Although Diabetes is Not Obvious, Its Complications May Be Obvious, Frequency of Nephropathy in Prediabetic Patients
Abstract
BACKGROUND/AIMS: Prediabetes is considered a risk factor for diabetes mellitus (DM) and cardiovascular diseases. Complications are also detected during diagnosis in 10-40% of diabetes patients. Diabetic nephropathy is one of the critical microvascular complications of diabetes. Studies have shown that prediabetes is associated with the development of glomerular hyperfiltration and albuminuria, as in the early stages of diabetes. Identifying patients before overt DM occurs is important for early diagnosis and treatment of nephropathy and DM.
The aim of our study is to investigate the presence and frequency of nephropathy in prediabetes patients.
METHODS: Patients who applied to the outpatient internal medicine and endocrinology outpatient clinics and whose random fasting blood sugar was ≥100 mg/dl were evaluated. Oral glucose tolerance test (OGTT) was performed and HbA1C values were measured. 280 patients diagnosed with prediabetes and evaluated for nephropathy were included in the study.
RESULTS: Nephropathy was detected in 81 (28.9%) of the patients. The average HbA1C value of the group with nephropathy was 6.28% (sd: 0.52) and the average HbA1C value of the group without nephropathy was 6.05% (sd: 0.29). The average HbA1C value was found to be significantly higher in the group with nephropathy (p=0.000).
CONCLUSIONS: The fact that nephropathy was detected in 28.9% of the patients showed once again the seriousness of prediabetes. Therefore, patients with prediabetes, especially those with higher HbA1C values, need to be evaluated more carefully in terms of nephropathy and CKD.
Keywords
References
- 1. Deshpande AD, Harris-Hayes M, Schootman M. Epidemiology of diabetes and diabetes-related complications. Physical therapy. 2008;88(11):1254-64.
- 2. Diabetes Atlas | International Diabetes Federation [Internet]. [cited 2018 april 05]. https://diabetesatlas.org/atlas/seventh-edition/
- 3. Çalışma, TEMD Diabetes Mellitus, and Eğitim Grubu. "TEMD Diabetes Mellitus ve Komplikasyonlarının Tanı, Tedavi ve İzlem Kılavuzu-2019. 12." Baskı. Ağustos (2019).
- 4. Ruggenenti P, Remuzzi G. Nephropathy of type 1 and type 2 diabetes: diverse pathophysiology, same treatment? Nephrol Dial Transplant. 2000 Dec;15(12):1900-2.
- 5. SeyAhi N, AltIpARMA MR, SüleyMAnlAR G. Türkiye’de Renal Replasman Tedavilerinin Güncel Durumu: Türk Nefroloji Derneği Kayıt Sistemi 2013 Yılı Özet Raporu Current Status of Renal Replacement Therapy in Turkey: A Summary of Turkish Society of Nephrology 2013 Annual Registry Report. Süleymanlar, Gültekin–Ateş, Kenan–Seyahi, Nurhan. 2015.
- 6. TURKDİAB Diyabet Tanı ve Tedavi Rehberi Nisan 2019, . Türkiye Diyabet Vakfı. 2019. [Internet]. https://www.turkdiab.org/admin/PICS/files/Diyabet_Tani_ve_Tedavi_Rehberi_2019.pdf
- 7. Melsom T, Schei J, Stefansson VT, Solbu MD, Jenssen TG, Mathisen UD, Wilsgaard T, Eriksen BO. Prediabetes and Risk of Glomerular Hyperfiltration and Albuminuria in the General Nondiabetic Population: A Prospective Cohort Study. Am J Kidney Dis. 2016 Jun;67(6):841-50.
- 8. Tabák AG, Herder C, Rathmann W, Brunner EJ, Kivimäki M. Prediabetes: a high-risk state for diabetes development. Lancet. 2012 Jun 16;379(9833):2279-90.
- 9. Honigberg MC, Zekavat SM, Pirruccello JP, Natarajan P, Vaduganathan M. Cardiovascular and Kidney Outcomes Across the Glycemic Spectrum: Insights From the UK Biobank. J Am Coll Cardiol. 2021 Aug 3;78(5):453-464.
- 10. Schlesinger S, Neuenschwander M, Barbaresko J, Lang A, Maalmi H, Rathmann W, Roden M, Herder C. Prediabetes and risk of mortality, diabetes-related complications and comorbidities: umbrella review of meta-analyses of prospective studies. Diabetologia. 2022 Feb;65(2):275-285.
