MMPAD Munich Meeting Report

MEETING REPORT 11 European Roadshow - Friday 25 th May, 2018 Munich, Germany over 40 years develop microalbuminuria, and only 10% develop macroalbuminuria . 12 There also appear to be some patients who are protected, and therefore it is difficult to predict the patients who will develop these complications early on . 13 Hyperglycaemia leads to a local tissue reaction in which toxic metabolites develop. In the case of microangiopathy, basal membranes of the retina, nerves and kidneys thicken; the speaker explained. Changes do not only affect the kidneys, nerves and retina, but also the muscles, including the heart. He also referred to another study, including 269 children with type 1 diabetes with disease onset between 1961 and 1985. Up until 1965, the percentage of severe nephropathies was high and rose with increasing diabetes duration (severe albumin secretion >200 µg/minute) and up until 1970, the same was true for In his second presentation, Klemens Raile talked about the micro- and macrovascular complications of type 1 diabetes, the risk factors for which can be seen in Table 1 below, and the pathomechanisms by which these complications manifest. In his own study, he demonstrated that approximately 25% of patients who have had diabetes for Table 1 : Risk factors for micro- and macroalbuminuria (slide: Raile) . 12 An extract from Professor Raile's presentation is available here proliferative retinopathy. In the 1970s and 1980s, the risk of these complications was considerably lower . 14 However, according to studies by Nordwall and colleagues, the risk of nephropathy significantly increased when HbA1c levels were 9.6% or more, and there was also an exponential increase in retinopathies when HbA1c levels exceeded 8% . 14, 15 The majority of patients with long-standing diabetes had a mild risk of developing retinopathy. On a more positive note, Raile stressed that "these are all factors which can be well addressed". Of the risk factors for nephropathy and retinopathy, an HbA1c value above 7.5%, dyslipidaemia and hypertension are treatable. Smoking too is considered a risk factor. CHRONIC COMPLICATIONS Presented by Professor Klemens Raile - Charité University Medicine