The Concomitants of Raised Blood Sugar: Studies in Newly-Detected Hyperglycaemics

RENAL disease is a complication of diabetes mellitus of growing importance and is credited as the primary cause of death in some 11-12 per cent of diabetics.1 The first clinical indication of diabetic nephropathy is proteinuria2 and much of this protein is albumin.3 By modern techniques, albumin can be detected and measured in very small quantities; we have used a radio-immunoassay procedure to measure micro-albuminuria, following an oral glucose load, in normal and hyperglycaemic individuals from the population of Bedford, co-operating in the Diabetes Detection Survey conducted in 1962.4 The reasons for the study were threefold: firstly, to determine whether abnormalities of albumin excretion were already present at the time of diagnosis; secondly, to see whether the degree of albuminuria could qualify the interpretation of doubtfully abnormal glucose tolerance tests; and thirdly, to form a ‘baseline' for the evaluation of renal changes in a long-term double-blind trial of treatment.5