Microalbuminuria In Type Research Articles

A comparative study between current and past Helicobacter pylori infection in terms of microalbuminuria in patients with type 2 diabetes

BackgroundThe prevalence of Helicobacter pylori (H. pylori) infection and its potential relationship to various diseases is currently a focus of attention. The aim of this study is to investigate the association between current and past H. pylori infections and elevated levels of microalbuminuria in type 2 diabetic patients.MethodsTwo hundred patients with type 2 diabetes mellitus were tested for the presence of H. pylori infection. They were divided into three groups: 52 had a current H. pylori infection, 38 had a past H. pylori infection, and 110 had no H. pylori infection. All study participants underwent assessments of plasma glucose levels, glycated hemoglobin (HbA1c), albuminuria levels, inflammatory markers such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), as well as other relevant investigations.ResultsThe prevalence of H. pylori infection (current and past) was detected in 90 out of 200 diabetic patients (45%). There was no statistically significant difference between the three groups in terms of age, diabetes duration, family history of DM, family history of hypertension, residence, or dyspeptic symptoms, indicating that current or past infection with H. pylori has no association with these variables. The current H. pylori infection group showed the highest levels of inflammatory markers, ESR and CRP, which were significantly different from those in the non-infected group (p = 0.013 and p < 0.001, respectively). The median (IQR) of albuminuria levels in the current H. pylori infection group, the past H. pylori infection group, and the non-infected group were 125 (4.8–290), 7.6 (2.4–271), and 5.1 (1.2–173), respectively. The current H. pylori infection group showed the highest albuminuria level, which was significantly different from that of the non-infected group (p = 0.001).ConclusionThere might be an association between microalbuminuria levels, general inflammatory markers (ESR and CRP), and current H. pylori infection in type 2 diabetic patients.

Study of Microalbuminuria in Type 2 Diabetic Patients in the Reference Health Center of Commune VI of the Bamako District

Study of Microalbuminuria in Type 2 Diabetic Patients in the Reference Health Center of Commune VI of the Bamako District

A Cross-Sectional Study to Determine the Association of Corrected QT Interval With Microalbuminuria in Type 2 Diabetes Mellitus.

Introduction Cardiac autonomic neuropathy (CAN) is a frequent and life-threatening complication of type 2 diabetes. Failure to diagnose can lead to high mortality and morbidity. In patients who have diabetes mellitus, microalbuminuria is an independent marker for cardiovascular disease. This study aimed to assess the corrected QT interval with microalbuminuria in type 2 diabetes mellitus. The objective of this study was to estimate the corrected QT interval in subjects with type 2 diabetes mellitus and to determine the association of the corrected QT interval with microalbuminuria type 2 diabetes mellitus. Methodology Ninety-five adult patients (>18 years to 65 years) diagnosed with type 2 diabetes mellitus with microalbuminuria were included in this study. Data were collected on the proforma through history taking and a general physicalandsystemic examination. An electrocardiograph was taken on the day of admission; the most prolonged QT interval was measured, and the RR interval was calculated. The data were statistically analyzed using IBMSPSSStatistics for Windows, Version 24 (Released 2016; IBM Corp., Armonk, New York, United States). Results There was a significant difference in the corrected QT interval prolongation prevalence between diabetic patients with microalbuminuria and without microalbuminuria(P-value <0.001). The mean corrected QT interval distribution did not differ significantly across various age groups of cases studied with microalbuminuria(P-value 0.98). The distribution of mean corrected QT interval did not differ significantly between the group of male cases and group of female cases studied with microalbuminuria(P-value 0.66). The mean corrected QT interval distribution did not differ significantly across various duration of diabetes groups among the cases studied with microalbuminuria(P-value 0.60). The mean corrected QT interval distribution did not differ significantly across different types of anti-diabetic treatment groups among the cases studied with microalbuminuria(P-value 0.64). Conclusion Type 2 diabetes has been prevalent in Indian and Asian populations. The early management of type 2 diabetes is necessary since the early stages of the disease can reduce the risk of CAN. Therefore, these patients should be diagnosed as early as possible and treated to reduce associated mortality and risk and to improve quality of care.

