Are glomerular volume differences between type 1 and type 2 diabetic patients pathologically significant?

The observation that patients with type 2 diabetes tend to have larger glomeruli than patients with type 1 diabetes was first made more than 10 years ago. It has also been noted that type 2 diabetic patients with nephropathy often have more heterogeneous renal function and structure than type 1 pati...

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Bibliographic Details
Published in:Diabetologia 2007-05, Vol.50 (5), p.906-912
Main Authors: WHITE, K. E, MARSHALL, S. M, BILOUS, R. W
Format: Article
Language:English
Subjects:
Adult
Associated diseases and complications
Biological and medical sciences
Biopsy
Blood pressure
Body Mass Index
Diabetes
Diabetes Mellitus, Type 1 - pathology
Diabetes Mellitus, Type 1 - physiopathology
Diabetes Mellitus, Type 2 - pathology
Diabetes Mellitus, Type 2 - physiopathology
Diabetes. Impaired glucose tolerance
Diabetic Nephropathies - pathology
Diabetic Nephropathies - physiopathology
Diabetic nephropathy
Endocrine pancreas. Apud cells (diseases)
Endocrinopathies
Etiopathogenesis. Screening. Investigations. Target tissue resistance
Female
Glomerular Filtration Rate
Humans
Hypotheses
Kidney Glomerulus - anatomy & histology
Kidney Glomerulus - pathology
Kidneys
Male
Medical sciences
Middle Aged
Nephrology. Urinary tract diseases
Proteinuria
Urinary system involvement in other diseases. Miscellaneous
Urinary tract. Prostate gland
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Summary:The observation that patients with type 2 diabetes tend to have larger glomeruli than patients with type 1 diabetes was first made more than 10 years ago. It has also been noted that type 2 diabetic patients with nephropathy often have more heterogeneous renal function and structure than type 1 patients. However, whether these observations are linked or have any bearing on the progression of nephropathy in the two types of diabetes remains uncertain. Here we put forward several hypotheses as to why glomerular volume in type 1 differs from that in type 2 diabetes. We suggest that although type 1 and type 2 diabetic patients appear to progress through similar stages of diabetic nephropathy, the route they take may differ. Differences in the way in which the glomeruli respond to the diabetic milieu may enable some type 2 diabetic patients to preserve their filtration surface in the face of an expanding mesangium.
ISSN:0012-186X
1432-0428
DOI:10.1007/s00125-007-0624-1