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Objectives: To estimate the incidence of microvascular complications among subjects with type 2 diabetes at a tertiary care hospital
Methods: This retrospective longitudinal follow-up study assessed the data records of type 2 diabetic subjects who visited the outpatient department of Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, from January 2005 to April 2016. Subjects with gestational diabetes, type 1 diabetes and with history of any microvascular complication were excluded. Medical records were obtained through electronic database [Health Management System]. Statistical analyses were conducted using STATA version 14 and SPSS version 20
Results: The incidence of microvascular complications was 92.8, 106.2, and 130.2 per 1000 person per years for retinopathy, neuropathy and nephropathy respectively. Retinopathy, neuropathy and nephropathy were significantly high among diabetic patients with duration of diabetes >10 years followed by 5-10 years. Incidence of retinopathy and nephropathy was significantly higher in patients who had HbA1c>7 percent than patients with HbA1c=7 percent [p-value<0.05]. Higher incidence rate of all three microvascular complications were seen in subjects with hypertension than subjects without hypertension
Conclusion: A high incidence of microvascular complications is found in subjects with type 2 diabetes. Poor glycaemic control, longer duration of diabetes and hypertension was found to be associated with the occurrence of these complications
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Objective: To determine the frequency of depressive symptoms among young people with Type-I diabetes
Methods: This cross sectional study was conducted at Baqai Institute of Diabetology and Endocrinology, Karachi, Pakistan from February to December 2015. All People aged between 12-20 years with Type-I diabetes for at least 1 year attending the OPD were included in the study. Information about participants' demographic characteristics, co morbidities and Complications, current treatment and medications were obtained. Acylated hemoglobin [HbA1C] levels were checked in all People. The Center for Epidemiologic Studies Depression [CES-D] scale was used to assess the depressive symptoms in the study participants. A cut off value of >/= 16 was used to screen for depression. SPSS 19 was used to analyze the results
Results: Out of 104 people with Type-I diabetes, depressive symptoms were observed in 44 [42.3%] participants. Depressive symptoms were more frequent in females [28/55, 50.9%]. Depressed people had more episodes of DKA [11/44, 25%], hypoglycemia [12/44, 27.3%] or hospitalization [7/44, 15.9%] in the last six months which were not statistically significant
Conclusion: Depressive symptoms are quite common in people with Type-I diabetes. Health care professionals should consider screening youth with diabetes for depression regularly. Further large scale studies are needed to validate our findings
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Background and Objective: Catalase [CAT] is an important endogenous antioxidant enzyme that detoxifies H[2]O[2] into water and oxygen, consequently limiting the deleterious effects of reactive oxygen species. It has suggested that CAT -21A/T [rs7943316] OMIM: 115500 gene promoter polymorphism is predominantly associated with different human disorders such as hypertension, cancers, diabetes, nephropathy, and other diseases accompanied by oxidative stress. This study was designed to investigate the prevalence of mutant T allele frequency in healthy individuals
Methods: The study group consisted of 110 healthy individuals were enrolled from Baqai Institute of Diabetology and Endocrinology [BIDE], Karachi, Pakistan, during the period of April 2010 to May 2013. DNA was isolated from leukocytes. Genotyping of CAT -21A/T [rs7943316] gene promoter polymorphism was carried out using thermal cycler followed by RFLP. Blast N analysis was performed for the confirmation of gene sequences
Results: In CAT -21A/T [rs7943316] gene promoter polymorphism, wild type genotype [AA] was observed in 18.26% and alterered genotype [AT/TT] found in 81.74% cases
Conclusions: Data demonstrates that frequency and distribution of mutant T allele was more prevalent as compared to wild type A allele in the study group
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Objective: There is a strong positive association between increased low-density lipoprotein cholesterol [LDL-C] and coronary heart disease [CHD]
The accuracy of LDL-C estimation is essential and critically important. The aim of present study was to compare calculated LDL-C with direct homogeneous assay in patients with type 2 diabetes
Methods: This observational study was carried out at Baqai Institute of Diabetology and Endocrinology [BIDE] from January 2011 to December 2013. A total of 9620 patients with type 2 diabetes were included in the study
