Obese diabetics at high risk for kidney disease
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Adults with type 1 diabetes who are obese, especially those who carry excess weight around the middle, are at increased risk for developing kidney disease, a study shows.
“These results,” Dr. Ian H. de Boer told Reuters Health, “suggest that weight control is important in type 1 diabetes…and that lifestyle interventions, such as exercise and diet, may be useful in preventing kidney and heart disease in this group of people.”
Among 1,105 type 1, or “insulin-dependent,” diabetes patients followed for an average of six years, 93 (8.4 percent) developed microalbuminuria—small amounts of the protein albumin in urine, the first sign of diabetic kidney disease and a marker of increased risk for heart disease.
According to de Boer of University of Washington in Seattle and colleagues, the risk of microalbuminuria was significantly higher for patients who were particularly thick around the middle, what doctor’s call “central obesity.”
For each four-inch increase in waist circumference, the risk of microalbuminuria increased by 34 percent, the team reports in the Journal of the American Society of Nephrology.
The subjects in the study were part of the landmark Diabetes Control and Complications Trial (DCCT), which showed that intensive insulin therapy—keeping blood sugar as close to normal as possible—substantially lowers the risk of kidney disease and other complications of diabetes.
“The current study showed again that, overall, intensive insulin therapy is protective against kidney disease in type 1 diabetes,” de Boer told Reuters Health. Risk of kidney disease was 4.5 percent for patients receiving intensive insulin therapy, compared with 12.8 percent for patients receiving conventional insulin treatment.
SOURCE: Journal of the American Society of Nephrology, January 2007.
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