Risk factors and risk determinants for the evolution of the diabetic nephropathy in IDDM: a case control study of 108 IDDM patients in the Bucharest Center of Diabetes.
The study included 108 IDDM patients (59 males, 49 females, aged 15-59 years) from the Bucharest Diabetic Centre which participated in the EURODIAB multicentric study. They were divided into three groups according to the duration of diabetes (less than 7 years; 8 to 14 years; more than 15 years) and we have made a comparison between the importance of some risk factors, as elevated blood pressures, age, elevated levels of the total plasma cholesterol, and glycosylated hemoglobin (HbA1C) on the progression of the microalbuminuria in these groups. Excluding the patients in the renal failure stage of the diabetic nephropathy or with other chronic diseases, our results confirm the data in the literature referring to the important role of the elevated diastolic blood pressure and elevated levels of the total plasma cholesterol in the rapid progression of the renal injury, especially after more than 8 years of IDDM evolution. We also found, between the long-term diabetics (over 15 years of evolution) a large proportion which appears to be genetically protected against the diabetic nephropathy. This point confirms some data from the literature (the Steno hypothesis). The HbA1C levels appears to lower with the duration of the diabetes and they are not correlated with the degree of the renal injury. These findings appear to be in contradiction with the data from the literature.