Assessment of urinary microalbumin levels in type 1 and type 2 diabetic subjects

Abstract

Abstract: Introduction: Diabetes mellitus is one of the most prevalent metabolic diseases all over the globe, including India. Prolonged diabetes is accompanied with many complications including diabetic nephropathy. Diabetic nephropathy is defined clinically as the presence of microalbuminuria or overt nephropathy in patients with diabetes without the manifestations of renal diseases due to other causes. The earliest sign of diabetic nephropathy leading to an end stage renal disease is microalbuminuria and is estimated as UAE (Urinary Albumin Excretion) in 24 h urine samples and also as UACR (Urinary Albumin Creatinine Ratio) by estimating the albumin/creatinine ratio in spot urine specimens. Indian clinical guidelines strategize the aspects of prevention or prolongation or even reversion of diabetic complications such as diabetic nephropathy at primary, secondary and tertiary stages to yield beneficial effects. With a view of beneficial effect of assessing the onset of nephropathy in diabetic patients we analyzed the microalbumin levels for an early detection of the existence of microalbuminuria and its prevalence in both type-1 and type-2 diabetic patients. Materials and Methods: Morning spot urine samples were collected from diabetic patients. Microalbumin and creatinine were estimated from these urine samples by immuno-turbidometric and alkaline-picrate methods respectively. Microalbumin was expressed in terms of mg/ g creatinine. Lipid profile was also estimated in these patients. Student’s ‘t’ test was applied for significance. Results: A total of 75 samples were analyzed for microalbuminuria, of these 25 were healthy controls and 50 were diabetics (both type-1 and type-2) with 4 to 25 years duration of diabetes. We observed an incidence of 72% microalbuminuria in diabetics (both type-1 and type-2) patients and 65% in type-2 diabetic patients. A good correlation was found between duration of diabetes & incidence of microalbuminuria (p = 0.02) in both types of diabetes. Conclusion: Percentage of subjects with microalbuminuria was significantly high in both the types of diabetes, and it correlates with higher age and longer duration of diabetes. Early and routine screening for microalbuminuria in diabetic patients is desirable for an early detection and prevention of diabetic nephropathy.