Fasting blood glucose, total Cholesterol, triglyceride, HDL cholesterol and LDL cholesterol were obtained using standard methods. Calculated LDL-C was obtained by Friedewald formula
Results: Mean difference of measured and calculated LDL-C was found to be -0.25, 6.63 and 46.55 mg/dl at triglyceride levels < 150 mg/dl, 150 - 400 mg/dl and > 400 mg/dl, respectively
The result shows that the difference between measured and calculated LDL-C increases as the triglyceride level increases
Conclusions: The findings of our study suggested that calculated LDL-C was lower, as compared to measured LDL-C, which may cause misclassifications that may have an impact on therapeutic decisions in patients with diabetes. Calculated LDL-C may depend on triglyceride levels so LDL-C should be measured by direct assay in routine clinical laboratories
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Objective: To assess the effect of angiotensin converting enzyme inhibition on glomerular filtration rate [GFR] in normotensive patient with type 1 diabetes
Methods: A two year non-placebo control prospective study was conducted after ethical approval at Diabetes Centre of Diabetic Association of Pakistan, a WHO collaborating centre in Karachi, Pakistan. All patients with type 1 diabetes visited the out-patients department from August 2009 till July 2011 and those who fulfilled the inclusion criteria were invited to participate. A total of 121 people aged >/=18 years and >/= 5 years of diabetes were included. Pregnant and lactating woman and those aged <18 years were excluded. GFR was calculated by using CKD-EPI formula [eGFR] at baseline and after two year. On the basis of estimated GFR, patients at baseline were divided according to KDIGO classification of chronic kidney diseases into, hyperfiltration [eGFR >/= 100 ml/min] and normal filtration group [eGFR < 100 ml/min]. All subjects in hyperfiltration group received ACE inhibitor [treatment group] while patients with normal filtration did not receive ACE inhibitor [control group]
Results: Fifty two patients [43%] were in the treatment and sixty nine [57%] were in the control group. At baseline eGFR, systolic and diastolic blood pressures between groups were non-significantly different. After two years, compared to baseline, eGFR of the treatment group declined and the control group increased significantly. No significant difference in systolic while diastolic blood pressure of the treatment group increased significantly after two years compared to baseline. In contrast both systolic and diastolic blood pressure of control group increased significantly after two years compared to their baseline values
Conclusion: Present study demonstrated that initiation of ACEI in hyperfiltration stage declined GFR and keep blood pressure within normal range
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Objective: To assess the 10-year risk of coronary artery disease [CAD] in subjects with impaired glucose tolerance [IGT] using Framingham risk score
Methods:Data for this study was collected from Diabetes Prevention and Awareness Program. Primary prevention team visited different primary health care centers, factories, service organizations and offices within Karachi, Pakistan. IGT was diagnosed according to World Health Organization criteria after taking informed consent. Information regarding social-demography, dietary habits and physical activities were obtained by a designed questionnaire on one-to-one based interview. Framingham risk score [FRS] was used to assess risk of developing CAD
Results:A total of 315 subjects with IGT were recruited for the study. Mean age of subjects was 44.1 +/- 9.8 years and mean BMI was 27.3 +/- 5.0 kg/m[2]. Overall, 31.4% of the participants were at risk of having CAD. Males were 6.4 times and hypertensive subjects were 2.44 times more likely to have CAD in next 10 years
Conclusion:According to the findings of the study, male and hypertensive IGT subjects were more likely to develop CAD in next 10 years. Community based awareness programs are needed to educate people regarding healthy lifestyle in order to reduce the risk of IGT and CAD
