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<0.000) difference between the two age groups a) below 60 years and b) above 60 years of the age. Highly significant difference (p<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.
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<0.000) and significantly higher values of microalbumin (p<0.000) and ACR (p<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.
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