Assessment of microalbuminuria and glycated hemoglobin in type 2 diabetes mellitus complications

Objective: To relate microalbuminuria with the degree of glycaemic control in type 2 diabetic\udpatients and determine the prevalence of poor glycemic control amongst the normotensive\uddiabetes mellitus (NDM ) and hypertensive diabetes mellitus (HDM ) with or without\udmicroalbuminuria. Methods: A total of 95 type 2 diabetes mellitus patients and 30 healthy\udcontrols were randomly selected and studied. 17 of the 95 patients were normotensive diabetic\udwith microalbuminuria, 40 of them were HDM presenting with microalbuminuria and 38 were\udNDM without microalbuminuria. Their blood was obtained for fasting plasma glucose and\udglycated haemoglobin while their urine was obtained for albumin and creatinine estimation\udand the ratio was calculated. Results: Out of the 95 diabetic patients studied, 57 (60%) of them\udhad microalbuminuria while 38 (40%) had normoalbuminuria. The mean ages in the diabetics\udwith microalbuminuria were higher than those without microalbuminuria (P=0.054 6). The\udmean glycated haemoglobin was the highest (5.95暲2.06)% in NDM with microalbuminuria when\udcompared with HDM with microalbuminuria (5.83暲 1.62)% and that in (5.66暲 2.49)% in NDM\udwithout microalbuminuria (P=0.000 9). Similarly, fasting plasma glucose was the highest (9.09暲\ud4.31) mmol/L in NDM with microalbuminuria than those without microalbuminuria (7.70暲3.33)\udmmol/L (P=0.000 1). The prevalence of poor glycaemic control was the highest (29%) in NDM with\udmicroalbuminuria while the least (21%) in NDM without microalbuminuria. Conclusions: The\udrisk of microalbuminuria increases with poor glycemic control. Persistent increase in glycated\udhaemoglobin may be an indicator of worsening albumin creatinine ratio and diabetic nephropathy.\udTherefore, regular screening for microalbuminuria in addition to continuous (3-monthly) glycated\udHbA1c estimation is advised