PREVALENCE OF MICROALBUMINURIA WITH RELATION TO GLYCEMIC CONTROL IN TYPE-2 DIABETIC PATIENTS IN KARACHI

Authors

  • Shehnaz A Sheikh
  • Jawed Altaf Baig
  • Tehseen Iqbal
  • Tahseen Kazmi
  • Muhammad Baig
  • Syed Shajee Husain

Abstract

Background: Diabetes is one of the most common endocrine disorders characterized byhyperglycaemia. Diabetic nephropathy is a consequence of long standing diabetes. The prevalence ofmicroalbuminuria predicts progression to diabetic nephropathy. The present study was conducted todetermine the prevalence of microalbuminuria in relation to duration of diabetes, BMI, SerumCreatinine and HbA1c in an ethnic group of Type 2 diabetes mellitus residing in Karachi. Methods:This cross-sectional descriptive study was carried out in a community diabetic centre, located at GardenEast Karachi from July to December 2007. One hundred known Type 2 diabetic patients with age 30–70 years were included in the study. Informed consent and a structured questionnaire of each patientwere recorded. Fasting venous blood and morning urine sample was collected for analysis of creatinine,HbA1c and microalbuminuria respectively. Statistical analysis was done using SPSS version 13.0.Pearson correlation was applied to observe association of microalbuminuria with different parameters.All p-values <0.05 were considered as statistically significant. Results: Microalbuminuria had a highlysignificant correlation with duration of diabetes, serum creatinine (p<0.001), HbA1c (p<0.05) and BMI(p<0.024). A strong correlation exists between age and serum creatinine (r=0.73). Conclusion: Thepresent study found an early onset of microalbuminuria in the selected community which could be dueto poor glycaemic control (high HbA1c >7%) or heredity factors. Screening for microalbuminuria andHbA1c test should be done in both newly and already diagnosed Type 2 diabetic patients as an earlymarker of renal dysfunction and glycaemic control.Keywords: Microalbuminuria, HbA1c, duration, diabetes, Serum Creatinine

References

Powers A C. Diabetes Mellitus. In: Jameson JL. (editor)

Harrison’s Endocrinology. 1st ed. New York: McGraw-Hill;

p 303–4.

Satchell S, Tooke JF. What is the mechanism of

microalbuminuria in diabetes: a role for the glomerular

endothelium? Diabetologia 2008;51:714–25.

Microalbuminuria test. Available at www.nlm.nih.gov/

medlineplus/ency/article/003591.htm [Accessed Oct 19, 2008]

Diabetes and High Blood pressure. Available at

http://www.patient.co.uk/health/Diabetes-and-High-BloodPressure.htm [Accessed Oct 19, 2008]

Maahs DM, Snively BM, Bell RA, Dolan L, Hirsch I, Imperatore

G, et al. Higher Prevalence of Elevated Albumin Excretion in

Youth with Type 2 than Type 1 Diabetes: The SEARCH for

Diabetes in Youth Study. Diabetes Care 2007;30:2593–8.

Shaukat A, Arian TM, Shahid A. Microalbuminuria:

Incidence in patience of diabetes at Bhawalpur. Pak J Pathol

;16(1):17–21.

Buell C, Kermah D, Davidson MB. Utility of A1C for diabetes

screening in the 1999–2004 NHANES Population. Diabetes care

;30:2233–5.

Saudek CD, Kalyani RR, Derr RL. Assessment of Glycemia in

Diabetes Mellitus: Hemoglobin A1c. J Assoc Physicians India.

;53:299–304.

Kilpatrick ES. Hemoglobin A1c in the diagnosis and monitoring

of diabetes mellitus. J Clin Pathol 2008;61:977–82.

McCarter RJ, Hempe JM, Chalew SA. Mean blood glucose and

biological variation have greater influence on HbA1c levels than

glucose instability: An analysis of data from the Diabetes Control

and Complications Trial. Diabetes Care 2006;29(2):352–5.

Kassab A, Ajmi T, Issaoui M, Chaeib L, Miled A, Hammami M.

Homocysteine enhances LDL fatty acid peroxidation, promoting

microalbuminuria in Type 2 diabetes. Ann Clin Biochem

;45:476–80.

Myers MD. Definition of obesity. Available at

www.weight.com/definition. [Accessed Oct 20, 2008]

Hawkins RC. Comparison of four point-of-care HbA1c

Analytical Systems against central laboratory analysis. Singapore

Med J 2003;44(1):8–11.

Naz S, Sadaruddin A, Khannum A , Osmani R. Frequency of

microalbuminuria in diabetic patients of Islamabad and

Rawalpindi. Pak J Med Res 2007;46(3):70–4.

Adler AI, Stevens RJ, Manley SE, Bilous RW, Cull CA, Holman

RR. UKPDS GROUP. Development and progression of

nephropathy in type 2 diabetes: The United Kingdom prospective

diabetes study. Kidney Int 2003;63(7):225–32.

Tagle R, Acevedo M, Vidt DG. Microalbuminuria: Is it a valid

predictor of cardiovascular risk? Cleve Clin J Med

;70(3):255–61.

Body mass index calculator. Available at:

http://www.kcnet.com/~marc/bmi.html. [Accessed Oct 10, 2008]

Mokdad AH, Ford ES, Bowman BA, Dietz WH, Vinicor F,

Bales VS, et al. Prevalence of obesity, diabetes, and obesityrelated health risk factors, 2001. JAMA 2003;289:76–9.

Brownlee M, Hirsch IB. Glycemic variability: A hemoglobin

A1c–independent risk factor for diabetic complications. JAMA

;295(14):1707–8.

Giunti S, Barit D, Cooper ME. Mechanism of diabetic

nephropathy. Role of hypertension Hypertension

;48:519–26.

Justesen TI, Petersen JLA, Ekbom P, Damm P, Mathiesen

ER. Albumin-to-Creatinine ratio in random urine samples might

replace 24-h urine collections in screening for Micro-and

Macroalbuminuria in pregnant woman with Type 1 diabetes.

Diabetes Care 2006;29:924–5.

Hebert CJ. Preventing kidney failure; primary care physicians

must intervene earlier. Cleveland clinic journal of medicine

;70(4):337–44.

Araki S, Haneda M, Koya D, Hidaka H, Sugimoto T, Isono M, et

al. Reduction in microalbuminuria as an integrated indicator for

renal and cardiovascular risk reduction in patients with Type 2

Diabetes . Diabetes 2007;56:1727–30.

Wright J, Vardhan A. Review: The problem of diabetic

nephropathy and practical prevention of its progression. Br J

Diabetes Vasc Dis 2008;8(6):272–7.

Derakhshan A, Akhavan M, Karamifar H. Evaluation of

microalbuminuria 4 to 6 years following Type 1 Diabetes in

Children. Iranian J Paediatr 2007;17:252–6.

Published

2009-09-01

Issue

Vol. 21 No. 3 (2009): JOURNAL OF AYUB MEDICAL COLLEGE, ABBOTTABAD

Section

ORIGINAL ARTICLE

License

Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License  CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.

USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.

AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.