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