Prevalence of Microalbuminuria in Newly Diagnosed Type 2 Diabetes Mellitus in Government Vellore Medical College Hospital, Vellore

BACKGROUND: Diabetic nephropathy is the leading cause of end stage renal disease world wide. Microalbuminuria is considered to be an early stage of diabetic nephropathy. Microalbuminuria is also considered to be a predictor for cardiovascular disease both among diabetic and non-diabetic subjects, and is one of the components of the metabolic syndrome (insulin resistance syndrome). Recent statistics from the World Health Organisation (WHO) project an increase in the prevalence of diabetes world wide particularly in developing countries. Currently, India leads the world with the largest number of diabetic subjects and this is expected to further rise in the coming years. Hence studies on diabetes related complications are essential to assess the burden of diabetes. In this study we report on the prevalence of microalbuminuria in newly diagnosed type 2 diabetic patients in Government Vellore Medical College. OBJECTIVES: The aim of this study was to determine the prevalence and risk factors for microalbuminuria among newly diagnosed type 2 diabetes mellitus patients in Government Vellore Medical College. MATERIALS AND METHODS: It is a hospital based case control study conducted over a period of one year among 100 patients who had been diagnosed as type 2 diabetes mellitus within a period of 6 months in an outpatient basis in Government Vellore Medical College Hospital, Vellore. RESULTS: The prevalence of microalbuminuria in this study was 23% with diagnosis made as DN fitting the criteria of KDIGO guidelines in a newly diagnosed type 2 DM (Newly diagnosed Type 2 DM arbitrarily set as within diagnosis of Type 2 DM). The prevalence of microalbuminuria in this study with Random blood Sugar >140 mg/dl is 33% and the prevalence of HbA1C level > 7.5 is 37%. My study showed that microalbuminuria and RBS and HbA1c levels are stastically significant with p value=0.00. Also the prevalence of Microalbuminuria is more when the systolic blood pressure rises. In my study the prevalence among women is more than that of men. This is attributed to the higher incidence of asymptomatic UTI in women. Study shows microalbuminuria among normal weight individuals to be 9.5% and among overweight individuals as 22% and among obese individuals as 54.5%. It is stastically significant with p value 0.015. This study shows 75% of patients with elevated cholesterol have MALB and 56.5% of patients with high normal cholesterol have MALB.The study also showed 92.4% of patients within target range of serum triglycerides have normal ACR and 64.3% of patients with elevated Serum Triglycerides have Microalbuminuria. Both Serum cholesterol and Serum Triglycerides are statistically significant with the prevalence of microalbuminuria with p value=0.00. CONCLUSION: Diabetes mellitus is a mounting health problem in the community early diagnosis and intervention delay the onset of diabetic nephropathy and progression to CKD. The microvascular complications like diabetic nephropathy, dyslipidemia and coronary artery disease starts as soon as patient is diagnosed as diabetes mellitus. Prevalence of microalbuminuria was more in High HbA1c and High RBS when compared to normal ones. In my study the prevalence of microalbuminuria in newly diagnosed type 2 DM is 23%. Early detection of microalbuminuria in outpatients with type 2 DM, we can treat microalbuminuria to slow the progression of diabetic nephropathy and may prevent the catastrophic renal complications such as ESRD. Based on study, the screening of microalbuminuria in newly diagnosed type 2 DM should be made mandatory and should be incorporated into National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular diseases and stroke(NPCDCS) coming under the control of Minister of Health and Family Welfare. However there are limitations to this study with a low sample size and not adequately followed time period