Microalbuminuria and hypertension rates are higher in youth with type 2 diabetes
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Microalbuminuria and hypertension rates are higher in youth with type 2 diabetes compared to those with type 1 diabetes.
Researchers in Australia conducted a study “to compare the prevalence of diabetes complications and their risk factors in youth with type 1 versus type 2 diabetes.”
M.C. Eppens and colleagues working with the Children’s Hospital “performed a comparative clinic-based study of 1,433 patients with type 1 diabetes and 68 patients with type 2 diabetes aged <18 years from New South Wales, Australia. Retinopathy was assessed by sevenfield stereoscopic retinal photography; albumin excretion rate from three consecutive, timed, overnight urine collections; peripheral neuropathy by thermal and vibration threshold; and autonomic neuropathy by pupillometry. HbA[1c] (A1C) and lipids were measured in all patients and C-peptide in patients with type 2 diabetes.”
They found, “In patients with type 1 versus type 2 diabetes, median (interquartile range) age was 15.7 years (13.9-17.0) and 15.3 years (13.6-16.4), respectively (p=0.2), whereas median diabetes duration was 6.8 years (4.7-9.6) and 1.3 years (0.6-3.1), respectively (p <0.0001). Retinopathy was significantly more common in patients with type I diabetes (20 vs. 4%, p=0.04), while microalbuminuria and hypertension were significantly less common (6 and 16% in type 1 diabetes vs. 28 and 36% in type 2 diabetes).
“Rates of peripheral and autonomic neuropathy were similar (27 and 61% in type 1 diabetes vs. 21 and 57% in type 2 diabetes), In multivariate analyses, microalbuminuria was significantly associated with older age (odds ratio 1.3 [95% CI 1.2-1.5], p<0.001) and systolic hypertension (3.63 [2.0-6.3], p<0.001) in type I diabetes, while only higher A1C (1.7[1.3-2.9], p=0.002) was significant in patients with type 2 diabetes.”
Investigators concluded, “Youth with type 2 diabetes have significantly higher rates of microalbuminuria and hypertension than their peers with type 1 diabetes, despite shorter diabetes duration and lower A1C. The results of this study support recommendations for early complications screening and aggressive targeting of glycemic control in patients with type 2 diabetes.”
Eppens and colleagues published the results of their research in Diabetes Care (Prevalence of diabetes complications in adolescents with type 2 compared with type 1 diabetes. Diabetes Care, 2006;29(6):1300-1306).
For additional information, contact M.E. Craig, Children’s Hospital, Institute Endocrinol & Diabetes, Locked Bag 4001, Westmead, NSW 2145, Australia.
The publisher of the journal Diabetes Care can be contacted at: American Diabetes Association, 1701 N Beauregard St., Alexandria, VA 22311-1717, USA.
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