Effect of Magnesium Status on Microalbuminuria in Type 2 Diabetic Patients.

There are several controversies regarding the association between serum magnesium depletion and microalbuminuria in type 2 diabetic patients. Therefore, this study aimed to assess serum magnesium concentrations in Type 2 diabetic patients with microalbuminuria and normoalbuminuria in Birjand, Iran, in 2019. In this cross-sectional study, 25 type 2 diabetes patients with microalbuminuria were enrolled as the case group and 25 type 2 diabetes patients with normoalbuminuria as the control group. Both groups were matched for age, sex, hypertension, and dyslipidemia. Blood samples were obtained for serum magnesium measurement. Our findings showed no significant difference between serum magnesium concentration in the case and control groups (mean serum magnesium concentration for case group: 2.34 ± 0.35 mg/dl and control group: 2.27 ± 0.33 mg/dl). Pearson correlation coefficient analysis did not show any correlation between serum magnesium levels and urine albumin levels in patients with microalbuminuria versus patients with normoalbuminuria (r = 0.06, p = 0.67). This study did not indicate a correlation between serum magnesium concentrations and microalbuminuria in Type 2 diabetic patients.

CORRELATION BETWEEN MICROALBUMINURIA AND CORRECTED QT INTERVAL PROLONGATION IN PATIENTS WITH DIABETES MELLITUS

Background and Objectives: Diabetic cardiac autonomic neuropathy is a severe and common complication of diabetes. QTc prolongation is a predictor of Cardiac Autonomic Neuropathy (CAN), and microalbuminuria is a predictor of nephropathy. The main aim of the present study is to nd the association between prolonged QTc interval and microalbuminuria in Type 2 Diabetes Mellitus(T2DM). Methods: Sixty patients of type 2 diabetics, attending RLJH hospital in Kolar, were included in the study. We divided these patients into two groups, each with thirty patients. One group consists of patients with microalbuminuria and the other with normoalbuminuria. All these patients were tested for microalbuminuria and looked for QTc interval prolongation in ECG. A chi-square test was used to analyze t h e two sample proportions. Most of the p Results: atients were in the 50 to 70 years of age group. There is a signicant associa n between QTc prolongation with microalbuminuria, as evidenced by (66.6%, P-Value &lt;0.0001). The male-tofemale ratio is 3.8:1, and as the duration of diabetes increases, there is an increase in the incidence of QTc interval prolongation andmicroalbuminuria. There was also a signicant association with retinopathy and neuropathy with cardiac autonomic neuropathy(CAN). Interpretation and Conclusion: There was a signicant association between CAN(QTc prolongation) and microalbuminuria. Microalbuminuria per se doesn't cause QTc prolongation, and the reason for this is not clearly understood. QTc prolongation is one of the independent cause of mortality seen in microalbuminuria patients, which is preventable. Hence the aim is to prevent and reduce the mortality in T2DM patients

A cross sectional study to assess prediction of microalbuminuria using neutrophilto- lymphocyte ratio and red blood cell distribution width in diabetic patients

Background: This study was devised to evaluate the predictive value of neutrophilto- lymphocyte ratio (NLR), mean platelet volume (MPV), and red blood cell distribution width (RDW) to detect microalbuminuria in type 2 diabetic patients. This can help in early detection of microalbuminuria and assessment of prognosis inn patients suffering from type 2 diabetes mellitus (DM). Aims and Objectives: The objectives of the study were to assess the diagnostic accuracy of microalbuminuria using neutrophil-to-lymphocyte ratio and red blood cell distribution width in diabetic patients. Materials and Methods: A total of 188 patients with type 2 DM were selected for this study. Subjects were classified into three groups based on hemoglobin A1c and microalbuminuria. Group A had 63 patients with controlled diabetes, Group B had 62 patients with uncontrolled diabetes, both without microalbuminuria, and Group C had 62 patients with uncontrolled diabetes with microalbuminuria. Levels of NLR, MPV, and RDW between the study groups were analyzed. Results: A significant difference in NLR was found between Group C and Groups A and B (P&lt;0.001 and P=0.005, respectively). RDW was significantly different between Groups B and C (P=0.014). Receiver operating characteristic curve analysis was done between NLR and RDW. The area under curve was found to be of 0.678 for NLR (confidence interval: 0.59–0.75, P&lt;0.001) and 0.616 for RDW (confidence interval: 0.49–0.73, P=0.013). The study shows that an NLR cutoff point of 2.54 has 39.7% sensitivity, 78.8% specificity, and 45% positive predictive value (PPV). An RDW cutoff point of 14.44 has 37.9% sensitivity, 76% specificity, and 41.5% PPV. Conclusion: NLR and RDW can be beneficial to detect microalbuminuria in diabetic patients.

