Microalbuminuria in smoking insulin-treated diabetics without manifest nephropathy

Urinary albumin excretion [UAE] was estimated in forty insulin- treated diabetic patients with a diabetes duration not exceeding twenty years. Twenty of them were cigarette smokers [all were males with mean age of 29.5 +/- 3 years and mean duration of diabetes of 8.3 +/- 5.1 years] and twenty were non-smokers [twelve males and eight females with mean age of 28.6 +/- 2.1 years and mean duration of diabetes was 7.8 +/- 3.8 years]. Microalbuminuria [UAE = 30-300 mg/24 h] was much more prevalent in smokers and significant at higher level than non-smokers [99.8 +/- 75.8 vs 26.9 +/- 15.1]. UAE was significantly higher in patients with long duration of diabetes [ten- twenty years] than patients with short duration [zero-nine years] [169.3 +/- 46 vs 42.9 +/- 36.8]. Smoking diabetes with increased UAE had significantly younger age at onset [20 +/- 3 years], longer duration of diabetes [10.7 +/- 4.7 years] and higher smoking index than smoking diabetics with normal UAE [177.3 +/- 117.9 vs 73 +/- 2.9]. This study suggested that smoking diabetics with younger age at onset and duration of diabetes more than ten years are at higher risk to develop microalbuminuria and hence nephropathy than nonsmoking diabetics

Thrombin-antithrombin activity and C1-inactivator in type I diabetics

Previous studies on Diabetes mellitus Type 1 ended in a controversy as to whether there was an increased or decreased fibrinolysis. Also whether fibrinolysis if present was primary or secondary to a hypercoagulable state. The results of screening tests of fibrinolysis are frequently indecisive. C[1]-Inactivator [C[1]-1] [%] as inhibitor of fibrinolysis and thrombin anti-throbmin [TA T] [ug/ml] complex as a sensitive index of the coagulation cascade were determined in 41 male patients with type I diabetes mellitus without complications and in 25 patients of the same disease with microvascular complications [retinopathy, nephropathy and/or neuropathy]. The effect of duration of the disease and the response of the disease to control, were studied. In spite of the fact that screening results of fibrinolysis were not decisive, C[1] -1 and TA T were specific and indicative. TA T was higher in complicated cases [m 9.7 +/- 2.1 SD] than in non-complicated ones [m 5.6 +/- 2.7 SD]; and in uncontrolled complicated cases [m 11.3 +/- 3.0 SD] than in controlled ones [m 9.7 +/- 2.1 SD]. The effect of control was evident also in non-complicated cases where TAT was higher in uncontrolled [m 6.2 +/- 1.9 SD] versus controlled ones [5.6 +/- 2.7 SD]. The longer the duration of the disease the higher the level of TA T, where it was [m 7.2 +/- 2.1 SD] in 1-2 yrs duration and reached m 10.2 +/- 3.1 SD in 5-9 yrs duration. C[1]-l was also higher in complicated diabetes [m 118.6. +/- 18.5 SD] than in non-complicated cases [m 107.5 +/- 16.0 SD] and in both complicated uncontrolled cases [116.3 +/- 15.0 SD] than in complicated controlled ones [118.6 +/- 18.5 SD] also in non-complicated uncontrolled cases [m 115.0 +/- 18.8 SD] than in controlled ones [m 107.5 +/- 160 SD]. The results point to an increased rate of fibrinolysis in response to increased hypercoagulable state in type I Diabetes Mellitus and this is more accentuated the longer the duration of the diseases and that both improve on a better control of the disease