Association of Microalbuminuria with the Severity of Diabetic Retinopathy in Patients with type II Diabetes Mellitus.

Objective: To evaluate the association of microalbuminuria with the severity of diabetic retinopathy. Methodology: This is a cross-sectional study that was conducted at Combined Military Hospital Lahore from Dec 2019 to Dec 2020. All Patients having type II diabetes mellitus fulfilling the inclusion and exclusion criteria were selected for this study. All patients underwent complete ocular examination including fundoscopy to grade the stage of diabetic retinopathy using the ETDRS chart. To assess the extent of microalbuminuria, a urine albumin to creatinine ratio was carried out using the urine spot test and classified as mild, moderate and severe according to KIDGO 2012 clinical practice guidelines. Results: Out of 300 patients 104 (34.6%) had some stage of diabetic retinopathy. Microalbuminuria was present in all (104) patients with diabetic retinopathy and in 55 (28.06%) patients with no diabetic retinopathy. The severity of microalbuminuria correlates with the advancement in stages of retinopathy with as the number of patients with moderate and severe microalbuminuria had higher stages of diabetic retinopathy. None of the patients with very mild diabetic retinopathy had moderately or severely increased microalbuminuria whereas 88% of patients with advanced diabetic retinopathy had moderately increased microalbuminuria and 4% had severely increased microalbuminuria. Furthermore, 76% of the patients had moderately increased and 12% had severely increased microalbuminuria in patients >7 HbA1c and only 28% of patients had moderately increased microalbuminuria and none had severely increased microalbuminuria in patients with ≤ 7 HbA1c. Conclusion: This study showed that the degree of microalbuminuria increases with each higher stage of diabetic retinopathy.