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Rivista sulle Malattie del Sistema Endocrino
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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Minerva Endocrinologica 2016 December;41(4):486-9
Type II diabetes patients with proteinuria and the recovery of their metabolic parameters
Ya-Zhuo LIU 1, Keqi WANG 2, Xiang LI 3, Bin CHEN 4 ✉
1 Department of Metabolic Diseases and Nutritional Disorders, Affiliated Zhongshan Hospital of Dalian University, Liaoning, China; 2 Nutritional Department, Affiliated Zhongshan Hospital of Dalian University, Liaoning, China; 3 Department of Osteoporosis, Affiliated Zhongshan Hospital of Dalian University, Liaoning, China; 4 Nursing Department, Affiliated Zhongshan Hospital of Dalian University, Liaoning, China
BACKGROUND: The aim of this study was to provide reasonable guidelines for type II diabetes patients with proteinuria to recover their metabolic parameters.
METHODS: A cross-sectional study was conducted in selected groups of type 2 diabetic patients. Hypoglycemic and antihypertensive drug use was recorded. Certain physical examinations were conducted including routine urine test, urinary albumin/creatinine ratio (ACR), metabolic parameters of blood glucose and lipid, and other biochemical indicators. Medication and metabolic indicators were compared between the groups based on the seriousness of the proteinuria.
RESULTS: A total of 923 cases were selected for this study, with an average age of 63 years. Based on the proteinuria contents, the cases were divided into three groups of proteinuria negative, microalbuminuria and clinical proteinuria. The recovery rates of the blood pressure control for the groups were 44.2%, 35.3% and 36.3% respectively. The glycated hemoglobin control recovery rates were 22.2%, 18.5% and 15.2% in the groups. The groups’ triglyceride control satisfaction rates were 44.4%, 43.3%, and 39.8%. The satisfaction rates of total cholesterol control were 34.5%, 26.8% and 25.7% respectively and the satisfaction rates of LDL-c control of the three groups were 30.6%, 23.8% and 22.1%. This indicated an unregulated use of hypoglycemic agents, antihypertensives and lipid-lowering drugs and low recovery rates for metabolic indicators of the cases. Amongst the 923 cases, 397 had microalbuminuria or clinical proteinuria, and only 22 patients took angiotensin converting enzyme inhibitors (ACEI) or angiotensin receptor blocker (ARB), as antihypertensive drugs.
CONCLUSIONS: The use of antihypertensive drugs is not standardized, and only a small portion of patients were treated with ACEI or ARB drugs. Therefore, the proteinuria in diabetic patients should be timely screened and evaluated, as well as renal and metabolic function and antihypertensives and lipid-lowering drugs rationally used.