DIABETES NEPHROPATHY AMONG ADOLECENTS WITH TYPE 1 DIABETES MELLITUS

Abstract

INTRODUCTION
Diabetic nephropathy (DN) is a common cause of mortality and morbidity of young T1DM adult patients. This study is to assess the prevalence of DN in T1DM among adolescents, and its association with duration of diabetes and control.

METHODOLOGY
This is a multicenter retrospective study in paediatric department University Malaya Medical Centre (UMMC) and paediatric department University Teknologi MARA (UiTM), involving children between 10 to 20 years old. Data collection on patient background, control and treatment were obtained. Patients are considered to have DN if the urine albumin/creatinine ratio is >3.5 mg/mmol (girls) >2.5 mg/mmol (boys) in 2 out of 3 samples within 6 months.

RESULTS
109 patients (40% boys) were eligible in the study. Mean age is 15.1±2.7 years old (10.6-20.3). The mean age of diagnosis is 8.8±3.5 years old. The prevalence of DN is 10.1%. Amongst patients with DN, the mean duration of diabetes is 5.9±2.5 years, and the mean HbA1C at year of DN diagnosis was 11.3±2.3%. Only one patient was diagnosed with DN <11 years old. This is due to initial poorly controlled DM. One patient had hypertension at the point of DN diagnosis. The odds of having DN is higher with poorly controlled T1DM (OR 6.9 if HbA1c>9% vs OR 0.76 if HbA1c 7.5-8.9%).

CONCLUSION
This study has shown children with T1DM may exhibit earlier changes of DN. Poor control is a known contributing factor. Consistent screening and early treatment should be routinely done.