Abstract
Background The purpose of the present study was to determine whether patients with DM1 have
shown improvement, stabilization or deterioration of their urine albumin excretion
levels during a close follow-up.
Patients and Methods A cohort of 84 patients, 18–76 years of age, a median duration of diabetes of 24
years (1–50 years) and a median follow-up duration of 12 years (1–37 years) were included
in the study.
Results Among the 84 patients for whom we had UAE levels at the beginning and by the end
of the study, mean glycosylated hemoglobin was statistically significantly decreased
during the follow-up period, from 8.02±2.04–7.06±1.05% (p=0.036). Normoalbuminuria
was present in 66 patients and remained so in 56 patients while 9 patients progressed
to microalbuminuria and one patient to macroalbuminuria by the end of the study. Microalbuminuria
was present in 15 patients: regression was observed in 8 patients, and progression
in one patient. Regression of macroalbuminuria to microalbuminuria was noted in one
patient and to normoalbuminuria was noted in one participant, too.
Conclusions Improvement of glycemic control with close monitoring of DM1 patients together with
the appropriate use ACE or AT2 inhibitors and statins, seems to exert nephron-protective
potential and to delay or even reverse the presence of micro/macroalbuminuria. This
long term follow-up study has demonstrated a statistically significant increase in
serum HDLcholesterol levels. The study also revealed that intensively treated diabetes
patients may show reductions in serum ALP levels. Whether this finding is related
to diabetic nephropathy, NAFLD, or diabetic hepatosclerosis remains to be assessed
in future trials.
Key words
type 1 diabetes - microalbuminuria - alkaline phosphatase - diabetic hepatosclerosis
- steatosis
