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The risk for diabetic nephropathy is low in young adults in a 17-year follow-up from the Diabetes Incidence Study in Sweden (DISS). Older age and higher BMI at diabetes onset can be important risk factors
University of Gothenburg, Sweden.
Lund University, Sweden.
Umeå University, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Endocrinology.
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2015 (English)In: Diabetes/Metabolism Research Reviews, ISSN 1520-7552, E-ISSN 1520-7560, Vol. 31, no 2, 138-146 p.Article in journal (Refereed) Published
Abstract [en]

AimsThe main objective of this study was to estimate the occurrence of diabetic nephropathy in a population-based cohort of patients diagnosed with diabetes as young adults (15-34years). MethodsAll 794 patients registered 1987-1988 in the Diabetes Incidence Study in Sweden (DISS) were invited to a follow-up study 15-19years after diagnosis, and 468 (58%) participated. Analysis of islet antibodies was used to classify type of diabetes. ResultsAfter median 17years of diabetes, 15% of all patients, 14% T1DM and 25% T2DM, were diagnosed with diabetic nephropathy. Ninety-one percent had microalbuminuria and 8.6% macroalbuminuria. Older age at diagnosis (HR 1.05; 95% CI 1.01-1.10 per year) was an independent and a higher BMI at diabetes diagnosis (HR 1.04; 95% CI 1.00-1.09 per 1kg/m(2)), a near-significant predictor of development of diabetic nephropathy. Age at onset of diabetes (p=0.041), BMI (p=0.012) and HbA1c (pless than0.001) were significant predictors of developing diabetic nephropathy between 9 and 17years of diabetes. At 17years of diabetes duration, a high HbA1c level (OR 1.06; 95% CI 1.03-1.08 per 1mmol/mol increase) and systolic blood pressure (OR 1.08; 95% CI 1.051.12 per 1mmHg increase) were associated with DN. ConclusionsPatients with T2DM diagnosed as young adults seem to have an increased risk to develop diabetic nephropathy compared with those with T1DM. Older age and higher BMI at diagnosis of diabetes were risk markers for development of diabetic nephropathy. In addition, poor glycaemic control but not systolic blood pressure at 9years of follow-up was a risk marker for later development of diabetic nephropathy.

Place, publisher, year, edition, pages
Wiley: 12 months , 2015. Vol. 31, no 2, 138-146 p.
Keyword [en]
diabetic nephropathy; hyperglycaemia; blood pressure; type 1 diabetes mellitus; type 2 diabetes mellitus; islet antibodies
National Category
Clinical Medicine
URN: urn:nbn:se:liu:diva-116523DOI: 10.1002/dmrr.2574ISI: 000349969600003PubMedID: 25044633OAI: diva2:798867

Funding Agencies|Swedish Diabetes Association; Lundstrom Foundation; Novo-Nordisk Foundation; Malmo University Hospital; Swedish Research Council [14531, 14287]; Juvenile Diabetes Research Foundation-Wallenberg Diabetes Research Program [K98-99 JD-128B]; Swedish Life Insurance Foundation; Trygg-Hansa Foundation; Faculty of Medicine at Umea University; Swedish Association for Patients with Kidney Disease; Swedish Society of Medicine and Heart and Lung foundation

Available from: 2015-03-27 Created: 2015-03-27 Last updated: 2015-03-27

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Arnqvist, Hans
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Division of Cell BiologyFaculty of Health SciencesDepartment of Endocrinology
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