complete urine samples for evaluation of albuminuria were obtained from 295 patients, with a mean age of 33 yr (range 20.9–44.0) and mean diabetes duration of 24 yr (range 19.3–29.9). Persistent microalbuminuria and overt nephropathy [albumin excretion rate (AER) 15–200 μg/min and AER > 200 μg/min, respectively] in at least two out of three consecutive overnight urine samples were defined as diabetic nephropathy. Results: Overt nephropathy was found in 7.8% [95% confidence interval (CI) 4.7–10.9] and persistent microalbuminuria in 14.9% (95% CI 10.8–19.0) of the subjects. Hemoglobin A1c (HbA1c) (p = 0.001), systolic blood pressure (BP) (p = 0.002), total cholesterol (p = 0.019), and C‐reactive protein (CRP) (p = 0.019) were associated with diabetic nephropathy. Significant predictors in 1989–1990 for the development of diabetic nephropathy in 2002–2003 were HbA1c (p < 0.001), AER (p = 0.007), and cholesterol (p = 0.022). Conclusions: In a subgroup of patients diagnosed with childhood‐onset T1DM in 1973–1982, 7.8% had overt nephropathy after 19–30 yr of diabetes duration, which is low compared with studies from other countries. HbA1c, systolic BP, total cholesterol, and CRP were each independently associated with diabetic nephropathy.