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To determine the association of SNP in FTO gene, rs9939609, with Metabolic Syndrome [MS] in type 2 diabetic subjects at a tertiary care unit of Karachi, Pakistan. We genotyped FTO rs9939609 SNP in 296 patients with type 2 diabetes from the Out Patient Department [OPD] of Baqai Institute of Diabetology and Endocrinology [BIDE]. MS was defined on the basis of International Diabetes Federation [IDF] and National Cholesterol Education program [NCEP]criterion. Association between the rs9939609 SNP and MS was tested through chi-square and Z-tests by using odds ratio [OR] with 95% confidence intervals. The frequency of MS as defined by IDF criterion was significantly higher in female subjects as compared to male subjects [p= 0.006]. Carriers of ? 1 copy of the rs9939609 A allele were significantly more likely to had MS [69.6%] than non-carriers [30.4%], corresponding to a carrier odds ratio [OR] of 0.52 [95% confidence interval [CI] [0.29-0.93], with a similar trend for the ATP III-defined MS."A" allele carriers under dominant model, carry all the criterion of MS more significantly as compared to non-carriers. The FTO rs9939609 SNP was associated with an increased risk for Metabolic Syndrome in type 2 diabetic populations at a tertiary care unit of Karachi, Pakistan
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To observe the differences of various biochemical and clinical parameters with respect to Family History [FH] of Non-communicable Diseases [NCDs] in fourth year Bachelor of Medicine, Bachelor of Surgery [MBBS] students. This observational study was conducted at Baqai Institute of Diabetology and Endocrinology from December 2013 to January 2014. Total 50 medical students from Dow University of Health Sciences [DUHS] participated in the study. Statistical Package for Social Sciences [SPSS] version 13 was used to analyze the data. For cross tabulation and mean comparison z-test and t test were applied. Out of 50 subjects, there were 26 [52%] females. Mean age of the study population was 21.56 +/- 0.90 years. Mean serum cholesterol levels with positive FH of NCDs was significantly higher than negative FH of NCDs [p=0.005]. Mean value of low density lipoprotein [LDL] of positive family history of NCDs was found higher than those with negative FH [p=0.006] being statistically significant. The insulin levels in subjects with positive FH of NCDs were higher than subjects with negative FH of NCDs [p=0.685]. However, serum leptin and plasma renin showed no significant difference with the negative FH of NCDs being higher compared to positive FH of NCDs [p=0.068] and [p=0.884] respectively. However, Waist circumference, Body mass index and central obesity in subjects with positive FH of NCDs shows increasing trend but no statistically significant difference [p > 0.05] was observed. In our study of various biochemical and clinical parameters with respect to FH of NCDs, Serum Cholesterol and LDL levels were observed higher and statistically significant
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Objective: To determine the acceptance of retinal screening, Laser uptake and subsequent follow-up in diabetic patients attending the Diabetes Centre of Diabetic Association of Pakistan [DAP], Karachi
Study Design: Observational case series
Place and Duration of Study: Diabetic Centre of Diabetic Association of Pakistan [DAP], Karachi, from January 2011 to December 2012
Methodology: All the diabetic patients were screened for Diabetic Retinopathy [DR] with non-Mydriatic Fundus Camera [NMFC]. Patients with DR were examined by the ophthalmologist using fundus lens and slit lamp. DR was graded for severity on the basis of modified Airlie House Classification. Patients with Sight Threatening Diabetic Retinopathy [STDR] were advised Laser treatment. Each patient was followed-up for at least 6 months. The records of patients recommended Laser were retrieved, and called for re-examination
Results: Retinal screening was accepted by all of the 8368 registered diabetics attending DAP Centre. On fundus photography, 21.2% [1777] individuals were found to have DR. Seven hundred and five [39.5%] patients were found to have STDR. Laser was advised to 96.4% [680] of STDR patients; amongst whom 70.5% [480] accepted Laser treatment. Out of 480 patients who had Laser treatment, 21.2% [107] turned out for follow-up after 6 months
Conclusion: Acceptance of retinal screening and Laser application was good; but follow-up was suboptional
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To find out the various factors associated with non-adherence to diet, physical activity and insulin among patients with type 1 diabetes. [T1DM]. This cross sectional study was conducted among T1DM subjects attending the Baqai Institute of Diabetology and Endocrinology [BIDE] and Diabetic Association of Pakistan [DAP], from July 2011 to June 2012.Clinical characteristics, anthropometric measurements, knowledge regarding type 1 diabetes along with adherence to dietary advice, physical activity and insulin were noted on a predesigned questionnaire and score was assigned to each question. Patients were categorized as adherent or non-adherent on the basis of scores obtained. Statistical Package for Social Sciences [SPSS] for windows version 17.0 was used to analyze the data. A total of 194 patients [Male 94, Female 100], with mean age of 17.9 +/- 6.4 years, mean duration of diabetes 5.37 +/- 4.96 years [38.1% > 5 yrs, 61.9% < 5 yrs] were included in the study. One hundred and fourteen [58.5%] patients were non adherent to dietary advice, 82[42.3%] non adherent to physical activity while 88.1% respondents were non adherent to their prescribed insulin regimen. Factors associated with non-compliance were family type, occupation and educational level of respondent's parents, duration of T1DM, family history of diabetes, frequency of visits to diabetic clinic, knowledge regarding diabetes, lack of family support and fear of hypoglycemia. Non adherence to prescribed treatment regimen in patient with TIDM is quite high. There is need to design strategies to help patients and their family members understand their treatment regimen in order to improve their adherence
