Inflammatory response and timeline of chronic complications in patients with type 1 and 2 diabetes mellitus

Abstract

The chronic complications of diabetes mellitus (DM) are accompanied by inflammatory manifestations. Our study aimed to assess the association between inflammatory status, reflected by C-reactive protein (CRP) values and the evolution of type 1 and 2 DM patients, evaluated by glycated hemoglobin (HbA1c) levels, the length of disease duration, the average time until the onset of microvascular complications and their risk of occurrence. We conducted a retrospective observational study, involving 192 patients, randomly selected from the medical records of the Centre for Diabetes Mellitus, Nutrition and Metabolic Diseases, Cluj-Napoca, Romania. We noted significant differences between the two patient groups concerning HbA1c levels in patients with stage I nephropathy and CRP values in those with retinopathy. A significant positive correlation between the levels of studied biomarkers and disease duration was noted for type 1, but not for type 2 patients. We found a higher risk of chronic complications in patients with type 2, compared to those with type 1 DM: the relative risk was higher by 1.87 (1.59–1.97) times for nephropathy, 2.57 (1.56–4.18) times for retinopathy and 3.66 (3.00–3.82) times for neuropathy. Our study indicates a direct link between systemic inflammation and the timely progression of type 1 DM. In patients with type 2 DM, no statistical significance was found between the levels of studied biomarkers and the occurrence of microvascular complications. Nephropathy appeared sooner in type 1 DM patients, while retinopathy and neuropathy had a similar pattern of occurrence in both types of patients.