Nephrotic range proteinuria; does it predict lung involvement in patients with type 2 diabetes.

BACKGROUND: Diabetes mellitus is a chronic metabolic disorder that is well known for its long term serious complications. Proteinuria whether micro or macroproteinuria is one of these complications. Many studies has related proteinuria to other complications of diabetes as retinopathy and cardiovascular disease of diabetes, while the lungs of diabetic patients which is the largest organ in the body with a large macro and microvascular bed, has not been related to this complication. AIM: The aim of the study was to find out whether proteinuria in diabetic patients can predict lung involvement. PATIENTS AND METHODS: A comparative cross sectional study in which we compared the lung function of 100 type 2 diabetic patients with proteinuria with that of 100 type 2 diabetic patients without proteinuria. Proteinuria is measured in a random sample by "urine protein/urine creatinine ratio". FEV1 and FVC were measured by spirometer. RESULTS: The results showed that patients with proteinuria had a high frequency of abnormal PFT (86%), while patients without proteinuria had a low frequency of abnormal PFT (11%).Also diabetic patients with proteinuria had lower FVC (72.9 ±â€¯6.5 vs. 88.2 ±â€¯8.2), than diabetic patients without proteinuria. CONCLUSIONS: We concluded that diabetes mellitus causes a significant impairment in pulmonary function test. This impairment is significantly related with proteinuria.

Rhabdomyolysis; is it an overlooked DKA complication.

BACKGROUND: Rhabdomyolysis is considered by some studies as a rare complication of a common disorder of diabetic ketoacidosis, while others consider it as not so uncommon. The mechanism is still not clear but can be attributed to a number of factors like acidosis, hyperglycemia and electrolyte disturbances especially hypophosphatemia and hypokalaemia. Missing it may lead to more serious complications and may prolong and/or complicate full recovery of diabetic ketoacidosis. AIM: The aim of this study was to measure the incidence of rhabdomyolysis among patients presented with diabetic ketoacidosis in the emergency department of Baghdad Teaching hospital, its relation to the severity of diabetic ketoacidosis and the associated electrolytes disturbances. PATIENTS AND METHODS: This is a cross sectional study carried out in the emergency department of Baghdad teaching hospital/Iraq; where 43 patients with type1 diabetes presenting with diabetic ketoacidosis were included. Diabetic ketoacidosis was classified into mild, moderate and severe, and the incidence of rhabdomyolysis was calculated accordingly. Full blood investigations, urinary ketones and arterial blood gasses were done. RESULTS: Rhabdomyolysis was found in 3 (6.98%) patients with more severe acidosis and urinary ketones in the setting of moderate and severe diabetic ketoacidosis. Statistically significant finding was observed with the duration of diabetes, higher serum creatinine, higher serum potassium, higher serum chloride, severe acidosis and urinary ketones. CONCLUSIONS: Rhabdomyolysis incidence in this study was 6.98% of patients with more severe acidosis, urinary ketones in the setting of moderate to severe diabetic ketoacidosis and with longer duration of diabetes.