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To determine the frequency, severity and risk indicators of diabetic retinopathy [DR] in patients with diabetes attending a primary care diabetes centre. This observational study was conducted at Diabetic Association of Pakistan - a World Health Organization collaborating center in Karachi, from March 2009 to December 2011. Registered patients with diabetes were screened by two field fundus photographs. Retina specialists graded the signs of retinopathy according to diabetic retinopathy disease severity scale. Of total registered diabetic patients [n=11,158], 10,768 [96.5%] were screened for DR. Overall DR was found in 2661 [24.7%] patients. DR was found in decreasing order of frequency in patients with type 2 [n= 2555, 23.7%] followed by patients with type 1 diabetes [n=101, 0.93%] and patients with gestational diabetes mellitus [GDM] [n=5, 0.46%]. Among patients with DR, signs of non-sight threatening retinopathy was dominant. Females and patients of working age group predominantly had retinopathy. Type 1 patients >16 years and type 2 patients < 5 years of history of diabetes had sign of retinopathy in increased frequency. Every forth patient with diabetes in this large cohort had signs of diabetic retinopathy. Females and patients in working age group predominantly had retinopathy. Type 2 patients with short while type 1 patients with long history of diabetes most frequently had DR. Dissemination of the present study findings may help in increasing the awareness of this serious complication of diabetes
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To explore an association between oral mucosal alterations and type 2 Diabetes mellitus. This study was conducted at Baqai Institute of Diabetology and Endocrinology and Baqai Medical University from September 2010 to September 2012. A total of 800 individuals' 395 type 2 diabetes mellitus patients and 405 healthy individuals were enrolled in this study. An oral clinical examination was carried out for all participants using a mouth mirror, visible light source and cotton gauze. The prevalence of oral mucosal lesions was high significantly < 0.0001; odd ratio 2.601, CI 1.929-3.509 in type 2 diabetic as compared to non-diabetic. With respect to specific oral mucosal lesions, highly significant association p < 0.0001; Odd ratio 4.275, CI 2.798-6.534 was found between coated tongue with type 2 diabetes mellitus. This study did not find any association [p > 0.05] between type 2 diabetes mellitus and potentially malignant disorders. This study showed that the prevalence of oral mucosal lesions was higher in type 2 diabetic than non-diabetics. This study provides evidence that diabetes has a negative influence on oral health
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To determine the antibiogram of Pseudomonas aeruginosa and Methicillin-resistant Staphylococcus aureus [MRSA] in patients with diabetes. The study was carried out in the Microbiology Department of Clinical and Research Laboratory, Baqai Institute of Diabetology and Endocrinology [BIDE] from January 2012 to December 2012. All samples received in the laboratory were processed according to Clinical and Laboratory Standards Institute [CLSI] guidelines. Identification of Pseudomonas aeruginosa and Methicillin-resistant Staphylococcus aureus [MRSA] was done and antimicrobial susceptibility pattern was determined by disc diffusion method. A total of 585 pathogens were isolated from 542 specimens of patients with diabetes. One hundred twenty one [20.68%] Pseudomonas aeruginosa and 25[4.27%] non-aeruginosa Pseudomonas were detected from 542 samples. Among 108 [18%] samples detecting the growth of Staphylococcus aureus, Methicillin-resistant Staphylococcus aureus [MRSA] were found in 42 [39%] samples. Pseudomonas aeruginosa showed marked susceptibility to imipenem [100%] followed by piperacillin / tazobactam [90.91%]. All MRSA positive specimens were susceptible to vancomycin, but highly or completely resistant to the other antimicrobial drugs. In the present study imipenem, piperacillin/tazobactam and sulbactam-cefoperazone were found to be the most effective drugs against Pseudomonas aeruginosa. The majority of MRSA were resistant to one or more than one antimicrobial drugs. Vancomycin and imipenem were the most effective drugsagainst Staphylococcus aureus and MRSA
