Interrelationships of microangiopathy, plasma glucose and other risk factors in 3583 diabetic patients: A multinational study

Abstract

In a multinational study, fasting plasma glucose values in 3583 diabetic patients, aged 34-56 years, were related to the characteristics of these subjects and to the presence and severity of microangiopathy as ascertained by standardised methods. The patients were from nine different populations and ranged in number from 193 to 686 per population (London, Warsaw, Berlin (FRG), New Delhi, Tokyo, Havana, Oklahoma Indians, Arizona Pima Indians, and a national sample in Switzerland). In the total group, mean fasting plasma glucose was 8.1 mmol/l for those on diet alone, 9.7 mmol/l for those on oral agents, and 12.7 mmol/l for insulin-treated patients, of whom 25% had values exceeding 16.5 mmol/l. Since many variables were measured in each patient, it was possible to take into account many confounding factors in evaluating the relationship of plasma glucose levels to retinopathy and nephropathy.

The Pattern of Diabetic Nephropathy Among Saudi Patients with Noninsulin-Dependent Diabetes Mellitus

“…These discrepancies may be due to less than optimal treatment by today's standards, inadequate sample size, inadequate duration of the study, varying starting points in the disease or the possibility that the stage being studied was already irreversible. Duration of diabetes is a very important factor in the development of diabetic nephropathy as demonstrated in several studies; [29][30][31][32][33][34][35][36][37][38][39][40][41] this has also been confirmed in our study -the longer the duration of diabetes, the higher the frequency of diabetic nephropathy. However, duration of the disease is not the only factor since many patients with longstanding diabetes will not develop nephropathy, as shown by the normal group in our study.…”

“…31 -35 We did not find a good correlation between degree of proteinuria and diabetic control. Although some studies, in particular, the large trials of the University group diabetes program (UGDP) 38 which were concluded in the late 1960s, did not show good correlation of hyperglycemia with diabetic nephropathy, other population-based cross-sectional studies 38,39 and the most recently published results of the diabetes complications and control trial (DCCT) 40 support the cause-and-effect relationship between hyperglycemia and diabetic nephropathy. These discrepancies may be due to less than optimal treatment by today's standards, inadequate sample size, inadequate duration of the study, varying starting points in the disease or the possibility that the stage being studied was already irreversible.…”

Prevalence of small vessel and large vessel disease in diabetic patients from 14 centres

“…Prospective data will investigate this possibility further. Similar logistic analyses for triglyceride and glucose data from five of the 14 populations in this study showed that higher glyceride values in the diabetics were associated with 'Large-Vessel Disease', 'Stroke Only' and 'Leg VD' categories, while fasting glucose showed no association with 'Heart VD' [29]. Withincentre analyses showed blood pressure, followed by age, to be the most consistent independent variables associated with LVD and HVD.…”

Plasma Asymmetric Dimethylarginine (ADMA) Is Associated With Retinopathy in Type 2 Diabetes

“…Thus, one might expect that high ADMA levels in diabetic retinopathy subjects reflect a phenomenon of the coexistence of diabetic retinopathy and diabetic nephropathy (13). The mean creatinine levels were, however, within the normal range in both diabetic groups.…”