title: Morbidity in 565 type 2 diabetic patients according to stage of nephropathy.
abstract: Between 1988 and 1992, 565 type 2 diabetic patients were examined for nephropathy and diabetes-associated diseases during hospital treatment. Stages of nephropathy were defined as no clinical sign of nephropathy (N = 280), microalbuminuria (N = 38), overt proteinuria (N = 105), impaired renal function (N = 55), and chronic dialysis therapy (N = 87). In dialyzed patients, HbA1c averaged 6.8%, and, in the other groups, HbA1c was between 7.6% and 8.3% (normal range, 3.8%-6.1%). Cataract was not associated with the severity of nephropathy. Stroke was most common in the stage of renal insufficiency (34%). The following complications, as found in medical history or as current event, showed a significant association with the stage of nephropathy and occurred most frequently in dialysis patients (percentage is displayed for patients with nephropathy in comparison to diabetic dialysis patients): hypertension (53%-89%), left ventricular hypertrophy (39%-81%), myocardial infarction (14%-36%), peripheral vascular disease (27%-77%), foot lesions (7%-75%), minor or major amputations (3%-23%), proliferative retinopathy (6%-46%), blindness (2.9%-16.1%), and internal carotid artery stenosis (15%-36%). In this preselected cohort of diabetic patients, a high morbidity was found already without nephropathy that increased several-fold in the course of the development of nephropathy. Our data identify patients with diabetic nephropathy as a high-risk group for excess morbidity.
authors.affiliation: Medical Department A, Hospital Ludwigshafen, Ludwigshafen/Rhein, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Schleiffer
authors.forename: H
authors.initials: H
authors.lastname: Hölken
authors.forename: H
authors.initials: H
authors.lastname: Brass
mesh_terms: D000328:Adult; D000368:Aged; D000419:Albuminuria; D001794:Blood Pressure; D016893:Carotid Stenosis / Q000453:epidemiology; D002561:Cerebrovascular Disorders / Q000453:epidemiology; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000503:physiopathology; D003928:Diabetic Nephropathies / Q000145:classification / Q000453:epidemiology* / Q000503:physiopathology*; D003930:Diabetic Retinopathy / Q000145:classification / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D017379:Hypertrophy, Left Ventricular / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009203:Myocardial Infarction / Q000453:epidemiology; D011507:Proteinuria; D017582:Renal Replacement Therapy; D012307:Risk Factors