INCREASED PREVALENCE OF ELEVATED URINARY ALBUMIN EXCRETION RATE IN TYPE-2 DIABETIC-PATIENTS SUFFERING FROM ISCHEMIC FOOT LESIONS

Present cross-sectional clinical study was aimed at the evaluation the prevalence of cardiovascular risk factors in Type 2-diabetics sufferi ng from different clinical manifestations of diabetic foot lesions due to peripheral vascular disease and/or diabetic neuropathy. 1025 non-i nsulin-dependent (Type 2) diabetics (NIDDM) of both sexes were investi gated. Patients were classified in Type II diabetes without peripheral vascular disease and foot lesions (group 0, controls), with macroangi opathic related foot lesions (group 2), with neuropathic foot lesions (group 3), and with mixed neuropathic-ischemic foot lesions (group 4). Apart from urinary albumin excretion rate (UAE), the following micro- and macroangiopathic risk factors and diseases were taken into account : Hypertension, degree of metabolic control (HbA(1c)), lipid concentra tions, duration of diabetes, retinopathy, clinical nephropathy. Result s: In the total population the UAE was significantly (p < 0.01) correl ated with duration of diabetes, serum creatinine, hypertension, age, l ipid concentrations, HbA(1c) and insulin requirement. In comparison to Type II diabetic patients without peripheral vascular disease (group 0) and with neuropathic foot lesions group 3), subjects with ischemic (group 2) and mixed neuropathic-ischemic foot lesions demonstrated an increased prevalence of pathological UAE, which was associated with a higher frequency of clinical nephropathy, retinopathy, an older age an d longer duration of diabetes. It is concluded that microalbuminuria i n Type 2 diabetes reflects both the existence of diabetic nephropathy and peripheral vascular disease which is often associated with the ins ulin resistance syndrom.