Effect of the nurse-led program on blood glucose control and microalbuminuria development in type 2 diabetic populations.

Current study was to evaluate whether the nurse-led program can improve glycated hemoglobin (HbA1c) control and reduce the incidence of microalbuminuria in type 2 diabetic mellitus (DM2) populations. A total of 150 DM2 subjects were randomly assigned to the usual-care group and nurse-led program group. Study endpoints included the HbA1c value, the percentage of subjects with HbA1c < 7.0%, the incidence of microalbuminuria, and the rate of adhering to antidiabetic drug at 6 months’ follow-up. At baseline, there was no difference in fasting plasma glucose, HbA1c, proportion of subjects with HbA1c < 7.0%, the use of antidiabetic drug, and urinary albumin-creatinine ratio between these two groups. After 6 months’ follow-up, the mean fasting plasma glucose and HbA1c were lower in the nurse-led program group, as was the proportion of subjects with HbA1c < 7.0%. The median urinary albumin-creatinine ratio and rate of incident microalbuminuria were also lower in the nurse-led program. The nurse-led program was associated with higher odds of achieving HbA1c < 7.0% and a lower incidence of microalbuminuria. After adjusted for covariates, the nurse-led program was still associated with 32% higher odds of achieving HbA1c < 7.0% and 11% lower incidence of microalbuminuria. These benefits were consistent by sex and age, while greater in those with obesity or hypertension (P interaction < .05). The nurse-led program is beneficial for blood glucose control and prevention of microalbuminuria.

Association of Lipopolysaccharide-Toll-Like Receptor 4 Signaling and Microalbuminuria in Patients with Type 2 Diabetes Mellitus.

PurposeIntestinal flora imbalance has been implicated in the activation of innate immunity in the kidneys. However, little is known about the potential links between lipopolysaccharide (LPS)-toll-like. receptor 4 (TLR4) signaling activated by intestinal barrier dysfunction and microalbuminuria in type 2 diabetes mellitus (T2DM).Patients and Methods61 patients with T2DM were stratified based on the absence (n=32) or presence (n=29) of microalbuminuria. There were also 28 control subjects. Urinary albumin excretion rate (UAER), serum levels of LPS, D-lactic acid (DLA), diamine oxidase (DAO), fasting blood glucose (FBG), interleukin-6 (IL-6), glycosylated hemoglobin A1 (HbA1c), and high-sensitivity C-reactive protein (hs-CRP), and TLR4 expression in peripheral blood mononuclear cells (PBMCs) were measured.Resultshs-CRP, IL-6, LPS, DLA, DAO, and TLR4 were markedly increased in subjects with T2DM compared to the controls (P < 0.05 for all). Moreover, LPS was positively correlated with FBG, HbA1c, hs-CRP, IL-6, UAER, DLA, DAO, and TLR4 (P < 0.05 for all). In addition, TLR4 was positively correlated with UAER, hs-CRP, FBG, DLA, HbA1c, and LPS (P < 0.05 for all). In regression analyses, TLR4, LPS, HbA1c, and hs-CRP were independently associated with UAER (P < 0.05 for all), while FBG, LPS, TLR4, and hs-CRP (P < 0.05 for all) were found to be risk factors for microalbuminuria in T2DM.ConclusionIntestinal integrity is compromised in subjects with T2DM, and the activation of LPS-TLR4 signaling might play an important role in the development of microalbuminuria in T2DM.

