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Diabetic Nephropathy

Diabetic Nephropathy

Definition Diabetic nephropathy is a chronic kidney complication that results from prolonged hyperglycemia.Prevalence It is the most common cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD) worldwide, affecting up to half of individuals with diabetes.Pathophysiology • Sustained hyperglycemia triggers multiple hemodynamic and metabolic changes in the kidney. • Early in the disease, increased renal blood flow and glomerular hyperfiltration occur due to afferent arteriolar...

Diabetic Retinopathy

Diabetic Retinopathy

DefinitionDiabetic retinopathy is a microvascular complication of diabetes affecting the retinal blood vessels.Risk FactorsDiabetic retinopathy is present in almost all individuals with type 1 diabetes and more than 60% of those with type 2 diabetes after two decades of disease.The risk increases with poor glycemic control, hypertension, dyslipidemia, smoking, pregnancy, and puberty.Although cataracts and glaucoma are also more frequent in people with diabetes, retinopathy remains the leading...

Type I Diabetes II: Pathophysiology

Type I Diabetes II: Pathophysiology

Type 1 diabetes mellitus arises from an immune-mediated destruction of pancreatic β-cells, resulting in an absolute deficiency of insulin. This process develops in genetically susceptible individuals when autoimmunity, environmental exposures, and immunologic dysregulation converge to trigger a targeted attack on the insulin-producing cells of the pancreas. The β-cells are located within the islets of Langerhans and are essential for regulating blood glucose by facilitating cellular uptake of...

Type II Diabetes II: Pathophysiology

Type II Diabetes II: Pathophysiology

PathophysiologyType 2 diabetes mellitus (T2DM ) is a chronic metabolic disorder characterized by insulin resistance and progressive pancreatic β-cell dysfunction, leading to impaired glucose homeostasis. It results from interactions among genetic predisposition, environmental factors, and metabolic stressors, such as overnutrition and a sedentary lifestyle.Insulin Resistance and Glucose DysregulationEarly T2DM involves insulin resistance in skeletal muscle, adipose tissue, and the liver.

Diabetic Neuropathy

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DefinitionDiabetic neuropathy is nerve damage caused by long-standing diabetes mellitus. It results directly from prolonged high blood sugar levels.PathophysiologyThe pathophysiology of diabetic neuropathy involves both metabolic and vascular disturbances triggered by chronic hyperglycemia.Metabolic injury: Elevated glucose levels activate the polyol pathway within nerve cells, leading to the accumulation of sorbitol and fructose. This increases oxidative stress, disrupts normal nerve...

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Type 1 diabetes mellitus typically presents with rapid-onset symptoms due to the body’s inability to utilize glucose in the absence of insulin. Since insulin is required for glucose uptake into cells, its deficiency leads to hyperglycemia and cellular energy deprivation, resulting in characteristic clinical features.Polyuria and PolydipsiaOne of the earliest, most prominent symptoms is polyuria (excessive urination). When blood glucose concentrations rise above the renal threshold, the kidneys...

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Related Experiment Video

Updated: Jun 1, 2026

Comparative Proteomic Analysis of Whole Kidney, Medulla, and Cortical Tubules in Diabetic Pathogenesis of Kidney Injury in Mice

Comparative Proteomic Analysis of Whole Kidney, Medulla, and Cortical Tubules in Diabetic Pathogenesis of Kidney Injury in Mice

Published on: May 2, 2025

Podocyte detachment in type 2 diabetic nephropathy.

E Jennifer Weil¹, Kevin V Lemley, Berne Yee

¹National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA.

American Journal of Nephrology

|June 11, 2011

Summary

Podocyte detachment from kidney glomeruli occurs in type 2 diabetes mellitus (T2DM). This study quantifies podocyte detachment in T2DM patients, offering insights into diabetic kidney disease progression.

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Last Updated: Jun 1, 2026

Comparative Proteomic Analysis of Whole Kidney, Medulla, and Cortical Tubules in Diabetic Pathogenesis of Kidney Injury in Mice

Comparative Proteomic Analysis of Whole Kidney, Medulla, and Cortical Tubules in Diabetic Pathogenesis of Kidney Injury in Mice

Published on: May 2, 2025

Assessment of Kidney Function in Mouse Models of Glomerular Disease

Assessment of Kidney Function in Mouse Models of Glomerular Disease

Published on: June 30, 2018

Generation of Patient-Derived Podocytes from Skin Biopsies

Generation of Patient-Derived Podocytes from Skin Biopsies

Published on: May 26, 2023

Area of Science:

Nephrology
Diabetology
Pathology

Background:

Glomerular podocyte number decreases and urinary podocyte excretion rises with kidney disease progression in type 2 diabetes mellitus (T2DM).
Podocyte injury is a key factor in the pathogenesis of diabetic nephropathy.

Purpose of the Study:

To microscopically document and morphometrically quantify podocyte detachment from the glomerular basement membrane in humans with T2DM.
To investigate the role of podocyte detachment in the functional impairment and glomerular sclerosis observed in diabetic kidney disease.

Main Methods:

High-power electron microscopy was used to evaluate glomeruli from Pima Indian subjects with T2DM.
Podocyte detachment was quantified by measuring the percentage of glomerular basement membrane area lacking podocyte coverage.

Main Results:

106 glomeruli from 40 T2DM subjects were analyzed.
35% of subjects showed no evidence of podocyte detachment.
Among those with detachment, the median percentage of basement membrane with podocyte detachment was 0.62% (IQR = 0.32-1.52%).

Conclusions:

Podocyte detachment from the glomerular basement membrane is a quantifiable histologic finding in humans with T2DM.
This provides quantitative support for podocyte detachment as a mechanism contributing to functional impairment and glomerular sclerosis in diabetic kidney disease.
Findings complement previous studies in type 1 diabetes mellitus, highlighting a common pathway in diabetic nephropathy.