Inflammatory response and timeline of chronic complications in patients with type 1 and 2 diabetes mellitus
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ORIGINAL ARTICLE
Inflammatory response and timeline of chronic complications in patients with type 1 and 2 diabetes mellitus Ancuța Cutaș 1,2 & Cristina Drugan 3 Tudor Drugan 1
&
Gabriela Roman 2 & Adriana Rusu 2 & Dan Istrate 1 & Andrei Achimaș-Cadariu 1 &
Received: 21 November 2019 / Accepted: 21 April 2020 # Research Society for Study of Diabetes in India 2020
Abstract Background and aim The chronic complications of diabetes mellitus (DM) are accompanied by inflammatory manifestations. Our study aimed to assess the association between inflammatory status, reflected by C-reactive protein (CRP) values and the evolution of type 1 and 2 DM patients, evaluated by glycated hemoglobin (HbA1c) levels, the length of disease duration, the average time until the onset of microvascular complications and their risk of occurrence. Methods We conducted a retrospective observational study, involving 192 patients, randomly selected from the medical records of the Centre for Diabetes Mellitus, Nutrition and Metabolic Diseases, Cluj-Napoca, Romania. Results We noted significant differences between the two patient groups concerning HbA1c levels in patients with stage I nephropathy and CRP values in those with retinopathy. A significant positive correlation between the levels of studied biomarkers and disease duration was noted for type 1, but not for type 2 patients. We found a higher risk of chronic complications in patients with type 2, compared to those with type 1 DM: the relative risk was higher by 1.87 (1.59–1.97) times for nephropathy, 2.57 (1.56–4.18) times for retinopathy and 3.66 (3.00–3.82) times for neuropathy. Conclusion Our study indicates a direct link between systemic inflammation and the timely progression of type 1 DM. In patients with type 2 DM, no statistical significance was found between the levels of studied biomarkers and the occurrence of microvascular complications. Nephropathy appeared sooner in type 1 DM patients, while retinopathy and neuropathy had a similar pattern of occurrence in both types of patients. Keywords Diabetes mellitus . C-reactive protein . Glycated Hemoglobin . Inflammation . Chronic complications
Introduction Diabetes is regarded as a major healthcare problem, currently affecting 463 million people worldwide. By 2045, it is estimated that this number will reach 700 million people. In Europe, the latest estimate showed that 59.3 million people were affected by diabetes, with a continuously rising prevalence. One of the most affected areas is Romania, with a * Cristina Drugan [email protected] 1
Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy, Cluj-Napoca, Romania
2
Department of Nutrition and Metabolic Diseases, University of Medicine and Pharmacy, Cluj-Napoca, Romania
3
Department of Medical Biochemistry, University of Medicine and Pharmacy, 6 Pasteur Street, 400349 Cluj-Napoca, Romania
prevalence of over 8.8% and a proportion of undiagnosed diabetes of 20.7% [1]. Diabetes mellitus (DM) is a chronic and complex disease, requiring co
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