Association of microalbuminuria and glycosylated hemoglobin in type 2 diabetes mellitus

HbA1c is highly prognostic for long term diabetes related complications such as microalbuminuria. Albumin is one of the most commonly assessed clinical parameters in diabetic patients. Present study was aimed a) to estimate microalbuminuria, HbA1c, urinary creatinine and urinary albumin to creatinine ratio (ACR) in patients with type 2 DM and b) to find out the correlation of glycemic control with microalbuminuria and urinary creatinine. This work is extension of our previous work on microalbuminuria in type 2 DM. Patients with type 2 DM were involved in the study. Biochemical investigations like Blood sugar, Glycosylated hemoglobin (HbA1c), Urinary micro albumin and urinary creatinine were analyzed.There was a significant difference in the values of all parameters i) between patients and normal standard values, ii) Among the three groups based on duration of diabetes. Significantly lower values of urinary creatinine (p&amp;#60;0.000) and significantly higher values of microalbumin (p&amp;#60;0.000) and ACR (p&amp;#60;0.000) were found in patients with poor glycemic control than moderate glycemic control in our study. We observed positive correlation between microalbuminuria and glycemic control.Hyperglycemia in type 2 diabetes is leading to lethal effects by damaging the kidney. Early detection and prevention of nephropathy in patients with type 2 DM will be possible by frequent and timely screening the patients for HbA1c, microalbuminuria, urinary creatinine and ACR. This will definitely help to reduce the mortality rate due to diabetic nephropathy and also the economic burden of society.

Correlation between Urinary Angiotensin Converting Enzyme-2 &amp; Micro Albuminuria in Non-Diabetic-Hypertensive and Type 2 Diabetic-Hypertensive patients

Background: The Renin Angiotensin System (RAS) is one of the main contributors to insulin resistance which leads to T2DM and its complications. The ACE2/Angiotensin-(1-7)/Mas axis has lately been anticipated to function as a negative regulator of the RAS, consequently, rendering a shielding task against progress of type 2 diabetes, as well as, lowering blood pressure. Aim: To correlate urinary angiotensin 2 levels and microalbuminuria in Type 2 Diabetic and non-Diabetic-hypertensive patients. Methods: A particular population of selected subjects was categorized into 2 groups, with 49 subjects in each group. Diabetic and hypertensive patients were selected from the SIMS diabetic Clinic and medical wards, Lahore. Anthrometric parameters, as well as, BSR were recorded in the clinics. Blood and urine samples were collected and stored for evaluating the biochemical parameters in the Physiology Laboratory, UHS. Results: Microalbuminuria, as well as urinary ACE2 levels in group A (non-diabetic-hypertensive subjects), were greater than in group B (diabetic-hypertensive subjects). There was a significant positive correlation between uACE2 levels and microalbuminuria in group A patients. Conclusion: Although the current study reinforced the fact that both T2DM and hypertension are risk factors for CKD, contrary to our prediction based on evidence gained from various research studies, we were unable to prove that urinary ACE 2 levels are higher in patients with hypertension compounded with diabetes mellitus. Keywords: The Renin Angiotensin System (RAS), angiotensin converting enzyme 2, microalbuminuria levels.

A study of microalbuminuria in patients with type 2 diabetes mellitus, visiting tertiary care center Sangli

