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Comparative Proteomic Analysis of Whole Kidney, Medulla, and Cortical Tubules in Diabetic Pathogenesis of Kidney Injury in Mice
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High risk of renal dysfunction in patients with fulminant type 1 diabetes

Nobuyuki Takahashi1,2, Tetsuro Tsujimoto1, Daisuke Chujo1

  • 1Department of Diabetes, Endocrinology, and Metabolism, Center Hospital, National Center for Global Health and Medicine, Tokyo, Japan.

Journal of Diabetes Investigation
|March 8, 2017
PubMed

Insights

Patients with fulminant type 1 diabetes face a higher risk of renal dysfunction compared to those with acute-onset type 1 diabetes. This increased risk persists even with better glycemic control in fulminant type 1 diabetes cases.

Area of Science:

  • Endocrinology
  • Nephrology
  • Diabetology

Background:

  • Type 1 diabetes presents with varying clinical courses, including fulminant and acute-onset forms.
  • Renal dysfunction is a significant complication of diabetes, impacting patient outcomes.
  • Understanding the differential risk of renal complications between diabetes subtypes is crucial for targeted management.

Purpose of the Study:

  • To compare the incidence rate of renal dysfunction between patients diagnosed with fulminant type 1 diabetes and those with acute-onset type 1 diabetes.
  • To investigate the association between diabetes type and the development of renal impairment.

Main Methods:

  • A retrospective cohort study was conducted involving patients diagnosed with fulminant or acute-onset type 1 diabetes between 1993 and 2016.
  • Key metrics analyzed included glycated hemoglobin levels, incidence of renal dysfunction (eGFR <60 mL/min/1.73 m²), and microalbuminuria.
  • Kaplan-Meier analysis and sensitivity analyses were employed to compare outcomes between the two groups.

Main Results:

  • The study included 115 patients: 10 with fulminant type 1 diabetes and 105 with acute-onset type 1 diabetes.
  • Patients with fulminant type 1 diabetes exhibited significantly lower glycated hemoglobin levels throughout the follow-up period compared to the acute-onset group.
  • A significantly higher incidence rate of renal dysfunction was observed in the fulminant type 1 diabetes group (HR 1.72, P=0.037), while microalbuminuria rates did not differ significantly.

Conclusions:

  • Fulminant type 1 diabetes is associated with an elevated risk of developing renal dysfunction compared to acute-onset type 1 diabetes.
  • This increased renal risk in fulminant type 1 diabetes occurs despite achieving better glycemic control.
  • The findings highlight the importance of monitoring renal function closely in patients with fulminant type 1 diabetes.
Abstract

Keywords:
Fulminant type 1 diabetesMicroalbuminuriaRenal dysfunction

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