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Objective: To observe the adherence of Healthcare Professionals to American Diabetes Association [ADA] 2004 guidelines for the care of patients with type 2 diabetes at Peripheral Diabetes Clinics [PDCs] in Karachi, Pakistan
Methodology: The study was conducted using a retrospective medical chart review of patients with type 2 diabetes at four PDCs in four townships of Karachi district from January 2005 to December 2006. Entire medical records of patients were evaluated for the evidence of documentation of testing and treatment
Results: Medical records of 691 patients [332 males and 359 females] with type 2 diabetes were reviewed. Mean age of the patients was 50.79 +/- 10.75 years. Deficiencies were observed in most areas of diabetes care. Blood pressure was documented in 85.81% patients, whereas, serum creatinine, HbA1c and lipid profile were noted in 56%, 44.57% and 40.08% of the patients respectively. Similarly, lower leg examination was registered in 44% patients, while in 30.53% of the patients fundoscopic examination was recorded. Co-morbid conditions like hypertension and hyperlipidemia were documented in 92.7% and 84.6% patients respectively. HbA1c < 7% was achieved by 59.04% patients, while 27.50% of the patients attained the recommended level of serum cholesterol. Likewise, ADA recommended goal for blood pressure and LDL was achieved by13.02% and 12.16% patients respectively
Conclusions: The study showed that adherence of healthcare professionals to ADA guidelines was suboptimal. Moreover, insufficient documentation of medical records reflected inadequate care of patients with type 2 diabetes
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Alteration in platelet morphology and functions are associated with pathological processes and increased risk of vascular complications in patients with diabetes. The purpose of the study was to find the correlation between platelet indices with fasting blood glucose, HbA1c and hs-CRP level in pathogenesis of vascular complications in type 2 diabetic patients. The study has been carried out on 51 Type 2 Diabetics and 55 age and sex matched healthy control subjects. Fasting blood glucose [FBG], Glycosylated hemoglobin [HbA1c], high sensitivity C- reactive protein [hs-CRP] level and platelet indices including Platelet count [PLT], Plateletcrit [PCT], Mean platelet volume [MPV], Platelet distribution width [PDW] were estimated and compared with normal subjects. The results were evaluated statistically. The study demonstrated that FBG, HbA1c, MPV, PDW and hs-CRP were statistically higher in diabetics in comparison with control subjects [P is less than 0.05]. Positive correlation of FBG with HbA1c [r is equal to 0.993, P is equal to 0.0001], PLT with PCT [r is equal to 0.922, P is equal to 0.0001] and MPV with PDW [r is equal to 0.332, P is equal to 0.024] was found in diabetics. The poor glycemic control is positively correlated with high HbA1c level. The increased values of MPV, PDW and elevated hs-CRP level may also serve as confirmatory test in finding risk of developing complications
Subject(s)
Humans , Male , Female , Diabetes Mellitus, Type 2/complications , Blood Platelets , Blood Glucose , Glycated Hemoglobin , C-Reactive Protein , Mean Platelet Volume , Platelet CountABSTRACT
Resistance to multiple antimicrobials is the major cause of debility and death due to infectious diseases around the world. Our objective was to determine the frequency and antimicrobial susceptibility pattern of aerobic microbial isolates in a clinical laboratory. All culture specimens of tissue, pus, urine, bone, blood, fluid, stool, sputum, and high vaginal swab received in the Microbiology Department of Clinical and Research Laboratory, Baqai Institute of Diabetology and Endocrinology from May 2010 to January 2011 were included in the present study. Bacterial isolates were identified and their antimicrobial susceptibility pattern was determined. Out of 312 cultured specimens, 272 [87.17%] were found infected with 437 microbial organisms [412 bacteria and 25 Candida isolates]. A total of 90 [20.59%] multi-drug resistant [MDR] isolates were found. MDR Escherichia coli was isolated in 40 [34.19%] out of 117 culture specimens which showed the growth of Escherichia coli, Pseudomonas aeruginosa in 17 [22.08%], Methicillin-resistant Staphylococcus aureus in 13 [11.50%], Klebsiella pneumoniae in 7 [22.58%], Proteus species in 6 [31.58%], Acinetobacter species in 3 [33.33%], Enterobacter species in 2 [28.57%], Coliform [Escherichia coli] in 1 [16.67%] and Enterococcus species were isolated in 1 [50%] culture specimen. High prevalence of multi-drug resistant bacteria was found in the present study. Emergence of antimicrobial resistance has become a major challenge in infectious disease medicine. Antimicrobial resistance may be due to misuse of antimicrobials by physicians and self medication in Pakistan. Further large scale studies are needed to validate our findings
