Ragoobirsingh, Dalip; Bennett, Franklyn I.; Morrison, Errol Y
Author Affiliation, Ana.
Basic Medical Sciences (Anatomy, Biochemistry, Physiology)
Kidney function in phasic insulin dependent diabetes mellitus in Jamaica.
West Indian Medical Journal
Date of Publication
In Jamaica, malnutrition related diabetes mellitus (MRDM) presents the clinical picture of phasic insulin dependence. This study investigated nephropathic changes associated with a group of patients. Fourteen phasic insulin dependent diabetes mellitus (PIDDM) patients were compared with 10 insulin dependent (IDDM), 10 non-insulin dependent (NIDDM) diabetes mellitus patients, and 10 normal controls. Each group was matched for age, sex, body mass index (BMI) and, in the case of the diabetic patient controls, duration of diabetes. Urinary microalbumin concentration was significantly (p<0.05) higher in the PIDDM group (mean ±SD: 153 ± 48.3 mg/dl) than in the groups of NIDDM (35.7 ± 9.6 mg/dl) or IDDM (38.6 ± 15.8 mg/dl) patients. Serum urea and creatinine concentration (mean ± SE 7.6 ± 1.0 mmol/l and 130.0 ± 20.3 µmol/l, respectively) were higher in the PIDDM patients than in the NIDDM and IDDM groups. Confounding factors such as hypertension and urinary tract infections were excluded as causes for these differences. PIDDM patients have more severe renal dysfunction than NIDDM patients do, and since glycosylated haemoglobin concentrations are comparable in these groups, this is attributed to a renal insult due to malnutrition predating the onset of PIDDM.....