Diabetic nephropathy forms a part of the classic diabetic complications and affects a large proportion of both insulin and non insulin dependant diabetic patients. 011 microglobulin is a low molecular weight protein and its urinary level markedly reflects a degree of proximal tubular dysfunction. In non insulin dependant diabetes (NIDD) urinary protein excretion and its relation to diabetic nephropathy and glycemic control has not been clearly characterized. The aim of the present study was to detect early tubular dysfunction evidenced by urinary a1 rnicroglobulin in NIDD and to study the relation between urinary excretion of this low molecular weight protein, glycemic control and duration of the disease. This study was carried on 56 subjects from both sexes, 7 normal subjects (group I), 7 recently diagnosed patients with NIDD (group II), 14 patients with NIDD since less than 10 years (group III), 14 patients with NIDD since 10~20 years (group IV) and 14 patients with NIDD since more than 20 years(group V). Each of the last 3 groups (111, IV and V) had 7 uncontrolled and 7 controlled patients (evidenced by glycohemoglobin level). The results obtained showed that urinary excretion of oil microglobulin was higher in all the studied groups compared with the control group, while creatinine clearance started to decrease late in the disease (group IV uncontrolled). This means that 011 microglobulin excretion in urine is an early manifestation of diabetic nephmpathy before appearance of albuminuria or decline of glomerular filtration rate. The results showed, also, that urinary excretion of a1 microglobulin in the uncontrolled diabetic patients was higher than that of the controlled patients and that all microglobulin corrected was correlated with glycohemoglobin. This means that urinary a1 microglobulin is, also, a good indicator of glycemic control in diabetic patients. |
