Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Kidney disease in diabetics relates to insulin’s effectiveness, say Pittsburgh researchers

02.09.2002

Insulin resistance, a condition commonly associated with the development of type 2 diabetes, is likely a major cause of kidney disease, or nephropathy, in people with type 1 diabetes, according to study results published by University of Pittsburgh Graduate School of Public Health (GSPH) researchers in the September issue of Kidney International, a journal of the International Society of Nephrology. "Kidney disease is a major lethal complication for people with diabetes, particularly those with type 1 diabetes, and until now there has been no clear explanation for its cause beyond blood sugar itself," said principal investigator Trevor Orchard, M.D., professor and acting chair, department of epidemiology, GSPH. "We now suspect that reducing or preventing insulin resistance, possibly through exercise, weight loss and drugs, may help people with type 1 diabetes avoid nephropathy."

The study analyzed data from the Pittsburgh Epidemiology of Diabetes Complication Study (PEDCS), a 10-year prospective investigation based on a cohort of adults with type 1, or childhood-onset, diabetes. Of the 658 subjects in PEDCS, 485 did not have nephropathy at baseline and were followed for the current study.

Fifty-six of the 485 subjects developed nephropathy during either the first five years of follow-up, or during years 6-10. Researchers found that in all cases, strong relationships existed between nephropathy and insulin resistance throughout follow up, unlike other risk factors such as blood pressure and blood fats, which only predicted nephropathy in the short term.

To measure insulin resistance, investigators used a novel calculation based on waist-to-hip ratio, hypertension status and long-term blood sugar levels.

"Although our measure of insulin resistance is an estimate based on easier-to-measure factors, it is strongly correlated with the gold standard – euglycemic clamp studies – and clearly stands out as the leading predictor of kidney disease in this study," said Dr. Orchard.

Other risk factors in those that developed nephropathy included elevated LDL ("bad") cholesterol, triglycerides, white blood cell count (a marker of inflammation) and blood pressure.

"The good news is that not all people with type 1 diabetes are insulin resistant, and for them the risk of kidney disease now appears to be low," Dr. Orchard said. "Even for someone with type 1 diabetes who is genetically predisposed to insulin resistance, the secret to avoiding nephropathy may well be to prevent insulin resistance through lifestyle changes such as proper diet, exercise, smoking cessation and perhaps medication.

"Another intriguing finding from this study is that since insulin resistance also predicts heart disease," Dr. Orchard continued, "it may explain the longstanding observation that in type 1 diabetes, kidney disease predicts heart disease. In other words, insulin resistance may be the ’common ground’ for both complications."

Investigators also examined genetic markers of risk and found that three markers linked to blood pressure and blood fats also predicted kidney disease.

Insulin resistance results when insulin fails to enable cells to admit glucose, necessary for cells’ energy production. Glucose then builds up in the blood, and additional insulin is required.

Up to 40 percent of people with type 1 diabetes develop kidney disease, in which the kidneys’ tiny blood vessels are damaged and unable to filter wastes and excess water from the blood. Untreated, nephropathy leads to end stage renal disease (ESRD), in which the kidneys’ entire filtration system closes down and the kidneys fail to function. A patient with ESRD requires dialysis or a kidney transplant to live.

Kathryn Duda | EurekAlert

More articles from Health and Medicine:

nachricht Organ-on-a-chip mimics heart's biomechanical properties
23.02.2017 | Vanderbilt University

nachricht Researchers identify cause of hereditary skeletal muscle disorder
22.02.2017 | Klinikum der Universität München

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Breakthrough with a chain of gold atoms

In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport

In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport

Im Focus: DNA repair: a new letter in the cell alphabet

Results reveal how discoveries may be hidden in scientific “blind spots”

Cells need to repair damaged DNA in our genes to prevent the development of cancer and other diseases. Our cells therefore activate and send “repair-proteins”...

Im Focus: Dresdner scientists print tomorrow’s world

The Fraunhofer IWS Dresden and Technische Universität Dresden inaugurated their jointly operated Center for Additive Manufacturing Dresden (AMCD) with a festive ceremony on February 7, 2017. Scientists from various disciplines perform research on materials, additive manufacturing processes and innovative technologies, which build up components in a layer by layer process. This technology opens up new horizons for component design and combinations of functions. For example during fabrication, electrical conductors and sensors are already able to be additively manufactured into components. They provide information about stress conditions of a product during operation.

The 3D-printing technology, or additive manufacturing as it is often called, has long made the step out of scientific research laboratories into industrial...

Im Focus: Mimicking nature's cellular architectures via 3-D printing

Research offers new level of control over the structure of 3-D printed materials

Nature does amazing things with limited design materials. Grass, for example, can support its own weight, resist strong wind loads, and recover after being...

Im Focus: Three Magnetic States for Each Hole

Nanometer-scale magnetic perforated grids could create new possibilities for computing. Together with international colleagues, scientists from the Helmholtz Zentrum Dresden-Rossendorf (HZDR) have shown how a cobalt grid can be reliably programmed at room temperature. In addition they discovered that for every hole ("antidot") three magnetic states can be configured. The results have been published in the journal "Scientific Reports".

Physicist Dr. Rantej Bali from the HZDR, together with scientists from Singapore and Australia, designed a special grid structure in a thin layer of cobalt in...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Booth and panel discussion – The Lindau Nobel Laureate Meetings at the AAAS 2017 Annual Meeting

13.02.2017 | Event News

Complex Loading versus Hidden Reserves

10.02.2017 | Event News

International Conference on Crystal Growth in Freiburg

09.02.2017 | Event News

 
Latest News

Stingless bees have their nests protected by soldiers

24.02.2017 | Life Sciences

New risk factors for anxiety disorders

24.02.2017 | Life Sciences

MWC 2017: 5G Capital Berlin

24.02.2017 | Trade Fair News

VideoLinks
B2B-VideoLinks
More VideoLinks >>>