About a third of patients diagnosed as having type 1 diabetes will develop persistent microalbuminuria within 20 years. Of the 277 patients with newly diagnosed type 1 diabetes followed up by Hovind and colleagues (p 1105) for a median of 18 years, 79 developed persistent microalbuminuria and 27 progressed further to persistent macroalbuminuria. Higher urinary albumin excretion rate, higher systolic and diastolic blood pressure, lower stature, higher glycated haemoglobin concentration, and male sex were all predictors of microalbuminuria. Poor glycaemic control at the onset of diabetes is an important predictor of microalbuminuria, say the authors, and spontaneous permanent regression to normoalbuminuria is uncommon.
Figure 1.
