Higher values of sensitive biomarker UACR tied to uncontrolled T2D
The prevalence of type 2 diabetes mellitus (T2DM) is increasing worldwide and so are the disease-associated complications. Long-term complications of diabetes cause significant morbidity and mortality.Diabetic nephropathy is one of the most common causes of chronic kidney disease (CKD) leading to end-stage renal disease (ESRD) and its prevalence is increasing because of the increasing burden of T2DM.
A recent study suggests that urine spot for albumin: creatinine ratio are higher in patients with uncontrolled type 2 diabetes and in patients with a longer duration of disease. The study findings were published online in Cureus on December 27, 2020.
For early detection of diabetic nephropathy, the American Diabetic Association (ADA) recommends screening for microalbuminuria once a year for diabetic patients. A spot morning sample for urinary albumin: creatinine ratio (UACR) is used for the screening of microalbuminuria. UACR has a direct relation to diabetic control and glycosylated hemoglobin (HbA1c) is a useful tool to assess diabetic control. Researchers of Pakistan conducted a study to report the prevalence of microalbuminuria in type 2 diabetics along with its association with diabetic control.
It was a cross-sectional study of 133 patients with T2D. The researchers evaluated co-morbidities, body mass index, mode of treatment of diabetes (oral hypoglycemic drugs and/or insulin), duration since diagnosis of T2DM, and hemoglobin A1c (HbA1c) levels. They collected morning, midstream urine sample and assessed a UACR. The study population was mostly male (60.9%) and had an average age of 54.5 years. The mean duration of diabetes in the group was 6.29 years, and mean A1C was 8.99%.
Upon analysis, they noted that 30.1% of patients had diabetic neuropathy, and 25.6% had microalbuminuria. In addition, they also found that 4.5% had macroalbuminuria.
The authors concluded, "UACR was higher in patients with uncontrolled T2DM (in terms of higher HbA1c value) and with a longer duration since diagnosis. We recommend that UACR should be inculcated in routine practice, annually, for all patients with T2DM for gauging the development of underlying renal involvement and prompt management."
For further information:
https://www.cureus.com/articles/48006-prevalence-of-microalbuminuria-in-type-2-diabetes-mellitus
