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Classification of diabetes in patients with end-stage renal disease. Validation of clinical criteria according to fasting plasma C-peptide.
Clin Nephrol 1992; 38(5):239-44CN

Abstract

An epidemiologic study of end-stage diabetic nephropathy in France (Uremidiab) was performed, aiming to establish the prevalence of both types of diabetes in dialysis patients. Because discrimination between type I and type II diabetes remains mostly clinical, our aim was to evaluate what the most fitted clinical criteria were. We studied 494 hemodialyzed diabetic patients. A first classification (Cn) was offered by the nephrologist. Clinical data of 472 patients (22 patients of the 494 have been excluded) were then collected with a standardized questionnaire, allowing one diabetologist of us to establish the diagnosis of type of diabetes (classification Cd). Plasma C-peptide at this stage of the disease was expected to be very discriminative, measured in 88 patients and defined classification Ccp (< or = 0.6 ng/ml = "negative C-peptide" = type I, > 0.6 ng/ml = "positive C-peptide" = type II). Classification Cd observed 98 type I and 374 type II diabetes. Cn overestimated type I diabetes, 37% of type II diabetes being misclassified because insulin-treated. Classification Ccp observed 74 positive C-peptide patients, classified as type II, among whom 45 were insulin-treated. Only 3 patients were discordant for classification Cd and Ccp. Predictive value of "negative C-peptide" and "positive C-peptide" were 100% and 96% respectively. Multiple regression analysis of the Ccp classification was performed with the clinical criteria and showed very significant correlation with: age at the time of diagnosis of diabetes (AGE), maximal body mass index ever reached (BMI MAX) and delay between diagnosis and consistent insulin use (DI).(

ABSTRACT

TRUNCATED AT 250 WORDS)

Authors+Show Affiliations

Service d'Endocrinologie-Diabétologie, CHRU, Grenoble, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

1451336

Citation

Benhamou, P Y., et al. "Classification of Diabetes in Patients With End-stage Renal Disease. Validation of Clinical Criteria According to Fasting Plasma C-peptide." Clinical Nephrology, vol. 38, no. 5, 1992, pp. 239-44.
Benhamou PY, Marwah T, Balducci F, et al. Classification of diabetes in patients with end-stage renal disease. Validation of clinical criteria according to fasting plasma C-peptide. Clin Nephrol. 1992;38(5):239-44.
Benhamou, P. Y., Marwah, T., Balducci, F., Zmirou, D., Borgel, F., Cordonnier, D., ... Papoz, L. (1992). Classification of diabetes in patients with end-stage renal disease. Validation of clinical criteria according to fasting plasma C-peptide. Clinical Nephrology, 38(5), pp. 239-44.
Benhamou PY, et al. Classification of Diabetes in Patients With End-stage Renal Disease. Validation of Clinical Criteria According to Fasting Plasma C-peptide. Clin Nephrol. 1992;38(5):239-44. PubMed PMID: 1451336.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Classification of diabetes in patients with end-stage renal disease. Validation of clinical criteria according to fasting plasma C-peptide. AU - Benhamou,P Y, AU - Marwah,T, AU - Balducci,F, AU - Zmirou,D, AU - Borgel,F, AU - Cordonnier,D, AU - Halimi,S, AU - Papoz,L, PY - 1992/11/1/pubmed PY - 1992/11/1/medline PY - 1992/11/1/entrez SP - 239 EP - 44 JF - Clinical nephrology JO - Clin. Nephrol. VL - 38 IS - 5 N2 - An epidemiologic study of end-stage diabetic nephropathy in France (Uremidiab) was performed, aiming to establish the prevalence of both types of diabetes in dialysis patients. Because discrimination between type I and type II diabetes remains mostly clinical, our aim was to evaluate what the most fitted clinical criteria were. We studied 494 hemodialyzed diabetic patients. A first classification (Cn) was offered by the nephrologist. Clinical data of 472 patients (22 patients of the 494 have been excluded) were then collected with a standardized questionnaire, allowing one diabetologist of us to establish the diagnosis of type of diabetes (classification Cd). Plasma C-peptide at this stage of the disease was expected to be very discriminative, measured in 88 patients and defined classification Ccp (< or = 0.6 ng/ml = "negative C-peptide" = type I, > 0.6 ng/ml = "positive C-peptide" = type II). Classification Cd observed 98 type I and 374 type II diabetes. Cn overestimated type I diabetes, 37% of type II diabetes being misclassified because insulin-treated. Classification Ccp observed 74 positive C-peptide patients, classified as type II, among whom 45 were insulin-treated. Only 3 patients were discordant for classification Cd and Ccp. Predictive value of "negative C-peptide" and "positive C-peptide" were 100% and 96% respectively. Multiple regression analysis of the Ccp classification was performed with the clinical criteria and showed very significant correlation with: age at the time of diagnosis of diabetes (AGE), maximal body mass index ever reached (BMI MAX) and delay between diagnosis and consistent insulin use (DI).(ABSTRACT TRUNCATED AT 250 WORDS) SN - 0301-0430 UR - https://www.unboundmedicine.com/medline/citation/1451336/Classification_of_diabetes_in_patients_with_end_stage_renal_disease__Validation_of_clinical_criteria_according_to_fasting_plasma_C_peptide_ L2 - http://www.diseaseinfosearch.org/result/2236 DB - PRIME DP - Unbound Medicine ER -