OBJECTIVEThe current study aimed to investigate whether microalbuminuria or moderately decreased glomerular filtration rate (GFR) is a better predictor for the development and progression of retinopathy in type 2 diabetic patients.RESEARCH DESIGN AND METHODSType 2 diabetic patients without cardiovascular diseases, malignancy, pregnancy, and acute intercurrent illness were enrolled between 1 August 2001 and 31 December 2002. All participants provided their detailed medical history and underwent an eye fundus examination. They were followed up in outpatient clinics, and serum creatinine, urinary albumin-to-creatinine ratio (UACR), and retinal photographs were followed up annually until 31 December 2009. The primary outcomes were development and progression of diabetic retinopathy and nephropathy. The secondary outcomes were cardiovascular events and all-cause mortality.RESULTSAmong 487 participants, 81 subjects had normoalbuminuria and moderate renal impairment (baseline eGFR 30–59.9 mL/min/1.73 m2), and 106 subjects had microalbuminuria and baseline eGFR ≥60 mL/min/1.73 m2. Patients with microalbuminuria and eGFR ≥60 mL/min/1.73 m2 had a significantly greater risk for development and progression of diabetic retinopathy (HR 3.34 [95% CI 1.04–10.70]) compared with those with moderate renal impairment and normoalbuminuria after multivariate adjustment. Risks for renal outcome, cardiovascular events, and all-cause mortality were not significantly different between the two groups.CONCLUSIONSMicroalbuminuria has a greater impact on predicting the development and progression of diabetic retinopathy compared with moderate decline in GFR among type 2 diabetic patients.

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Our study demonstrated the impact of pre-existing diabetes on clinical features and OS in patients with MM.

OBJECTIVE -In the U.K. Prospective Diabetes Study, A1C increased from 1.2 to 1.7% and fasting plasma glucose from 1.0 to 2.8 mmol/l over 10 years in type 2 diabetic patients. It is not known whether the blood glucose increase observed in long-term studies of type 2 diabetes results from small, steady increases throughout the year or from increases during discrete periods.RESEARCH DESIGN AND METHODS -To estimate the variation of actual glycemic control and its relation to holiday times, we measured A1C and fructosamine in 110 patients with type 2 diabetes. These measurements were performed four times at intervals of 4 -6 weeks; therefore, glycemic change was determined for three periods: preholiday period (from between November 13 and December 20 to between December 20 and January 20), holiday period (from between December 20 and January 20 to between January 28 and February 28), and postholiday period (from between January 28 and February 28 to between March 1 and April 10). A final measurement of A1C was obtained from 90 subjects in the following December or January.RESULTS -The mean A1C increased, but not significantly, during the preholiday (increase 0.135 Ϯ 0.723%, P ϭ 0.055) and holiday (increase 0.094 Ϯ 0.828%, P ϭ 0.239) periods. The mean A1C decreased, but not significantly, during the postholiday period (decrease 0.022 Ϯ 0.588%, P ϭ 0.695). Altogether, the A1C change during these three periods increased significantly (increase 0.207 Ϯ 0.943%, P ϭ 0.024). The mean fructosamine increased significantly during the preholiday period (increase 0.151 Ϯ 0.460 mmol/l, P ϭ 0.001), but there was no significant change during the holiday period (increase 0.057 Ϯ 0.593 mmol/l, P ϭ 0.321). However, fructosamine decreased significantly during the postholiday period (decrease 0.178 Ϯ 0.448 mmol/l, P Ͻ 0.001). Altogether, the fructosamine changes during the study periods showed no significant difference (increase 0.030 Ϯ 0.566 mmol/l, P ϭ 0.579). Between March or early April and the following December or January, there was no additional change in A1C (decrease 0.009 Ϯ 1.039%, P ϭ 0.935) for the 90 participants who returned for follow-up treatment.CONCLUSIONS -The present study demonstrates an influence of winter holidays on the glycemic control of patients who have type 2 diabetes, and this poor glycemic control might not be reversed during the summer and autumn months. Therefore, the cumulative effects of the yearly A1C gain during the winter holidays are likely to contribute to the substantial increase in A1C that occurs every year among type 2 diabetic individuals. Diabetes Care 27:326 -330, 2004P oor glycemic control in type 2 diabetes has serious consequences for health and is a major risk factor for the development of diabetes complications. Good control of blood glucose concentration leads to fewer complications (1). From the U.K. Prospective Diabetes Study data, A1C increased from 1.2 to 1.7% and fasting plasma glucose from 1.0 to 2.8 mmol/l over 10 years in type 2 diabetic subjects (1). It is not known whether t...

A clinically applicable prediction model including age, sex, and genetic information from AQP2 rs296766 and/or SLC12A rs12904216 SNPs can be developed to estimate the risk of TZD-related edema in type 2 diabetes patients.