Smoking and progression of diabetic nephropathy in type 1 diabetes mellitus

Yllka Themeli; Valbona Bajrami; Myftar Barbullushi; Alma Idrizi; Albana Daka

doi:10.1530/endoabs.32.P435

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Endocrine Abstracts (2013) 32 P435 | DOI: 10.1530/endoabs.32.P435

ECE2013 Poster Presentations Diabetes (151 abstracts)

Smoking and progression of diabetic nephropathy in type 1 diabetes mellitus

Yllka Themeli ^1, , Valbona Bajrami ¹ , Myftar Barbullushi ^2, , Alma Idrizi ³ & Albana Daka ^3,

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¹DC Ikeda-Euromedica, Tirana, Albania; ²DC Med.al, Tirana, Albania; ³UHC Mother Teresa, Tirana, Albania; ⁴American Hospital, Tirana, Albania.

Objective: To investigate the association between cigarette smoking and the progression of diabetic nephropathy in type 1 diabetic patients.

Research design and methods: A prospective, follow-up study over 1 year was conducted in a sequential sample of 30 smokers, 30 nonsmokers, and 30 ex-smokers with type 1 diabetes, hypertension, and diabetic nephropathy. Progression of renal disease was defined according to the stage of nephropathy as an increase in proteinuria or serum creatinine or a decrease in the glomerular filtration rate.

Results: Progression of nephropathy was less common in nonsmokers (10%) than in smokers (59%) and patients who had quit smoking (29%), P>0.001. In a stepwise logistic regression analysis, cigarette pack years, 24-h sodium excretion, and GHb were independent predictive factors for the progression of diabetic nephropathy. Because blood pressure (BP) was well controlled in these patients and most values were within a normotensive range, neither standing, sitting, nor supine BP values were associated with progression of nephropathy.

Conclusions: Cigarette smoking represents an important factor associated with progression of nephropathy in treated hypertensive type 1 diabetic patients.