EPIDEMIOLOGY, DEVELOPMENT AND TREATMENT OF END-STAGE RENAL-FAILURE INTYPE-2 (NON-INSULIN-DEPENDENT) DIABETES-MELLITUS - THE CASE OF MAINLAND FRANCE AND OF OVERSEAS FRENCH TERRITORIES

The prevalence of diabetes mellitus among patients treated for end-sta ge renal failure by dialysis in France was studied in two stages (UREM IDIAB Study). The first stage consisted of a questionnaire which was m ailed to all dialysis centres in mainland France. The response rate wa s 80.8 %, resulting in a study population of 12,903 patients. Of these patients 884 were declared diabetic (6.9 %). Later 295 of them were i nterviewed by seven specially-trained physicians who checked the medic al records together with the nephrologist in charge. Plasma C-peptide was measured in almost all of the patients. Effectively, 1.4 % were fo und to have Type 1 diabetes and 5.5 %, Type 2. Diabetic nephropathy wa s found to be the only primary renal diagnosis among 93.9 % of Type 1 diabetic patients and 36.8 % of Type 2. Of the latter 51.6 % had a non -diabetic cause of renal failure. In the second stage a survey.was lat er conducted in 13 of 14 dialysis centres located in the remote overse as French territories. Among 934 patients 1.04 % were Type 1 diabetic and 19.67 % Type 2 (22.9 % altogether). Type 2 diabetic patients treat ed overseas were essentially non-Caucasians (92.6 %). The sex ratio wa s 0.54 in the overseas territories vs 1.4 in the mainland. We conclude that the prevalence of diabetes among people on dialysis is low in ma inland France. But there are striking differences in the prevalence of Type 2 diabetes among dialysis patients in mainland France and its ov erseas territories. These differences are not related to access to dia lysis facilities.