Comparison of the Prevalence and Associated Features of Abnormal Albumin Excretion in Insulin-dependent and Non-insulin-dependent Diabetes

Overnight albumin excretion rates were measured in 940 diabetic patients, 416 with insulin dependent and 524 with non-insulin dependent diabetes, and in 106 healthy volunteers. A significantly higher number of noninsulin dependent diabetic patients had abnormal albumin excretion compared with the insulin-dependent group (χ2=15.2, p<0.002). Ten per cent of non-insulin-dependent and 7 per cent of insulin-dependent diabetic patients had albumin excretion rates in the range 30-150 μg/min and thus were at risk of the cardiovascular and renal complications of diabetes. Six per cent of non-insulin-dependent and 5 per cent of insulin-dependent diabetic patients had albumin excretion rates above 150 μg/min and thus were entering the phase of clinical diabetic nephropathy. Multivariate analysis revealed that male sex and retinopathy in insulin-dependent diabetes, and systolic blood pressure and retinopathy and peripheral vascular disease in non-insulin-dependent diabetes, were significantly related to albumin excretion. Only one patient with insulin-dependent diabetes were significanatly related of albumin excretion. Only one patient with insulin-dependents diabetes of less than 5 years know duration had an albumin excretion. Only one patient with insulin-dependent diabetes of less than 5 years known duration had an alburmi excretion rate in the range 30-150 μg/min, whereas such an excretion rate indicating patients at risk was observed at all duration of non-insulin-dependent diabetes. It is possible that during the long silent phase of non-insulin-dependent diabetes, before diagnosis, significant renal damage occured.