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Abstract
The present work is a longitudinal study to follow-up diabetic patients:
• The study included 60 Egyptian adolescents with type 1 DM (29 males, 31 females). This ages range from 14 to 18ys.
• Patients were divided according to UAE into 3 groups:
Group A: 20 patients with PMA (UAE between 30-300mg/mg U Cr) on twice sampling or more one month apart.
Group B: 20 patients with IMA (UAE between 30-300mg/mg U Cr) on one sample only.
Group C: 20 patients with (UAE less than 30mg/mg U Cr) (control group).
All patients in the study were subjected to: Full history taking, through clinical examination including autonomic function tests, and laboratory investi-gations including complete urine analysis, serum creatinine, creatinine clearance, UAE, RBS, HbA1c, serum testosterone, lipid profile.
• When diabetic patients at risk of DN screened for presence of an early marker of nephropathy: UAE (microalbuminuria).
• No sex preference with respect to occurrence of microalbuminuria was detected, the three groups were comparable as regard mean age diabetes duration.
There is no significant difference as regard hyperglycemic attacks between 3 groups. The frequency of hypoglycemia was significantly increased in both PMA, IMA as compared to normoalbuinuric one.
• A non significant difference was observed with respect to insulin dose during last 2ys prior the study.
• Although mean percentiles for weight, BMI were comparable in the 3 group. Short stature was significant frequently observed among both PMA, IMA groups.
• Delayed puberty was observed frequently among both PMA, IMA.
• Mean percentile of SBP and DBP were significantly elevated among microalbuminuric group.
• As regard the degree of glycemic control micro-albuminuric diabetics (PMA, IMA) were found to have higher mean RBs and mean HbA1C (During the last 2ys).
• Mean creatinine clearance level was signify-cantly lower in both PMA, IMA than normo-albuminuric.
• UAE positively correlated with diastolic blood pressure in both groups and inversely correlated with creatinine clearance in both groups.
• Lipid profiles were comparable in the 3 groups.
• In the current study serum testosterone in females were higher in microalbuminuric groups (PMA, IMA) than normoalbuminuric. Where as in males serum testosterone were comparable in the 3 groups.
• In the current study presence of DAN was frequently observed (45%) among micro-albuminuric grups (PMA, IMA).
• CVR were statistically different between 3 groups so therefore they help us for early detection of cardiovascular autonomic neuro-pathies. So, we can decreased cardiovascular morbidities and mortalities.
• In the current study HR vulsalva and DBP (handgrip) were the most sensitive predictors associated with PMA. While HR deep breath and DBP were the most sensitive predictors associated with IMA.