Diabetic nephropathy is accompanied with significant micro vascular risk and is the leading cause of kidney disease. Hence there is an immense need to detect early for better quality of the care of affected patients and treat effectively those at high risk of diabetic kidney disease. Our study was aimed to assess the levels of microalbuminuria, glycated hemoglobin, urinary creatinine, urinary albumin to creatinine ratio (ACR) along with blood urea and serum creatinine in patients with type 2 DM, and to observe the incidence of microalbuminuria at tertiary care center; and correlate the presence of microalbuminuria to the duration of DM as well as with ACR. : Estimation of Blood sugar, Blood Urea, Serum Creatinine, Glycosylated hemoglobin (HbA1c), Urinary micro albumin and creatinine was done. Values of urinary creatinine, microalbumin, urinary albumin to creatinine ratio (ACR) showed highly significant (p&amp;#60;0.000) difference between the two age groups a) below 60 years and b) above 60 years of the age. Highly significant difference (p&amp;#60;0.000) was found among the results of the three groups based on duration of diabetes. We found microalbuminuria was more predominant in patients having age more than 60 years as well as in patients having more than 10 years of duration of DM. Routine screening for microalbuminuria in type 2 diabetic patients will certainly helpful for early detection of renal damage and thus to minimize the burden of diabetic complications due to renal involvement. Hence addition of microalbuminuria along with diabetic profile for medical checkup will help to assess microalbuminuria at frequent intervals.

The Correlation between Microalbuminuria and Thyroid Nodules in Type 2 Diabetic Mellitus.

Objective To investigate the correlation between thyroid nodules and microalbuminuria in type 2 diabetic mellitus. Methods A total of 270 patients with type 2 diabetes at Tongzhou Branch of Dongzhimen Hospital were enrolled in this retrospective study. Data were collected from the inpatient electronic files between January 2018 and January 2020. The laboratory indexes of the two groups (thyroid nodule group with 172 cases and control group including 98 cases without thyroid nodules) were statistically analyzed by binomial logistic regression analysis and Spearman correlation analysis. Results The proportion of microalbuminuria (MAU) in the thyroid nodule group was larger than that in the control group. Age, serum TT4, and FT4 in the thyroid nodule group were significantly higher compared with the control group. The binary logistic regression analysis indicated that age, sex, FT4, and MAU were the risk factors for thyroid nodule in T2DM patients. Spearman correlation analysis showed that the thyroid nodule was significantly positively correlated with MAU, age, FT4, and TT4. Conclusions MAU might be an independent risk factor for thyroid nodule in type 2 diabetic mellitus.

The association between EKG abnormalities and the development of microalbuminuria in type 2 diabetes.

Microalbuminuria is associated with both with chronic kidney disease and various cardiovascular abnormalities. Given the common use of electrocardiograms (EKGs) in diagnosing cardiovascular dysfunction, this study is analyzing the relationship between EKG abnormalities and diabetic nephropathy in type 2 diabetes mellitus (DM) patients. The enrollments of this study were from the 10-year follow-up data (2003–2012) of the Diabetes Management through an Integrated Delivery System project. All study subjects underwent at least 1 EKG measurement. The urinary microalbuminuria was recorded annually. The logistic regression model was used to evaluate the association between EKG abnormalities and the occurrence of diabetic nephropathy in type 2 DM patients. The total of 1189 patients with type 2 DM are included in this study and a total of 552 patients had microalbuminuria during a 10-year follow-up. A significantly higher odds ratio of microalbuminuria occurrence (4.85) was found in the patients with premature supraventricular contraction or tachycardia compared to those without EKG abnormalities. The odds ratios of microalbuminuria occurrence were 1.00, 2.43, 2.64, and 2.98, respectively, for patients with insulin resistance in the Q (quartile) 1(as the reference), Q2, Q3, and Q4, respectively. Our findings can serve as a reference for the association between EKG abnormalities and the development of microalbuminuria in type 2 diabetes.

Diabetic Nephropathy – possibilities of early laboratory diagnostics and course prediction (review of literature)

The medical and social significance of diabetes mellitus is determined by a progressive increase in the incidence of the disease, as well as the development of disabling and reducing the quality of life of macro- and microvascular complications in patients of working age, in particular, with the development of diabetic nephropathy (DN), which develops in one third of patients with type 1 and 2 diabetes. DN is the third leading cause of death after diseases of the cardiovascular system and oncological pathologies. In this regard, the identification of DN at the early stages is an important task both from the standpoint of prevention and a more favorable prognosis of the course of diabetes. This review presents data on the possibilities of early diagnosis of DN using blood and urine biomarkers, as well as information on their diagnostic and prognostic value. The analysis of the interpretation of the indicator of microalbuminuria in type 1 and 2 diabetes was carried out. In addition, the literature data of recent years on the informative value of determining markers of podocyte damage, on the role of oxidative stress products, immune-inflammatory factors, and vascular endothelial growth factor in the process of the onset and development of DN are presented. The possibility of their practical use for the diagnosis of DN in clinical practice is discussed. The literature search for this review was carried out using the databases of the RSCI, CyberLeninka, Scopus, Web of Science, MedLine, PubMed for the period from 2011 to 2021. using the following keywords: diabetes mellitus, diabetic nephropathy, markers of diabetic nephropathy; kidney damage, early diagnosis of diabetic nephropathy.

