EYE AND KIDNEY COMPLICATION IN PATIENTS WITH TYPE 1 DIABETES MELLITUS Bùi Phương Thảo*, Nguyễn Trần Ngọc Hiếu**, Vũ Chí Dũng*, Nguyễn Ngọc Khánh*, Cấn Thị Bích Ngọc*, Trương Ngọc Dương** * National Hospital of Pediatrics ** Military Medical University – Military hospital 103

Background - DM 1: better glucose control, glucometer, insulin pen, HbA1c -> improvement life expectancy - Eye complication: most common cause of blindness in DM1 patients, closely related to glucose control, DM duration. - Kidney complication: important cause of end stage of renal failure, dissability and death. - Goal: Evaluate status of eye and kidney complication in patients with DM 1

Patients and method Patients - 81 patients DM 1 in National Hospital of Pediatrics (NHP) diagnosed and treated from June 2011 to July Inclusion criteria Patients with DM 1 + female and male + newly diagnosed and previously diagnosed + with or without complication

Exclusion criteria - Hematologic disorder - Malignant disease - Immunologic disorder - patient/family do not agree to participate in study Patients and method

Method - Research design and sample collection: prospective and retrospective, random collection. - Research parameters: + Eye complication: examination for cataract, fundi examination to find retinopathy (proliferative or non- proliferative) + Kidney complication: according to chronic renal disease classification - NKF KDOQI, based on Glomerular Filtration Rate + Evaluate renal complication (MAU), eye complication according to Vietnam Endocrine-Diabetes Association criteria. Patients and method

Result and discussion Diabetes duration 42 bệnh nhân chẩn đoán lần đầu 42 bệnh nhân chẩn đoán lần đầu Time (year) Cases (n=81) % ≤ 14251, , ,3 > ,6 Mean6,8±6,9

Result and discussion Proportion of eye and kidney complication Lievre M.: 25,4% eye complication, 28,3% kidney complication Bognetti E.: 22,7% eye complication, 11% kidney complication Lepore G.: 24,4% kidney complication Complication Cases (n=81)% Eye 1923,5 Kidney 1822,2 Eye and kidney 1113,6

Result and discussion Proportion of complication to diabetes duration Proportion of complication to diabetes duration ** p 4-1 <0,05, p 4-2 <0,05, p 3-1 <0,05, p 3-2 <0,05. *** p 4-1 <0,05. Bouhanick B.: eye (p<0,02), kidney (p<0,001). Chirallon JJ. : OR=1,19 Compli cation ≤ 1 year (n=42) (1) >1 – 5 years (n=14) (2) 6 – 10 years (n=14) (3) >10 years (n=11) (4) n%n%n%n% Eye37,11 757,1872,7** Kidney37,1321,43 981,8*

Result and discussion Eye complication according to diabetes duration * p 4-1 <0,05, p 4-2 <0,05.** p 4-1 <0,05 ≤ 1 year (n=42) (1) >1 – 5 years (n=14) (2) 6 – 10 years (n=14) (3) >10 years (n=11) (4) n%n%n%n% Proliferative retinopathy ,1436,4 Non-proliferative retinopathy 37,11 321,4327,3 Combined37,11 428,6763,6* Cataract12,400214,3545,5**

Result and discussion Kidney complication according to diabetes duration * p 4-1 <0,05, p 4-2 <0,05, p 4-3 <0,05 ≤ 1 year (n=42) (1) >1 – 5 years (n=14) (2) 6 – 10 years (n=14) (3) >10 years (n=11) (4) n%n%n%n% Edema436,4 Proteinuria (+)17,11 418,2 MAU (+)37,1321,43 981,8* Increased Urea545,5 Increased Creatinine545,45

Result and discussion Proportion of choric renal disease according to NKF/KDOQI StagesCases (n=81)% 189,9 256,

Result and discussion HbA1c level according to diabetes duration * p 4-1 <0,05 ≤1 year (n=42) (1) 1 – 5 years (n=14) (2) 6 – 10 years (n=14) (3) >10 years (n=11) (4) HbA1c (%) 8,58±2,439,03±2,549,67±2,32 10,14±2,7 *

Result and discussion Relationship between eye complication and HbA1c Chirallon JJ: OR = 3,3 Eric Kilpatrick: OR=1,7 HbA1c Without eye complication (n= 62) With eye complication (n= 19) OR ≤7,5%25 40,3% 3 15,8% OR=3,6 CI(1,91-15,25) >7,5% 37 59,7% 16 84,2% X±SD (%)8,77±2,559,99±2,67p<0,05

Result and discussion Relationship between kidney complication and HbA1c Eric Kilpatrick: OR=1,5 Fawar Amari: OR=1,5 HbA1c Without kidney complication (n= 62) With kidney complication (n= 18) OR ≤7,5%24 38,1% 4 22,2%OR=2,2 CI(1,12-7,96) >7,5%39 61,9% 14 77,8% X±SD (%) 8,7±2,3810,36±2,73p<0,05

Conclusion - Eye complication was found in 23,5%; Kidney complication figure was 22,2%. - Both eye and kidney complication occupied 13,6%. - Longer diabetes duration, more eye and kidney complication were found. - The best thing to postpone eye and renal complication is glucose control.