- 11. Zheng R, Xu Y, Li M, Gao Z, Wang G, Hou X, Chen L, Huo Y, Qin G, Yan L, Wan Q, Zeng T, Chen L, Shi L, Hu R, Tang X, Su Q, Yu X, Qin Y, Chen G, Gu X, Shen F, Luo Z, Chen Y, Zhang Y, Liu C, Wang Y, Wu S, Yang T, Li Q, Mu Y, Zhao J, Hu C, Jia X, Xu M, Wang T, Zhao Z, Wang S, Lin H, Ning G, Wang W, Lu J, Bi Y; China Cardiometabolic Disease and Cancer Cohort (4C) Study Group. Data-driven subgroups of prediabetes and the associations with outcomes in Chinese adults. Cell Rep Med. 2023 Mar 21;4(3):100958.
- 12. Plantinga LC, Crews DC, Coresh J, Miller ER 3rd, Saran R, Yee J, Hedgeman E, Pavkov M, Eberhardt MS, Williams DE, Powe NR; CDC CKD Surveillance Team. Prevalence of chronic kidney disease in US adults with undiagnosed diabetes or prediabetes. Clin J Am Soc Nephrol. 2010 Apr;5(4):673-82.
- 13. Tapp RJ, Shaw JE, Zimmet PZ, Balkau B, Chadban SJ, Tonkin AM, Welborn TA, Atkins RC. Albuminuria is evident in the early stages of diabetes onset: results from the Australian Diabetes, Obesity, and Lifestyle Study (AusDiab). Am J Kidney Dis. 2004 Nov;44(5):792-8.
- 14. Wang XL, Lu JM, Pan CY, Tian H, Li CL. A comparison of urinary albumin excretion rate and microalbuminuria in various glucose tolerance subjects. Diabet Med. 2005 Mar;22(3):332-5.
- 15. Echouffo-Tcheugui JB, Narayan KM, Weisman D, Golden SH, Jaar BG. Association between prediabetes and risk of chronic kidney disease: a systematic review and meta-analysis. Diabet Med. 2016 Dec;33(12):1615-1624.
Diyabet Aşikar Olmasa da Komplikasyonları Aşikar Olabilir, Prediyabet Hastalarında Nefropatinin Sıklığı
Abstract
GİRİŞ/AMAÇ: Prediyabet, diabetes mellitus (DM) ve kardiyovasküler hastalıklar için bir risk faktörü kabul edilmektedir. Tip 2 DM tanısı konduğu anda hastaların %10-40’ında komplikasyonlar vardır. Diyabetik nefropati diyabetin önemli mikrovasküler komplikasyonlarından biridir. Yapılan çalışmalar prediyabetin de diyabetin erken dönemlerinde olduğu gibi, glomerüler hiperfiltrasyon ve albüminüri gelişimi ile ilişkili olduğunu göstermiştir. Aşikar DM ortaya çıkmadan önce hastaların tespit edilmesi nefropatinin ve DM’ün erken tanı ve tedavisi için önemlidir.
Çalışmamızın amacı prediyabet hastalarında nefropatinin varlığını ve sıklığını araştırmaktır.
METOD: Ayaktan iç hastalıkları ve endokrinoloji polikliniğine başvuran, rastgele bakılan açlık kan şekeri ≥100 mg/dl olan hastalar değerlendirmeye alındı. Oral glukoz tolerans testi (OGTT) yapıldı ve HbA1C değerleri ölçüldü. Çalışmaya prediyabet tanısı konulan ve nefropati değerlendirmesi yapılan 280 hasta dahil edildi.
BULGULAR: Hastaların 81’sinde (%28,9) nefropati saptandı. Nefropatisi olan grubun ortalama HbA1C değeri %6,28 (ss:0,52) nefropatisi olmayan grubun ortalama HbA1C değeri %6,05 (ss:0,29) düzeyinde saptandı. Nefropatisi olan grupta ortalama HbA1C değerinin anlamlı olarak daha yüksek olduğu görüldü (p=0,000).
SONUÇ: Hastaların %28,9’unda nefropati saptanmış olması prediyabetin ciddiyetini bir kez daha göstermiş oldu. Bundan dolayı prediyabeti olan, özellikle de HbA1C değeri yüksek olan hastalarda nefropati ve KBY açısından daha dikkatli olunmalıdır.
Keywords
References
- 1. Deshpande AD, Harris-Hayes M, Schootman M. Epidemiology of diabetes and diabetes-related complications. Physical therapy. 2008;88(11):1254-64.
- 2. Diabetes Atlas | International Diabetes Federation [Internet]. [cited 2018 april 05]. https://diabetesatlas.org/atlas/seventh-edition/
- 3. Çalışma, TEMD Diabetes Mellitus, and Eğitim Grubu. "TEMD Diabetes Mellitus ve Komplikasyonlarının Tanı, Tedavi ve İzlem Kılavuzu-2019. 12." Baskı. Ağustos (2019).