FREQUENCY OF MICROALBUMINURIA IN ABNORMAL LIPID METABOLISM AND SUFFERING FROM TYPE II DIABETES MELLITUS

Objective: To determine the frequency of dyslipidaemia in type-2 diabetic patients and to compare the frequency of dyslipidaemia in patients with and without microalbuminuria in type 2 diabetes.&#x0D; Study Design: cross-sectional study.&#x0D; Place and Duration of Study: Department of General Medicine, Combined Military Hospital Quetta Pakistan, from Dec 2018 to Jun 2019.&#x0D; Methodology: All patients who fulfilled the inclusion criteria and visited General Medicine department of Combined Military Hospital Quetta with type II diabetes mellitus were included in the study. Blood sample following an 8-12 hours fasting over the last night and 24 hour urine sample for microalbuminuria was collected to assess the outcome i.e. frequency of dyslipidaemia and also its frequency with and without microalbuminuria.&#x0D; Result: A total of 165 patients with type 2 diabetes mellitus were included. Ninety nine (60%) were males and 66 (40%) were females with the mean age of 48.08 ± 7.63 years. Overall, dyslipidaemia was found in 48 (29.1%) patients, dyslipidaemia was noted in 29 (17.6%) with microalbuminuria and 19 (11.5%) without microalbuminuria. Chi-square test revealed that dyslipidaemia was significantly more in patients of diabetes mellites having microalbuminuria than those not having it (p-value=0.01).&#x0D; Conclusion: Abnormal lipid metabolism was present in significantly more in patients with microalbuminuria as compared to those without microalbuminuria suffering from type II diabetes mellitus.

Association of Cardiovascular Disease with Micro Albuminuria in Type 2 Diabetes Mellitus

Objective: The aim of this study is to determine the prevalence of cardiovascular disease with micro albuminuria in type 2 diabetes mellitus. Study Design: Observational study Place and Duration: Study was carried out in medicine department of DHQ category A hospital Batkhela and Combined Military Hospital, Multan for duration of six months from January 2020 to June 2020. Methods: Total 120 patients of both genders diagnosed diabetes 2 mellitus were presented in this study. Patients were aged between 20-80 years. Patients’ details demographics were recorded after taking written consent. Prevalence of cardiovascular disease with microalbuminuria was assessed by statistical analysis. Microalbuminuria was diagnosed among patients if urinary albumin excretion was &gt;30mg/g and in normal albuminuria urinary albumin excretion was &lt;30mg/g. Complete data was analyzed by SPSS 20.0 version. Results: Out of 120, 66 (55%) were males and 54 (45%) were females. Mean age of the patients were 45.71±16.9 years with mean BMI 26.14±9.22 kg/m2. Cardiovascular disease found in 90 (75%) cases. We found that 80 (66.7%) patients had microalbuminuria with mean ACR 160.4±74.6 mg/gm while rest of the patients 40 (33.3%) had normal albuminuria 19.14±5.4 mg/gm. Among 90 cases of cardiovascular disease frequency of microalbuminuria was 65 (72.22%) and among 30 diabetes patients of non- cardiovascular disease frequency of microalbuminuria were 15 (50%). Microalbuminuria was found significantly higher in patients of cardio vascular disease and increased systolic and diastolic blood pressure compared to normoalbuminuric patients. In patients with microalbuminuria, blood glucose and glycosylated hemoglobin have increased dramatically. Conclusion: We concluded in this study that the prevalence of cardiovascular disease with micro albuminuria in type 2 diabetes mellitus was significantly high &lt;0.05 with increased systolic diastolic pressure and fasting blood glucose as compared to normal albuminuria. Keywords: Microalbuminuria, Normal albuminuria, Type 2 Diabetes, Cardio vascular disease

