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Diabetic nephropathy in type 1 (insulin-dependent) diabetes: An epidemiological study

Diabetic nephropathy in type 1 (insulin-dependent) diabetes: An epidemiological study 125 25 25 6 6 A. R. Andersen J. Sandahl Christiansen J. K. Andersen S. Kreiner T. Deckert Steno Memorial Hospital Gentofte Department for Data Processing Copenhagen County Hospital Herlev Denmark Summary A follow-up of 1475 Type 1 (insulin-dependent) diabetic patients diagnosed before 1953 (815 males, 660 females) and before the age of 31 years was conducted. All patients were seen at the Steno Memorial Hospital and were referred from all parts of Denmark; 91 (6%) could not be traced. The rest (94%) were followed until death or for at least 25 years; 249 (17%) were followed for >40 years. Clinical diabetic nephropathy developed in 531 (41%) of the 1303 patients in whom sufficient information was available regarding proteinuria. Other causes of proteinuria were found in 3%, and 57% did not develop persistent proteinuria. The prevalence of diabetic nephropathy was 21% after 20–25 years of diabetes duration followed by a decline to 10% after 40 years. Two incidence peaks of the onset of proteinuria were seen, one after 16 and another after 32 years duration of diabetes. Incidence increased steeply 10 years after onset of diabetes and was low after 35 years duration. The cumulative incidence was 45% after 40 years of diabetes. A male preponderance was seen among patients with nephropathy. A significant difference in the pattern of annual incidence rates of diabetic nephropathy was seen, when groups with onset of diabetes before 1933, between 1933–1942, and 1943–1952, respectively, were compared. An association between daily insulin requirement and nephropathy incidence was found. Patients with nephropathy had a much poorer survival than those without proteinuria; 40 years after onset of diabetes, only 10% of patients who developed nephropathy were alive, whereas >70% of patients who did not develop nephropathy survived. Uraemia was the cause of death in 66% of the patients with nephropathy; 7 years after the onset of persistent proteinuria, 49% of the patients had died. It is concluded that diabetic nephropathy is the major life threatening complication in Type I diabetes of juvenile onset. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Diabetologia Springer Journals

Diabetic nephropathy in type 1 (insulin-dependent) diabetes: An epidemiological study

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References (24)

Publisher
Springer Journals
Copyright
Copyright © 1983 by Springer-Verlag
Subject
Medicine & Public Health; Human Physiology; Internal Medicine; Metabolic Diseases
ISSN
0012-186X
eISSN
1432-0428
DOI
10.1007/BF00284458
Publisher site
See Article on Publisher Site

Abstract

125 25 25 6 6 A. R. Andersen J. Sandahl Christiansen J. K. Andersen S. Kreiner T. Deckert Steno Memorial Hospital Gentofte Department for Data Processing Copenhagen County Hospital Herlev Denmark Summary A follow-up of 1475 Type 1 (insulin-dependent) diabetic patients diagnosed before 1953 (815 males, 660 females) and before the age of 31 years was conducted. All patients were seen at the Steno Memorial Hospital and were referred from all parts of Denmark; 91 (6%) could not be traced. The rest (94%) were followed until death or for at least 25 years; 249 (17%) were followed for >40 years. Clinical diabetic nephropathy developed in 531 (41%) of the 1303 patients in whom sufficient information was available regarding proteinuria. Other causes of proteinuria were found in 3%, and 57% did not develop persistent proteinuria. The prevalence of diabetic nephropathy was 21% after 20–25 years of diabetes duration followed by a decline to 10% after 40 years. Two incidence peaks of the onset of proteinuria were seen, one after 16 and another after 32 years duration of diabetes. Incidence increased steeply 10 years after onset of diabetes and was low after 35 years duration. The cumulative incidence was 45% after 40 years of diabetes. A male preponderance was seen among patients with nephropathy. A significant difference in the pattern of annual incidence rates of diabetic nephropathy was seen, when groups with onset of diabetes before 1933, between 1933–1942, and 1943–1952, respectively, were compared. An association between daily insulin requirement and nephropathy incidence was found. Patients with nephropathy had a much poorer survival than those without proteinuria; 40 years after onset of diabetes, only 10% of patients who developed nephropathy were alive, whereas >70% of patients who did not develop nephropathy survived. Uraemia was the cause of death in 66% of the patients with nephropathy; 7 years after the onset of persistent proteinuria, 49% of the patients had died. It is concluded that diabetic nephropathy is the major life threatening complication in Type I diabetes of juvenile onset.

Journal

Diabetologia – Springer Journals

Published: Dec 1, 1983

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