Subject(s)
Drug Resistance, Microbial , Bacteria, Aerobic/drug effects , Drug Resistance, Multiple, BacterialABSTRACT
This case study describes clinical and molecular genetic data of a 45 days old male patient of neonatal diabetes mellitus. PCR amplification followed by DNA sequencing revealed two point mutations at positions 67A>G and 1009G>A in KCNJ11 gene encoding Kir6.2 protein, a component of the beta-cell ATP-sensitive potassium [KATP] channel which is a key component involved in insulin secretion
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To determine the prevalence of metabolic syndrome in different ethnic subgroups of urban population of Karachi, Pakistan. This cross sectional study was conducted in Lyari Town. Data of 856 adults >25 years old was available in terms of ethnic subgroups for analysis; 363 of these subjects gave blood samples. Their anthropometric, demographic and biochemical data was collected. Distinct ethnic subgroups- Muhajir, Punjabi, Sindhi, Baluchi and Pushtun were defined on the basis of mother tongue. Out of 856 subjects, 73% were females. Mean age of the subjects was 40.7 +/- 14.1 years. Metabolic syndrome was found in 34.8% subjects according to the IDF criteria. In terms of ethnic groups the highest prevalence of metabolic syndrome was seen in Pushtuns [41.3%] and the lowest in Muhajirs [32.5%]. Statistically significant differences were seen in the age adjusted waist circumference, waist-hip ratio, fasting triglycerides, insulin and HOMA levels among ethnic subgroups. Prevalence of metabolic syndrome in the studied population was found to be significantly high but there was no statistical difference seen among various ethnic subgroups. Further large scale studies are needed to confirm these findings
Subject(s)
Humans , Female , Male , Metabolic Syndrome/epidemiology , Asia, Southeastern , Prevalence , Cross-Sectional StudiesABSTRACT
To assess frequency of insulin resistance [IR] in patients, presenting with polycystic ovarian syndrome using simple indices of insulin resistance and to determine the association of clinical manifestations of PCOS with insulin resistance indices. This cross sectional study was carried out at Baqai Institute of Diabetology and Endocrinology [BIDE]. One hundred patients fulfilling the revised 2003 Rotterdam diagnostic criteria for PCOS were included. Descriptive statistics were calculated using frequency and mean with standard deviation. Insulin resistance [IR] was calculated using fasting insulin levels [> 10 IU/ml], fasting glucose: insulin ratio [> 4.5]. Different surrogate marker of IR like HOMA-IR [> 2.6], QUICKI [< 0.357] and McAuley [< 5.8] were calculated. The value for HOMA-IR, QUICKI and McAuley in patients of PCOS were 65%, 88% and 51.2% respectively. Patients having fasting insulin level [> 10 iu/ml] were 75.32%. Menstrual irregularities were the commonest presentation followed by obesity, hirsutism and infertility. There was a strong association of BMI with various menstrual irregularities, hyperinsulinemia and insulin resistance. A significant high rate of hyperinsulinemia and insulin resistance has been observed in our patients of polycystic ovarian syndrome. Majority of clinical manifestation are found to be associated with insulin resistance indices
Subject(s)
Humans , Female , Adolescent , Adult , Polycystic Ovary Syndrome , Cross-Sectional StudiesABSTRACT
Microalbuminuria is a renal marker of general vascular endothelial damage and early atherosclerosis with adverse prognostic implications. It is associated with diabetes, insulin resistance, central adiposity and hypertension The Microalbuminuria Prevalence Study [MAPS] aimed to assess the prevalence of microalbuminuria in consecutively-screened hypertensive adult patients with type 2 diabetes mellitus in 103 centres of ten Asian countries. Cross-sectional clinic-based epidemiological study. This is the sub-analysis of data collected from patients attending the OPD of Baqai Institute of Diabetology and Endocrinology in Pakistan. Patients attended one study visit with no follow-up. Patients with bacteriuria and haematuria were excluded. A total of 99 subjects were studied out of which 56.3% were females. Mean age was 49.9 +/- 10.8 years. The prevalence of macroalbuminuria and microalbuminuria was 9.09% and 24.2% respectively. In Pakistan the prevalence of diabetic kidney disease was high in diabetic hypertensive subjects which is alarming and indicates an impending pandemic of diabetic renal and cardiovascular disease in the region