Early detection of neuropathy in patients with type 2 diabetes with or without microalbuminuria in the absence of peripheral neuropathy and retinopathy

Our goal is early detection of neuropathy in patients with type 2 diabetes with or without microalbuminuria in the absence of diabetic retinopathy and peripheral neuropathy by using in vivo corneal confocal microscopy (IVCCM). A total of 60 type-2 diabetic patients, assigned to either a diabetes mellitus (DM) with microalbuminuria group (DM/MA+, n=30) or a DM without microalbuminuria group (DM/MA-, n=30), and 30 age-matched control subjects were enrolled in this study. All cases underwent evaluation of blood glucose level, HbA1c, lipid fractions, body mass index (BMI), and corneal sensitivity (CS). Corneal nerve fiber length (NFL), nerve fiber density (NFD), nerve branch density (NBD), and tortuosity coefficient (TC) were quantified by IVCCM. None of the patients had peripheral neuropathy or retinopathy. Compared with the healthy subjects, NFL and NFD were reduced in both diabetic groups (P<0.0001), while NBD was significantly reduced in the DM/MA+ group. Between the diabetic groups, NFL, NFD, and NBD were significantly higher in the DM/MA- group (all P's<0.001). CS was significantly lower in DM/MA+ compared with DM/MA- and controls (both P's<0.0001). NFD and NFL were inversely correlated with age, triglyceride level, and BMI. These results indicate that significant damage to small nerves, quantified using IVCCM, can be detected in the absence of retinopathy, peripheral neuropathy or microalbuminuria in type 2 diabetic patients. The severity of corneal nerve involvement may further increase in the presence of nephropathy. This feature may also be valuable for early detection of microvascular complications of DM, allowing for the prevention of progression of life threatening microvascular complications.

The Effect of Selenium on Micro-Albuminuria in Diabetic Patients: A Randomized Clinical Trial

Objective: Oxidative stress plays an important role in the onset and progression of diabetic nephropathy. So antioxidant agents may be one of the key treatment strategies for prevention of diabetic nephropathy progression .The aim of this study was to determine the effect of selenium (Se) on micro-albuminuria in type 2 diabetic (T2DM) patients. Materials and Methods: This study was a clinical study on 60 T2DM patients with micro-albuminuria who were referred to Yazd diabetic research center from March 2016 till April 2017. Patients were randomized in to two groups: Se (200 microgram Se daily) and control. The control group did not receive placebo. The intervention duration was 12 weeks. Micro-albuminuria, fasting blood sugar (FBS), cholesterol, triglycerides, HDL-C, LDL-C, urea, creatinine, HbA1c, plasma Se concentration were measured at the baseline and after 12 weeks. Results: Micro-albuminuria decreased after 12 weeks in both studied groups but it was not statistically significant. Cholesterol and LDL levels improved statistically in both studied groups at the end of study (P-value: 0.034, 0.023 respectively). Plasma Se level increased in intervention group (P-value&lt; 0.001). There were clinically improvement in other studied variables after 12 weeks in two studied groups but not statistically significant Conclusion: Our study demonstrated that Se supplementation for 12 weeks among patients with micro-albuminuria had no beneficial effects on micro albuminuria.

Relations Between Urinary Albumin Excretion and a Dietary Intake of Fruits in Patients With Type 2 Diabetes.

