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 Team discovers how bacteria exploit a chink in the body's armor
20.01.2017 | University of Illinois at Urbana-Champaign

nachricht Rabies viruses reveal wiring in transparent brains
19.01.2017 | Rheinische Friedrich-Wilhelms-Universität Bonn

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: Traffic jam in empty space

New success for Konstanz physicists in studying the quantum vacuum

An important step towards a completely new experimental access to quantum physics has been made at University of Konstanz. The team of scientists headed by...

Im Focus: How gut bacteria can make us ill

HZI researchers decipher infection mechanisms of Yersinia and immune responses of the host

Yersiniae cause severe intestinal infections. Studies using Yersinia pseudotuberculosis as a model organism aim to elucidate the infection mechanisms of these...

Im Focus: Interfacial Superconductivity: Magnetic and superconducting order revealed simultaneously

Researchers from the University of Hamburg in Germany, in collaboration with colleagues from the University of Aarhus in Denmark, have synthesized a new superconducting material by growing a few layers of an antiferromagnetic transition-metal chalcogenide on a bismuth-based topological insulator, both being non-superconducting materials.

While superconductivity and magnetism are generally believed to be mutually exclusive, surprisingly, in this new material, superconducting correlations...

Im Focus: Studying fundamental particles in materials

Laser-driving of semimetals allows creating novel quasiparticle states within condensed matter systems and switching between different states on ultrafast time scales

Studying properties of fundamental particles in condensed matter systems is a promising approach to quantum field theory. Quasiparticles offer the opportunity...

Im Focus: Designing Architecture with Solar Building Envelopes

Among the general public, solar thermal energy is currently associated with dark blue, rectangular collectors on building roofs. Technologies are needed for aesthetically high quality architecture which offer the architect more room for manoeuvre when it comes to low- and plus-energy buildings. With the “ArKol” project, researchers at Fraunhofer ISE together with partners are currently developing two façade collectors for solar thermal energy generation, which permit a high degree of design flexibility: a strip collector for opaque façade sections and a solar thermal blind for transparent sections. The current state of the two developments will be presented at the BAU 2017 trade fair.

As part of the “ArKol – development of architecturally highly integrated façade collectors with heat pipes” project, Fraunhofer ISE together with its partners...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Sustainable Water use in Agriculture in Eastern Europe and Central Asia

19.01.2017 | Event News

12V, 48V, high-voltage – trends in E/E automotive architecture

10.01.2017 | Event News

2nd Conference on Non-Textual Information on 10 and 11 May 2017 in Hannover

09.01.2017 | Event News

 
Latest News

Helmholtz International Fellow Award for Sarah Amalia Teichmann

20.01.2017 | Awards Funding

An innovative high-performance material: biofibers made from green lacewing silk

20.01.2017 | Materials Sciences

Ion treatments for cardiac arrhythmia — Non-invasive alternative to catheter-based surgery

20.01.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>