Kidney Biopsy in Type 2 Diabetes: A Multicenter Cross-Sectional Study

2021 ◽  
pp. 1-10
Author(s):  
Jonathan M. Chemouny ◽  
Mickaël Bobot ◽  
Aurélie Sannier ◽  
Valentin Maisons ◽  
Noémie Jourde-Chiche ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Total Population ◽  
Cross Sectional Study ◽  
Rapid Progression ◽  
Hypertensive Nephropathy ◽  
Cross Sectional ◽  
Recent Onset ◽  
Atypical Features ◽  
Retinal Examination

<b><i>Introduction:</i></b> Kidney biopsies (KBs) are performed in patients with type 2 diabetes (T2D) to diagnose non-diabetic or hypertensive kidney disease (NDHKD) potentially requiring specific management compared to diabetic and or hypertensive nephropathy (absence of NDHKD). Indications for KB are based on the presence of atypical features compared to the typical course of diabetic nephropathy. In this study, we assessed the association of different patterns of atypical features, or KB indications, with NDHKD. <b><i>Methods:</i></b> Native KBs performed in patients with T2D were analyzed. Data were collected from the patients’ records. KB indications were determined according to the presence of different atypical features considered sequentially: (1) presence of any feature suggesting NDHKD which is not among the following ones, (2) recent onset of nephrotic syndrome, (3) low or rapidly declining estimated glomerular filtration rate (eGFR), (4) rapid increase in proteinuria, (5) short duration of diabetes, (6) presence of hematuria, or (7) normal retinal examination. <b><i>Results:</i></b> Among the 463 KBs analyzed, NDHKD was diagnosed in 40% of the total population and 54, 40, 24, and 7% of the KBs performed for indications 1–4 respectively. Conversely, no patient who underwent KB for indications 5–7 displayed NDHKD. Logistic regression analyses identified eGFR<sub>CKD-EPI</sub> &#x3e;15 mL/min/1.73 m<sup>2</sup>, urinary protein-to-Cr ratio &#x3c;0.3 g/mmol, hematuria, HbA1c &#x3c;7%, and diabetes duration &#x3c;5 years as predictors of NDHKD, independently from the indication group. <b><i>Conclusion:</i></b> NDHKD is frequent in T2D. Despite the association of hematuria with NDHKD, our results suggest that presence of hematuria and absence of DR are insufficient to indicate KB in the absence of concurrent atypical features. Conversely, rapid progression of proteinuria and rapid deterioration of eGFR are major signals of NDHKD.

Large-Scale Cross-Sectional Study of the Problem Areas in Diabetes Survey among Japanese Patients with Type 2 Diabetes Mellitus

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 2393-PUB
Author(s):  
KENICHIRO TAKAHASHI ◽  
MINORI SHINODA ◽  
RIKA SAKAMOTO ◽  
JUN SUZUKI ◽  
TADASHI YAMAKAWA ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Large Scale ◽  
Japanese Patients ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Diabetes Survey

Relative risk of cardiovascular disease is higher in women with type 2 diabetes, but not in those with prediabetes, as compared with men

2020 ◽  
Author(s):  
Elena Succurro ◽  
Teresa Vanessa Fiorentino ◽  
Sofia Miceli ◽  
Maria Perticone ◽  
Angela Sciacqua ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Longitudinal Study ◽  
Relative Risk ◽  
Hdl Cholesterol ◽  
Cross Sectional Study ◽  
Adverse Outcomes ◽  
Cross Sectional ◽  
Normal Glucose

<b>Objective</b>: Most, but not all studies suggested that women with type 2 diabetes have higher relative risk (RR) for cardiovascular disease (CVD) than men. More uncertainty exists on whether the RR for CVD is higher in prediabetic women compared to men. <p><b>Research Design and Methods</b>: In a cross-sectional study, in 3540 normal glucose tolerant (NGT), prediabetic, and diabetic adults, we compared the RR for prevalent non-fatal CVD between men and women. In a longitudinal study including 1658 NGT, prediabetic, and diabetic adults, we compared the RR for incident major adverse outcomes, including all-cause death, coronary heart disease, and cerebrovascular disease events after 5.6 years follow-up. </p> <p><b>Results:</b> Women with prediabetes and diabetes exhibited greater relative differences in BMI, waist circumference, blood pressure, total, LDL and HDL cholesterol, triglycerides, fasting glucose, hsCRP, and white blood cell count than men with prediabetes and diabetes when compared with their NGT counterparts. We found a higher RR for prevalent CVD in diabetic women (RR 9.29; 95% CI 4.73-18.25; <i>P</i><0.0001) than in men (RR 4.56; 95% CI 3.07-6.77; <i>P</i><0.0001), but no difference in RR for CVD was observed comparing prediabetic women and men. In the longitudinal study, we found that diabetic, but not prediabetic women have higher RR (RR 5.25; 95% CI 3.22-8.56; <i>P</i><0.0001) of incident major adverse outcomes than their male counterparts (RR 2.72; 95% CI 1.81-4.08; <i>P</i><0.0001).</p> <p><b>Conclusions:</b> This study suggests that diabetic, but not prediabetic, women have higher RR for prevalent and incident major adverse outcomes than men. </p>

scholarly journals Associations between multimorbidity and glycaemia (HbA1c) in people with type 2 diabetes: cross-sectional study in Australian general practice

