From the Archives - Kidney Disease

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zrebiec Posted: Sun, Dec 21 2008 12:39 PM

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>I read on Joslin's web page "Joslin Study Shows that Kidney Disease in People with Type 1 Diabetes is Frequently Reversible in Its Earliest Stage."

What I was wondering was whether it would be reasonable to assume that these improvements in kidney disease in early stages might extrapolate to Type 2's as well? Can one assume that the various stages of kidney disease and damage don't "discriminate" or "favor" whether one is a T1 or T2 (assuming no other extenuating health conditions/factors involved)?

>>We are inclined to the same opinion as the questioner; the kidneys do not care whether the hyperglycemia is due to type 1 or type 2 diabetes. We wrote about type 1 diabetes because we studied patients with type 1, and that was only because we were more successful in getting funding for studies of kidney disease in type 1 than we were for studies of kidney disease in type 2 diabetes. We are not prejudiced about the type of diabetes - just careful what we say about what we have not studied. The critical issue has to do with other things going on, your last phrase "assuming no other extenuating health conditions/ factors involved". Patients with type 2 diabetes are more likely to have hypertension and higher serum lipids than patients with type 1. Also, they are older (perhaps kidney function already diminished a little) and more likely to be obese. These other factors probably matter. But not everyone with type 2 diabetes is old, obese, hypertensive, and hyperlipidemic. We think the situation will depend on the characteristics of the individual, not the category of diabetes. James H. Warram, MD, ScD Section on Genetics and Epidemiology Joslin Diabetes Center One Joslin Place Boston, MA 02215 John Zrebiec, MSW, CDE