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PubMed · 2182996

Diabetic nephropathy--are there differences between type I and type II?

Abstract

It has commonly been assumed that the renal risk in type II diabetes is markedly lower than in type I diabetes since only approximately 5% of the former but 40% of the latter experience renal failure. Based on our observations in the diabetes outpatient department of the University of Heidelberg, we conclude that the cumulative risk of developing proteinuria for the nonproteinuric type II diabetic and the cumulative risk of developing renal failure for the proteinuric type II diabetic are comparable with the respective risks of the type I diabetic. This observation is noteworthy since there is no uncontroversial evidence of hyperfiltration in early type II diabetes. Type II diabetes may be an interesting model for testing the hyperfiltration theory.

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BibTeXRIS

E Ritz, C Hasslacher, W Tschöpe. 1990. Diabetic nephropathy--are there differences between type I and type II?. https://pubmed.ncbi.nlm.nih.gov/2182996/

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Pancreatin therapy in patients with insulin-treated diabetes mellitus and exocrine pancreatic insufficiency according to low fecal elastase 1 concentrations. Results of a prospective multi-centre trial.

BACKGROUND: Recently, high prevalence of exocrine dysfunction in diabetic populations has been reported. Patients with fecal elastase 1 concentration (FEC) <100 microg/g have also been demonstrated to suffer from steatorrhea in about 60% of cases, indicating the need of pancreatic enzyme replacement therapy. Until now, there have only been a few reports on the use of enzyme replacement therapy in diabetic patients with exocrine pancreatic insufficiency. This investigation was designed to evaluate the impact of enzyme-replacement therapy on glucose metabolism and diabetes treatment in a prospective study of insulin-treated patients with diabetes mellitus. METHODS: A total of 546 patients with diabetes mellitus requiring insulin treatment were screened for exocrine dysfunction by FEC measurements. One hundred and fifteen patients (21.1%) had FEC <100 microg/g (normal >200 microg/g). Of these, 95 patients entered the study and 80 patients were randomized to receive either pancreatin (Creon) (39 patients) or placebo (41 patients) in a double-blind manner. Parameters of glucose metabolism, diabetes therapy and clinical symptoms were recorded in standardized protocols for 16 weeks. RESULTS: During the observation phase of 16 weeks, there were no significant differences between both groups concerning HbA(1c), fasting glucose levels, 2-h pp glucose levels, clinical parameters and safety parameters. A reduction in mild and moderate hypoglycemia was observed in the pancreatin group at the end of the study. CONCLUSIONS: Pancreatin therapy can be used safely in patients with diabetes mellitus and exocrine dysfunction. Parameters of glucose metabolism were not improved by enzyme replacement therapy.

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