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Annals of the Academy of Medicine, Singapore ; : 502-508, 2018.
Article in English | WPRIM | ID: wpr-777414

ABSTRACT

INTRODUCTION@#This study aimed to determine the 5-year incidence of albuminuria among Asian persons with newly diagnosed type 2 diabetes mellitus (DM), and to identify the risk factors at diagnosis for progression to albuminuria.@*MATERIALS AND METHODS@#A retrospective 5-year closed cohort study was conducted among 1016 persons aged ≥18 years old who were diagnosed with type 2 DM between 1 January 2007 and 31 December 2009 at primary care facilities in Singapore. The cumulative incidence of progression from normoalbuminuria to albuminuria-termed "progression"-was determined. The risk factors associated with progression were evaluated using multiple logistic regression analysis.@*RESULTS@#A total of 541 (53.2%) participants were men. The mean (SD) onset age of type 2 DM was 54 (11) years. From diagnosis of type 2 DM, the 5-year cumulative incidence of progression was 17.3% and mean (SD) duration to progression was 2.88 (1.23) years. Higher onset age (OR 1.02; 95% CI, 1.00-1.04), history of hypertension (OR, 1.88; 95% CI, 1.32-2.70) and higher glycated haemoglobin (HbA1c) (OR, 1.17; 95% CI, 1.09-1.26) at diagnosis were associated with progression. In addition, being on angiotensin converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) treatment at baseline modified the effect of hypertension on progression.@*CONCLUSION@#This study highlighted the importance of early screening and treatment of diabetes as well as prevention of hypertension, which could potentially delay the onset of microalbuminuria in persons with type 2 DM. Persons on ACEI or ARB treatment should continue to be monitored regularly for progression to albuminuria.


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Age of Onset , Albuminuria , Epidemiology , Angiotensin Receptor Antagonists , Therapeutic Uses , Angiotensin-Converting Enzyme Inhibitors , Therapeutic Uses , Cohort Studies , Diabetes Mellitus, Type 2 , Diagnosis , Epidemiology , Metabolism , Disease Progression , Glycated Hemoglobin , Metabolism , Hypertension , Drug Therapy , Epidemiology , Logistic Models , Retrospective Studies , Risk Factors , Singapore , Epidemiology
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