Endocrine Abstracts

Introduction: Uncontrolled hyperglycemia in diabetes is a common cause of microvascular complications, including diabetic nephropathy (DN). Despite improvements in the management of type 2 diabetes (T2DM), diabetic nephropathy is still associated with high morbidity and mortality. The objective of our study is to evaluate the predictive factors of DN in adults with T2DM in order to prevent its development.

Patients and Methods: A retrospective study, including 300 patients diagnosed with T2DM hospitalized in the endocrinology department of Farhat Hached Hospital in Sousse between 2018 and 2019. DN was defined with a persistent albuminuria (>300 mg/dl) that is confirmed on at least 2 occasions 3-6 months apart. Predictive factors for DN were determined by univariate logistic regression analysis.

Results: It is about 272 patients with a mean age of 58 years. The sex-ratio M/F was 0.7. The mean diabetes duration was 10±8 years (1-44 years). DN was observed in 44% of patients. Approximately 91% of patients who had been diagnosed with DN were aged more than 50 years old (P<10^-3). DN was more frequent (93%) after 10 years evolution of diabetes (P<10^-3). Hypertension was present in 55% of patients with DN (P=10^-3). The mean systolic and diastolic BP were 130±10 mm Hg and 70 mmHg, respectively. The majority of patients with DN (76%) had LDL-C levels above recommended targets (P<10^-3). The results of our study showed that 65% of patients with DN were not on statin therapy (P<10^-3). It was found that 69% of patients with DN had simultaneous diabetic retinopathy (P<10^-3). However, only duration of T2DM ≥10 years, age > 50 years, LDL-C levels above recommended targets, no statin therapy and concurrent RD were significant in stepwise logistic regression analysis.

Conclusion: Our study suggests that the development of DN can be prevented by early control of its modifiable predictors such as: LDL-C levels which should be within the recommended targets with statin therapy.