DOI: http://dx.doi.org/10.18203/2349-3933.ijam20205454

A study to assess the correlation between HbA1c and microalbuminuria among diabetics

Sruthi Kare, Vishwanath N. Reddy, Thejdeep Mahamkali

Abstract


Background: India is one of the epicentres of the global diabetes mellitus pandemic. Rapid socioeconomic development and demographic changes, along with increased susceptibility for Indian individuals, have led to the explosive increase in the prevalence of diabetes mellitus in India over the past four decades. Diabetic Nephropathy is a common consequence of long-standing diabetes mellitus. The development of diabetic nephropathy has a dramatic increase on the morbidity and mortality of patients with diabetes. Objective of this study was to evaluate the prevalence of microalbuminuria in patients with diabetes mellitus patients.  

Methods: This cross-sectional study was conducted on T 2 diabetes mellitus patients visiting medicine OPD of R L Jalappa hospital constituent hospital of Sri Deveraj Urs Medical College, Tamaka, Kolar from May 2016 to July 2016. A total of 60 type-2 diabetes patients were enrolled in the study.

Results: Average duration of diabetes among study group was 8 years and most of the patients were between 6-10 years. In type 2DM patients, microalbuminuria and glycemic control have shown a significant linear correlation with duration of diabetes (p<0.05). Also, micro albuminuria has a significant correlation with increase in level of glycosylated haemoglobin.  

Conclusions: The prevalence of microalbuminuria in diabetic patients was found to be high and being a developing country; there is a dire need that microalbuminuria and HbA1c testing should be done in both, newly diagnosed as well as already diagnosed type 2DM patients as an early marker of renal risk factor.


Keywords


Microalbuminuria, Glycemic control, Diabetic, Nephropathy, Elderly

Full Text:

PDF

References


Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabet Care. 2003;26(1):5-20.

Satchell S, Tooke JF. What is the mechanism of microalbuminuria in diabetes: a role for the glomerular endothelium? Diabetologia. 2008;51:714-25.

Powers AC. Diabetes Mellitus. In: Jameson JL. (editor) Harrison's Endocrinology. 1st ed. New York: McGraw-Hill. 2006:303-4.

Mason RM, Wahab NA. Extracellular matrix metabolism in diabetic nephropathy. J Am Soc Nephrol. 2003;14:1358-73.

Vergouwe Y, Soedamah-Muthu SS, Zgibor J, Chaturvedi N, Forsblom C, Snell-Bergeon JK, et al. Progression to microalbuminuria in type 1 diabetes: development and validation of a prediction rule. Diabetologia. 2010;53:254-62.

American Diabetes Association. Testing in Asymptomatic Patients. Diabet Care. 2011;34(1):13-4.

American Diabetes Association. Diagnosis and Classification of Diabetes Mellitus. Diabet Care. 2011;34(1):62-9.

Bajaj S, Kannan V. Renal diseases in diabetes mellitus: Type-2 Diabet Melli. 2004:172-94.

Gupta SK, Singh Z, Purty AJ, Kar M, Vedapriya D, Mahajan P et al. Diabetes prevalence and its risk factors in rural area of Tamil Nadu. Ind J Comm Med. 2010; 35:396-9.

Viberti G, Mackintosh D, Rudolf W, Bilous, John C. Pickup, And Harry Keen. ‘Protienuria In Diabetes Mellitus: Role Of Spontaneous And Experimental variation of glycemia”. Kidney Int. 1982;21(5):714-20.

Parving HH, Oxenball B, Svendsen PA, Christiansen J S and Andersen AR. Early edetection of patients at risk of developing diabetic nephropathy: a longitudinal study of urinary albumin excretion”. Acta endocrinal (Copenh). 1982;100:550-5.

Viberti GC, Hill Rd, Jarrett RJ, Argyropoulos A, Mahmud U, Keen H. Microalbuminuria as a predictor of clinical nephropathy in insulin dependent diabetes mellitus. Lancet. 1982;1:1430-2.

Mogensen CE, Christensen CK. Predicting diabetic nephropathy in insulindependent patients. N Engl J Med. 1984;311:89-93.

Kassab A, Ajmi T, Issaoui M, Chaeib L, Miled A, Hammami M. Homocysteine enhances LDL fatty acid peroxidation, promotingmicroalbuminuria in Type 2 diabetes. Ann Clin Biochem. 2008;45:476–80.

Zelmanovitz T, Gerchman F, Amely P, Balthazar S, Fúlvio CS, Thomazell, Jorge D Matos and Luís H Canani. Diabetic nephropathy. Diabetol Metabol Synd. 2009;1(4):1-17.

Joshi PP, Nirwan D, Holay MP, Salkar RG. Significance of Microalbuminuria in Acute Myocardial Infraction. J Assoc Physic Ind. 2003;51:1-10.

Sheikh SA, Baig JA, Iqbal T, Kazmi T, Baig M, Syed Husain S. Prevalence of microalbuminuria with relation to glycemic control in type-2 diabetic patients in Karachi. J Ayub Med Coll Abbottabad. 2009;21(3):83-6.

Naveen P. Evaluation of Glycated hemoglobin and Microalbuminuria as early risk markers of Nephropathy in Type 2 Diabetes Mellitus. Int J Biol Med Res. 2012;3(2):1724-6.

Hsu CC, Chang HY, Huang MC, Hwang SJ, Yang YC, Lee YS, et al. HbA1c variability is associated with microalbuminuria development in type 2 diabetes: a 7-year prospective cohort study. Diabetologia. 2012;55(12):3163-72.

Kundu D, Roy A, Mandal T, Bandyopadhyay U, Ghosh E, Ray D. Relation of microalbuminuria to glycosylated hemoglobin and duration of type 2 diabetes. Nige J Clinic Pract. 2013;16(2):216-20.

Varghese A, Deepa R, Rema M, Mohan V. The prevalance of microalbuminuria in Type 2 diabetes mellitus at a diabetes center in southern India. Postgrad Med J. 2001;77:399-402

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.