Endocrine Abstracts

Introduction: Diabetes is the leading cause of end-stage renal disease in Europe (12 to 30%). In the United States, it is the cause of more than half of the cases of this disease. Renal disease is a cardiovascular morbidity and mortality preacher which is three times more common in diabetic patients with diabetic nephropathy (DN). The aim of our study was to describe the factors of cardiovascular risk associated with ND in a group of type 2 diabetes (T2D) Tunisians.

Materials and methods: It was a transversale, retrospective and descriptive study including 75 T2D patients with a confirmed ND, collected in the Diabetology departments of the National Institute of Nutrition and Food Technology of Tunis between 2018 and 2019.

Results: There were 42 women and 33 men with mean age was 62.25 ± 9.3 years. The body mass index was 29.67 ± 5.43 kg/m². The average duration of diabetes was 9.48 ± 6.88 years. In 90.6% of cases, treatment was insulin therapy. ND was at the microalbuminuria stage in 60 patients and 46.6% had renal failure (GFR <90 ml/min). High blood pressure was present in 44 patients, 81% of whom were on ACE inhibitors. Other microangiopathic complications were present, such as diabetic retinopathy in 28 patients, 6 of which had a proliferative form and peripheral neuropathy in 38 patients. Coronary artery disease was found in 9 patients and arteritis of the lower limbs in 9 patients also when two had suffered a stroke. Hyper triglyceridemia was observed in 27 patients, hypo-HDL-cholesterolemia in 35 patients and hyper LDL-emie in 65 patients. We did not found a correlation between the micro and macro albuminuria of a part and the presence of a coronary disease of another part (P = NS). We noted a positive correlation between the ND stage and the glycemic balance (P = 0.04). However, no correlation has been demonstrated between the micro and macro albuminuria firestly and the triglyceride level (P = NS), HDL cholesterol (P = NS) and the LDL cholesterol level (P = NS) on the other hand.

Conclusions: Kidney damage increases the cardiovascular risk in T2D. Its prevention and management requires an optimal glycemic and blood pressure balance in order to protect not only the kidney but also the heart and thus improve the prognosis of diabetics.