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The Natural History and Associations of Microalbuminuria in Type 2 Diabetes During the First Year After Diagnosis
Author(s) -
Patrick A. W.,
Leslie P. J.,
Clarke B. F.,
Frier B. M.
Publication year - 1990
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.1990.tb01326.x
Subject(s) - microalbuminuria , medicine , creatinine , diabetes mellitus , type 2 diabetes , excretion , albuminuria , endocrinology , blood pressure , gastroenterology , urine
The prevalence of microalbuminuria was assessed in 149 consecutive, newly‐diagnosed and untreated patients with Type 2 diabetes, 129 of whom were followed up for 1 year, with at least three urine specimens being obtained during this period. At initial presentation, 39 (26%) patients had a urinary albumin to creatinine ratio (ACR) of > 2.5 mg mmol −1 and compared with patients who had a normal ACR, they were older (64 (11) (SD) vs 58 (11) yr, p < 0.002), with higher random blood glucose (14.4 (4.5) vs 12.3 (4.4) mmol l −1 , p < 0.02) and glycosylated haemoglobin (13.0 (3.1) vs 11.3 (2.7)%, p < 0.01) concentrations. An elevated ACR was also associated with a higher systolic blood pressure (149 (22) vs 140 (22), p < 0.05) and the presence of macrovascular disease, particularly peripheral vascular disease ( p < 0.001), with this association persisting after adjustment for the effect of age. Ten patients reverted to normal albumin excretion on improving blood glucose control, this group having a significantly higher glycosylated haemoglobin concentration at initial presentation than the group with a persistently elevated ACR (14.4 (2.5) vs 12.0 (3.0)%, p < 0.05). The 21 (16%) patients with a persistently elevated ACR from diagnosis of Type 2 diabetes were older than those with normal albumin excretion throughout (64 (7) vs 58 (10) yr, p < 0.02) and it is probable that these patients have abnormal albumin excretion secondary to established renal pathology.