- 4. Ruggenenti P, Remuzzi G. Nephropathy of type 1 and type 2 diabetes: diverse pathophysiology, same treatment? Nephrol Dial Transplant. 2000 Dec;15(12):1900-2.
- 5. SeyAhi N, AltIpARMA MR, SüleyMAnlAR G. Türkiye’de Renal Replasman Tedavilerinin Güncel Durumu: Türk Nefroloji Derneği Kayıt Sistemi 2013 Yılı Özet Raporu Current Status of Renal Replacement Therapy in Turkey: A Summary of Turkish Society of Nephrology 2013 Annual Registry Report. Süleymanlar, Gültekin–Ateş, Kenan–Seyahi, Nurhan. 2015.
- 6. TURKDİAB Diyabet Tanı ve Tedavi Rehberi Nisan 2019, . Türkiye Diyabet Vakfı. 2019. [Internet]. https://www.turkdiab.org/admin/PICS/files/Diyabet_Tani_ve_Tedavi_Rehberi_2019.pdf
- 7. Melsom T, Schei J, Stefansson VT, Solbu MD, Jenssen TG, Mathisen UD, Wilsgaard T, Eriksen BO. Prediabetes and Risk of Glomerular Hyperfiltration and Albuminuria in the General Nondiabetic Population: A Prospective Cohort Study. Am J Kidney Dis. 2016 Jun;67(6):841-50.
- 8. Tabák AG, Herder C, Rathmann W, Brunner EJ, Kivimäki M. Prediabetes: a high-risk state for diabetes development. Lancet. 2012 Jun 16;379(9833):2279-90.
- 9. Honigberg MC, Zekavat SM, Pirruccello JP, Natarajan P, Vaduganathan M. Cardiovascular and Kidney Outcomes Across the Glycemic Spectrum: Insights From the UK Biobank. J Am Coll Cardiol. 2021 Aug 3;78(5):453-464.
- 10. Schlesinger S, Neuenschwander M, Barbaresko J, Lang A, Maalmi H, Rathmann W, Roden M, Herder C. Prediabetes and risk of mortality, diabetes-related complications and comorbidities: umbrella review of meta-analyses of prospective studies. Diabetologia. 2022 Feb;65(2):275-285.
- 11. Zheng R, Xu Y, Li M, Gao Z, Wang G, Hou X, Chen L, Huo Y, Qin G, Yan L, Wan Q, Zeng T, Chen L, Shi L, Hu R, Tang X, Su Q, Yu X, Qin Y, Chen G, Gu X, Shen F, Luo Z, Chen Y, Zhang Y, Liu C, Wang Y, Wu S, Yang T, Li Q, Mu Y, Zhao J, Hu C, Jia X, Xu M, Wang T, Zhao Z, Wang S, Lin H, Ning G, Wang W, Lu J, Bi Y; China Cardiometabolic Disease and Cancer Cohort (4C) Study Group. Data-driven subgroups of prediabetes and the associations with outcomes in Chinese adults. Cell Rep Med. 2023 Mar 21;4(3):100958.
- 12. Plantinga LC, Crews DC, Coresh J, Miller ER 3rd, Saran R, Yee J, Hedgeman E, Pavkov M, Eberhardt MS, Williams DE, Powe NR; CDC CKD Surveillance Team. Prevalence of chronic kidney disease in US adults with undiagnosed diabetes or prediabetes. Clin J Am Soc Nephrol. 2010 Apr;5(4):673-82.
- 13. Tapp RJ, Shaw JE, Zimmet PZ, Balkau B, Chadban SJ, Tonkin AM, Welborn TA, Atkins RC. Albuminuria is evident in the early stages of diabetes onset: results from the Australian Diabetes, Obesity, and Lifestyle Study (AusDiab). Am J Kidney Dis. 2004 Nov;44(5):792-8.
- 14. Wang XL, Lu JM, Pan CY, Tian H, Li CL. A comparison of urinary albumin excretion rate and microalbuminuria in various glucose tolerance subjects. Diabet Med. 2005 Mar;22(3):332-5.
- 15. Echouffo-Tcheugui JB, Narayan KM, Weisman D, Golden SH, Jaar BG. Association between prediabetes and risk of chronic kidney disease: a systematic review and meta-analysis. Diabet Med. 2016 Dec;33(12):1615-1624.
Details
| Primary Language | English |
|---|---|
| Subjects | Endocrinology, Nefroloji |
| Journal Section | Original Research |
| Authors | |
| Early Pub Date | February 1, 2024 |
| Publication Date | January 31, 2024 |
| Submission Date | November 10, 2023 |
| Acceptance Date | January 28, 2024 |
| Published in Issue | Year 2024 Volume: 14 Issue: 1 |
