title: Cardiovascular risk factors and complications associated with albuminuria and impaired renal function in insulin-treated diabetes.
abstract: OBJECTIVE
  To establish the association between albuminuria and cardiovascular risk factors as well as micro- and macrovascular complications in type 1 and insulin-treated type 2 diabetes, both in the presence and in the absence of reduced estimated glomerular filtration rate (eGFR).
  
  
  METHODS
  Cross-sectional study including 7640 insulin-treated diabetic patients (33% type 1) treated in specialist diabetes centers. Albuminuria was defined as ≥30 mg/g, 20 mg/L, 20 μg/min or 30 mg/24 h. Reduced eGFR was defined as <60 mL/min/1.73 m(2) (CKD-EPI equations).
  
  
  RESULTS
  Albuminuria, reduced eGFR or a combination was more prevalent in type 2 (21.5%, 15.9% and 16.5%) than in type 1 diabetes (16.1%, 4.7% and 4.0%, all P < 0.001 vs. type 2). Albuminuria was associated with poorer control of blood pressure, blood lipids and glycemia as well as higher prevalence of retinopathy and macrovascular disease, regardless of preserved/reduced eGFR or diabetes type. Reduced eGFR was associated with higher prevalence of micro- and macrovascular complications especially in type 2 diabetes. Combined presence of albuminuria and reduced eGFR was associated with the worst cardiovascular outcomes.
  
  
  CONCLUSIONS
  Albuminuria and impaired renal function are prevalent in type 1 and insulin-treated type 2 diabetes. Albuminuria, but also normoalbuminuric renal impairment, is associated with micro- and macrovascular complications.
authors.affiliation: Health Services Research Unit, Scientific Institute of Public Health, Brussels, Belgium. kris.doggen@wiv-isp.be
authors.forename: Kris
authors.initials: K
authors.lastname: Doggen
authors.forename: Frank
authors.initials: F
authors.lastname: Nobels
authors.forename: André J
authors.initials: AJ
authors.lastname: Scheen
authors.forename: Paul
authors.initials: P
authors.lastname: Van Crombrugge
authors.forename: Viviane
authors.initials: V
authors.lastname: Van Casteren
authors.forename: Chantal
authors.initials: C
authors.lastname: Mathieu
mesh_terms: D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D003928:Diabetic Nephropathies / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D005919:Glomerular Filtration Rate; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D008875:Middle Aged; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin