Effect of different theraputic regimens of diabetis mellitus on renal function

Diabetes mellitus (DM) is a metabolic disorders which is characterized by chronic hyperglycemia with disturbances of carbohydrates, fats and proteins metabolism resulting from defect in insulin secretion, insulin action, or both causing a significant disturbance of water and electrolytes homeostasis. This is a case control study conducted on 150 diabetic patients of both sexes, 87 (58% ) were males and 63 (42%) were females, 50 patients were only on insulin therapy (group 1), 50 patients were only on oral hypoglycemic agent therapy (group 2) and 50 patients were on insulin and hypoglycemic agent therapy (group 3). Renal function test ( blood urea, serum creatinine and serum electrolytes ) were measured for all patients and compared with each other and with 50 apparently healthy control. Regarding the results of renal function parameters, there were higher levels of serum urea (5.43) mmol/L and creatinine (82.3) µ mol in group 3 (p<0.001,p<0.05) respectively, with higher values of S.Na+ (142.36) mmol/L and K+ (5.15) mmol/L in group 2 (p<0.001, p<0.05) respectively, all in comparison with the control group. There was no significant difference in S.urea and S.creatinine level in all groups while significantly higher level of S.Na+ and S.K+ was found in group 2 (p<0.001). A part from significant higher level of S.creatinine in males of group 3 (86.75) µ mol (p<0.001), there was no significant difference in all other parameters between males and females. In group 1 S.urea (6.23) mmol/L and S.K+ (4.96) µ mol were higher in those with 5-10 years of disease duration (p<0.05), with higher level of S.Na+ (145.0) mmol/L in those of < 5 years of disease duration (P<0.05) in group 2, while no significant difference was seen in group 3. Also ultrasonography had shown no significant differences between the patients groups themselves and between them and the control group.