Background and Aims: Diabetes mellitus (DM) is a chronic disease which can evolve towards devastating micro and macro-vascular complications. Chronic kidney disease (CKD) is a worldwide public health problem, with adverse outcomes of kidney failure, cardiovascular disease (CVD) and premature death. The aim of our study was to evaluate the prognosis in patients with DM and CKD, depending on estimated glomerular filtration rate (eGFR) and albuminuria, according to the classification of Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease (KDIGO) from 2013 Materials and Methods: The study was epidemiological, transversal, non interventional type, with 600 subjects unselected patients divided into three subgroups: 200 patients with T1DM, 200 patients with T2DM and 200 age matched subjects without DM. The recorded data have been analyzed using the Statistic Package for Social Sciences (SPSS), the 17.00 software (IBM Corporation, Armonk, NY, United States of America). Results:. We found a statistically significant difference among the three study groups (p < 0.0001) regarding the prognosis of CKD. Conclusions: DM represents an important risk factor for the appearance of CKD but also a negative prognosis factor for the patients with CKD.
Insulin resistance (IR) is a fundamental disorder of type 2 Diabetes Mellitus (DM), but it is also involved in the etiopathogenesis of type 1 DM, with important implications in the onset and progression of micro- and macrovascular complications in type 1 DM. Overweight plays the main role in the increased incidence of both types of DM, exacerbating IR. The epidemic increase of overweight and obesity makes it difficult to diagnose the exact phenotype of DM, as IR and autoimmunity often coexist. Many studies showed an increase in incidence of micro- and macrovascular complications in patients with type 1 DM with IR, compared to patients with type 1 DM without IR. The gold standard of IR evaluation is represented by the method of euglycemic-hyperinsulinemic clamp, applied on a reduced scale in research. Thus, it is necessary to identify early IR markers (clinical or biological markers), less laboured ones, that could be used on a large scale in current medical practice, for the IR determination in type 1 DM. Clinicians and health experts should prevent/ reduce the epidemic of overweight and obesity in young people, thus decreasing IR, and implicitly the chronic complications of DM.
Background and Aims: Studies have shown an increased incidence of chronic complications in people with type 1 diabetes mellitus (T1DM) with insulin resistance (IR) compared to people with T1DM without IR. Estimated glucose disposal rate (eGDR) is an important indicator of IR in patients with T1DM, lower eGDR levels indicating greater IR. It was shown that T1DM patients with chronic complications (diabetic retinopathy - DR, diabetic peripheral neuropathy - DPN or diabetic kidney disease - DKD) exhibit higher IR compared to patients without chronic complications. The aim of our study was to evaluate eGDR as a marker for the assessment of IR in T1DM patients.
Materials and Methods: The study was observational, cross-sectional and included 140 T1DM patients with diabetes duration>10 years. The collected data were analyzed using the Statistic Package for Social Sciences (SPSS) version 22 software (IBM Corporation, Armonk, NY, USA).
Results: eGDR presented statistically significant correlations (p<0.05) with the presence of metabolic syndrome (MS), obesity, chronic complications of T1DM, cardiovascular risk (CVR) and smoking status in patients with T1DM duration >10 years.
Conclusions: eGDR represents a reliable marker for assessing the IR in T1DM.