Higher nocturnal blood pressure predictive of kidney disease in diabetes

September 11, 2002

Monitoring nighttime blood pressure is a simple, painless and noninvasive method of identifying patients with type 1 diabetes who are at increased risk for kidney disease, according to a study published in the Sept. 12 issue of The New England Journal of Medicine.

Daniel Batlle, M.D., professor of medicine at The Feinberg School of Medicine at Northwestern University and researchers from Spain showed that in persons with type 1 diabetes, an increase in systolic blood pressure during sleep precedes the development of microalbuminuria -- or a protein called albumin in the urine -- a condition that is predictive of kidney disease.

In their prospective study, the investigators used 24-hour ambulatory blood pressure monitoring in 75 adolescents and young adults with type 1 diabetes who had normal blood pressure and urinary albumin excretion levels at enrollment. Over a follow-up period of five years, 14 of the patients had developed microalbuminuria.

This group also had nighttime systolic blood pressure that was significantly higher than those in study participants with normal urinary albumin levels. By contrast, in those whose blood pressure during sleep decreased normally, the progression from normal albumin excretion to microalbuminuria appeared to be less likely.

Blood pressure has a normal circadian rhythm and varies depending on levels of stress and physical activity.

"Thus, blood pressure measured randomly at the physician's office cannot fully reflect blood pressure levels around the clock, particularly when it is close to the normal range at earlier stages of diabetes," Batlle said.

The researchers said that an increase in nighttime systolic pressure appears to be the earliest detectable manifestation of altered blood pressure regulation in patients with type 1 diabetes and may provide a good way for choosing or avoiding unnecessary therapies to prevent microalbuminuria and kidney disease in patients with type 1 diabetes.
-end-
KEYWORDS: type 1 diabetes, microalbuminuria, hypertension, kidney disease

Northwestern University

Related Diabetes Articles from Brightsurf:

New diabetes medication reduced heart event risk in those with diabetes and kidney disease
Sotagliflozin - a type of medication known as an SGLT2 inhibitor primarily prescribed for Type 2 diabetes - reduces the risk of adverse cardiovascular events for patients with diabetes and kidney disease.

Diabetes drug boosts survival in patients with type 2 diabetes and COVID-19 pneumonia
Sitagliptin, a drug to lower blood sugar in type 2 diabetes, also improves survival in diabetic patients hospitalized with COVID-19, suggests a multicenter observational study in Italy.

Making sense of diabetes
Throughout her 38-year nursing career, Laurel Despins has progressed from a bedside nurse to a clinical nurse specialist and has worked in medical, surgical and cardiac intensive care units.

Helping teens with type 1 diabetes improve diabetes control with MyDiaText
Adolescence is a difficult period of development, made more complex for those with Type 1 diabetes mellitus (T1DM).

Diabetes-in-a-dish model uncovers new insights into the cause of type 2 diabetes
Researchers have developed a novel 'disease-in-a-dish' model to study the basic molecular factors that lead to the development of type 2 diabetes, uncovering the potential existence of major signaling defects both inside and outside of the classical insulin signaling cascade, and providing new perspectives on the mechanisms behind insulin resistance in type 2 diabetes and possibly opportunities for the development of novel therapeutics for the disease.

Tele-diabetes to manage new-onset diabetes during COVID-19 pandemic
Two new case studies highlight the use of tele-diabetes to manage new-onset type 1 diabetes in an adult and an infant during the COVID-19 pandemic.

Genetic profile may predict type 2 diabetes risk among women with gestational diabetes
Women who go on to develop type 2 diabetes after having gestational, or pregnancy-related, diabetes are more likely to have particular genetic profiles, suggests an analysis by researchers at the National Institutes of Health and other institutions.

Maternal gestational diabetes linked to diabetes in children
Children and youth of mothers who had gestational diabetes during pregnancy are at increased risk of diabetes themselves, according to new research published in CMAJ (Canadian Medical Association Journal).

Two diabetes medications don't slow progression of type 2 diabetes in youth
In youth with impaired glucose tolerance or recent-onset type 2 diabetes, neither initial treatment with long-acting insulin followed by the drug metformin, nor metformin alone preserved the body's ability to make insulin, according to results published online June 25 in Diabetes Care.

People with diabetes visit the dentist less frequently despite link between diabetes, oral health
Adults with diabetes are less likely to visit the dentist than people with prediabetes or without diabetes, finds a new study led by researchers at NYU Rory Meyers College of Nursing and East Carolina University's Brody School of Medicine.

Read More: Diabetes News and Diabetes Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.