BackgroundIt was reported that microalbuminuria and a decline in renal function were associated with cardiovascular disease (CVD) mortality and renal events and prognostic serious complications. Dietary factors and nutrients affecting microalbuminuria in type 2 diabetes remain unclear, and accordingly we conducted a cross-sectional study on the possible relevance of dietary factors to urinary albumin excretion in patients with type 2 diabetes.MethodsForty-two patients with type 2 diabetes participated in this study, and these subjects were categorized into patients without microalbuminuria group with urine albumin-to-creatinine ratio (ACR) of less than 30 mg/g Cr (n = 29) and a microalbuminuria group with ACR of 30 - 299 mg/g Cr (n = 13). ACR levels were measured using spot urine samples. At the time of examination, body mass index (BMI) and systolic and diastolic blood pressures were measured and recorded. We performed sampling fasting-blood and spot urine and conducted a food frequency questionnaire based on food groups to examine dietary habits for the past 1 - 2 months.ResultsThere were no significant differences in sex, age, duration, BMI, blood pressures, biochemical data, and the median of daily intakes of energy and macronutrients between patients without microalbuminuria and microalbuminuria groups. In the intake of 17 food groups per day, fruits were significantly lower in the microalbuminuria group than in patients without microalbuminuria group (the median was 38 g vs. 120 g/day, P < 0.05), but intakes of other food groups were not significantly different between the two groups. Moreover, we examined a model of partial correlation between ACR to the intake of fruits, adjusted by age, sex, glycated hemoglobin and BMI. This partial correlation was insignificantly seen but close to a significant level (partial correlation coefficient: -0.270, P = 0.102).ConclusionsThese results suggest that the intake of fruits may be inversely associated with microalbuminuria in Japanese type 2 diabetic patients. It would be necessary to investigate the exact types and amounts of fruits to be consumed to address microalbuminuria.

Study of Microalbuminuria in Type 2 Diabetes Mellitus as a Predictor of Left Ventricular Dysfunction- A Cohort Study

Introduction: Diabetes Mellitus (DM) is a global health problem and India is the capital of it. It leads to acute metabolic and long-term complications with high morbidity and mortality. Cardiovascular (CV) disease is the major cause of mortality. Microalbuminuria (MAU) has been associated with generalised vasculopathy in major organ systems. Left Ventricular (LV) dysfunction and premature onset of CV disease is predicted by MAU. Aim: To evaluate the correlation of degree of microalbuminuria in Type 2 Diabetes Mellitus (Type2DM) as a predictor of LV dysfunction. Materials and Methods: This was a cohort study conducted in the Outpatient Department (OPD) of Medicine on 251 patients clinically diagnosed with Type2DM. Subjects were selected as per American Diabetic Association (ADA) criteria and cases having hypertension Ischaemic Heart Disease (IHD), valvular heart disease, Chronic Kidney Disease (CKD), Urinary Tract Infection (UTI), Chronic Liver Disease (CLD) were excluded from the study. MAU was assessed as having persistent albuminuria in two out of three urine samples as (30-300 mg/day or 20- 200 microgram per mg or an albumin creatinine ratio of 30- 300 microgram per mg creatinine). Echocardiogram to assess LV function were done in the Department of Cardiology using dual mode real time, 213/M-Mode, colour doppler, pulsed web doppler, continuous web doppler, considering criteria of American Society of Echocardiography and Mayo Clinic criteria. Data was analysed by Unpaired t-test for normal data, Chi-square test for dichotomous data and values were correlated using Pearson’s correlation coefficient. Results: Out of 251 study subjects, 148 were males and 103 were females with male to female ratio of 1.43:1. MAU was positive in 24.7% cases out of 251 cases. Echocardiogram revealed 77.4%% of study population have LV dysfunction and 46.8% of cases having diastolic dysfunction. With increased level of MAU, the incidence of LV diastolic dysfunction and LV systolic dysfunction also increased. In LV systolic dysfunction, severity of MAU was negatively correlated with Ejection fraction (EF), Fractional Shortening (FS), Cardiac Output (CO) and positively correlated with E Point Septal Separation (EPSS). In LV diastolic dysfunction, all parameters were positively correlated with severity of MAU. Severity of MAU and LV dysfunction were correlated and was found statistically significant (p&lt;0.05). Conclusion: Severity of MAU was found to have significant correlation with parameters of LV systolic and diastolic function with significant p-value. LV dysfunction has also a strong correlation with poor glycaemic control and duration of DM.