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e039625
Author(s):  
Jason I Chiang ◽  
John Furler ◽  
Frances Mair ◽  
Bhautesh D Jani ◽  
Barbara I Nicholl ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
General Practice ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Linear Regression Models ◽  
Sectional Study ◽  
Cross Sectional ◽  
Long Term Conditions ◽  
Australian General Practice

ObjectivesTo explore the prevalence of multimorbidity as well as individual and combinations of long-term conditions (LTCs) in people with type 2 diabetes (T2D) attending Australian general practice, using electronic health record (EHR) data. We also examine the association between multimorbidity condition count (total/concordant(T2D related)/discordant(unrelated)) and glycaemia (glycated haemoglobin, HbA1c).DesignCross-sectional study.SettingAustralian general practice.Participants69 718 people with T2D with a general practice encounter between 2013 and 2015 captured in the MedicineInsight database (EHR Data from 557 general practices and >3.8 million Australian patients).Primary and secondary outcome measuresPrevalence of multimorbidity, individual and combinations of LTCs. Multivariable linear regression models used to examine associations between multimorbidity counts and HbA1c (%).ResultsMean (SD) age 66.42 (12.70) years, 46.1% female and mean (SD) HbA1c 7.1 (1.4)%. More than 90% of participants with T2D were living with multimorbidity. Discordant conditions were more prevalent (83.4%) than concordant conditions (69.9 %). The three most prevalent discordant conditions were: painful conditions (55.4%), dyspepsia (31.6%) and depression (22.8%). The three most prevalent concordant conditions were hypertension (61.4%), coronary heart disease (17.1%) and chronic kidney disease (8.5%). The three most common combinations of conditions were: painful conditions and hypertension (38.8%), painful conditions and dyspepsia (23.1%) and hypertension and dyspepsia (22.7%). We found no associations between any multimorbidity counts (total, concordant and discordant) or combinations and HbA1c.ConclusionsMultimorbidity was common in our cohort of people with T2D attending Australian general practice, but was not associated with glycaemia. Although we did not explore mortality in this study, our results suggest that the increased mortality in those with multimorbidity and T2D observed in other studies may not be linked to glycaemia. Interestingly, discordant conditions were more prevalent than concordant conditions with painful conditions being the second most common comorbidity. Better understanding of the implications of different patterns of multimorbidity in people with T2D will allow more effective tailored care.

scholarly journals Home-Measured Blood Pressure Is Associated with Handgrip Strength in Patients with Type 2 Diabetes: The KAMOGAWA-HBP Study

2021 ◽  
Vol 10 (9) ◽  
pp. 1913
Author(s):  
Tomonori Kimura ◽  
Emi Ushigome ◽  
Yoshitaka Hashimoto ◽  
Naoko Nakanishi ◽  
Masahide Hamaguchi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Pulse Pressure ◽  
Handgrip Strength ◽  
Cross Sectional Study ◽  
Home Blood Pressure ◽  
Cross Sectional ◽  
The Relationship ◽  
At Home

The association between blood pressure measured at home and handgrip strength in patients with diabetes has not been investigated. Therefore, in this study, we aimed to assess this association among patients with type 2 diabetes. In this cross-sectional study, 157 patients with type 2 diabetes underwent muscle tests and morning and evening blood-pressure measurements at home in triplicate for 14 consecutive days throughout the study period. Univariate and multivariate regression analyses were conducted to analyze the relationship between home blood-pressure parameters and handgrip strength. The average age and hemoglobin A1c of the patients were 70.5 years and 7.1%, respectively. Morning diastolic blood pressure of [β (95% confidence interval; CI): 0.20 (0.03, 0.37)] was associated with handgrip strength in men, while morning systolic blood pressure of [−0.09 (−0.15, −0.04)], morning pulse pressure of [−0.14 (−0.21, −0.08)], and evening pulse pressure of [−0.12 (−0.19, −0.04)] were associated with handgrip strength in women. Home-measured blood pressure was associated with handgrip strength. Sex differences were found in the relationship between home blood-pressure parameters and handgrip strength.

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