Insulin resistance is most predictive of diabetic nephropathy in the long-term, according to the results of a 10-year prospective study published in the September issue of Kidney International. Blood pressure and lipids were only predictive of nephropathy in the short-term. Type 1 diabetics without insulin resistance therefore appear to have a low risk of kidney disease, and the secret to preventing nephropathy appears to be through lifestyle changes that can help prevent insulin resistance.
“Kidney disease is a major lethal complication for people with diabetes, particularly those with type 1 diabetes, and until now there has been no clear explanation for its cause beyond blood sugar itself,” lead author Trevor Orchard, MBBCh, MMedSci, from the University of Pittsburgh Graduate School of Public Health in Pennsylvania, says in a news release.
“We now suspect that reducing or preventing insulin resistance, possibly through exercise, weight loss and drugs, may help people with type 1 diabetes avoid nephropathy.” Of 658 adults with type 1 diabetes enrolled in the Pittsburgh Epidemiology of Diabetes Complication Study, 485 did not have nephropathy at baseline. To measure insulin resistance, the investigators used a novel calculation based on waist-to-hip ratio, hypertension status, and long-term blood glucose levels.
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