, Volume 29, Issue 8, pp 500–502 | Cite as

Cigarette-smoking as a risk factor for macroproteinuria and proliferative retinopathy in Type I (insulin-dependent) diabetes

  • I. Mühlhauser
  • P. Sawicki
  • M. Berger
Rapid Communication


In a case control study 192 cigarette-smoking patients with Type 1 (insulin-dependent) diabetes were compared with 192 non-cigarette-smoking patients pair-matched for sex (90 females), duration of diabetes (mean 14 years), and age (mean 32 years). Macroproteinuria was found in 19.3% of the smoking and in 8.3% of the non-smoking patients (p < 0.001). Proliferative retinopathy was present in 12.5% of the smoking and in 6.8% of the non-smoking patients (p < 0.025). The percentages of patients with normal proteinuria or without retinopathy were comparable between the two groups. In addition, glycosylated haemoglobin values and the prevalence of hypertension were similar between smoking and non-smoking patients. Thus, cigarette-smoking appears to be a risk factor for the progression of incipient to overt nephropathy and of background to proliferative retinopathy in Type 1 diabetes.


Diabetes smoking diabetic nephropathy diabetic retinopathy 


  1. 1.
    Parving HH, Andersen AR, Smidt UM, Svendsen PA (1983) Early aggressive antihypertensive treatment reduces rate of decline in kidney function in diabetic nephropathy. Lancet 1:1175–1179Google Scholar
  2. 2.
    The Kroc Collaborative Study Group (1984) Blood glucose control and the evolution of diabetic retinopathy and albuminuria. N Engl J Med 311:365–372Google Scholar
  3. 3.
    Feldt-Rasmussen B, Mathiesen ER, Hegedüs L, Deckert T (1986) Kidney function during 12 months of strict metabolic control in insulin-dependent diabetic patients with incipient nephropathy. N Engl J Med 314:665–670Google Scholar
  4. 4.
    Paetkau ME, Boyd TAS, Winship B, Grace M (1977) Cigarette smoking and diabetic retinopathy. Diabetes 26:46–49Google Scholar
  5. 5.
    Christiansen JS (1978) Cigarette smoking and prevalence of microangiopathy in juvenile-onset insulin-dependent diabetes mellitus. Diabetes Care 1:146–149Google Scholar
  6. 6.
    Nordén G, Nyberg G (1984) Smoking and diabetic nephropathy. Acta Med Scand 215:257–261Google Scholar
  7. 7.
    Mühlhauser I, Jörgens V, Berger M, Graninger W, Gürtler W, Hornke L, Kunz A, Schernthaner G, Scholz V, Voss HE (1983) Bicentric evaluation of a teaching and treatment programme for Type 1 (insulin-dependent) diabetic patients: improvement of metabolic control and other measures of diabetes care for up to 22 months. Diabetologia 25:470–476Google Scholar
  8. 8.
    Haase R (1986) Diagnostic assay of proteinuria using a novel laser turbidimeter. MD thesis, Düsseldorf University Medical SchoolGoogle Scholar
  9. 9.
    West KM, Erdreich LS, Stober JA (1980) Absence of a relationship between smoking and diabetic microangiopathy. Diabetes Care 3:250–252Google Scholar
  10. 10.
    Rand LI, Krolewski AS, Aiello LM, Warram JH, Baker RS, Maki T (1985) Multiple factors in the prediction of risk of proliferative diabetic retinopathy. N Engl J Med 313:1433–1438Google Scholar

Copyright information

© Springer-Verlag 1986

Authors and Affiliations

  • I. Mühlhauser
    • 1
    • 2
  • P. Sawicki
    • 1
  • M. Berger
    • 1
  1. 1.Department of Metabolic Diseases and Nutrition, WHO Collaborating Center for DiabetesUniversity of DüsseldorfGermany
  2. 2.Medizinische Klinik der Universität Düsseldorf Abteilung für Stoffwechselkrankheiten und ErnährungDüsseldorfGermany

Personalised recommendations