Prevalence of Microalbuminuria in Newly Diagnosed T2DM Patients attending a Tertiary Care Hospital in North India and its Association with Various Risk Factors

Introduction: The natural history of diabetic nephropathyhas generally been viewed as a descending path fromnormoalbuminuria to end stage renal disease through anintermediate stage marked by microalbuminuria and overtproteinuria. For this reason, measurement of urine albuminis often used as a sensitive marker and predictor of overtnephropathy in patients with diabetes mellitus. Study aimedto determine the prevalence of microalbuminuria in newlydiagnosed type 2 diabetes mellitus patients and to assess theprobable risk factors associated with microalbuminuria.Material and methods: A total of 155 newly diagnosed Type 2Diabetes mellitus patients were includedin our cross-sectionalstudy. After the history, general physical examination andanthropometry, various biochemical investigations includingkidney function test, plasma blood sugars, lipid profile andHbA1c. The detection of microalbuminuria was done byMicral Test (dipstick, Roche Diagnostic) method in a randomspot urine sample. Microalbuminuria was diagnosed if theurinary albumin excretion was ≥20 mg/L of urine.Results: The overall prevalence of nephropathy was 32.9%(51/155).There was significant association of albuminuriawith the increase in age of the patients, increased BMI, highglycated haemoglobin, high fasting plasma glucose, anddyslipidemia.Conclusion: A relatively high prevalence of microalbuminuriaat the time of diagnosis in our study reconfirms that evaluationfor microalbuminuria must be done at the time of diagnosis inall patients of T2DM

Allgrove (Triple A) Syndrome: A Case Report from the Kashmir Valley

Allgrove (Triple A) syndrome is a rare autosomal recessive disorder characterized by cardinal features of adrenal insufficiency due to adrenocorticotropic hormone (ACTH) resistance, achalasia, and alacrimia. It is frequently associated with neurological manifestations like polyneuropathy. Since its first description by Allgrove in 1978, approximately 100 cases have been reported in the literature. Here we report an 18-year-old boy diagnosed as having Allgrove syndrome, with ACTH resistant adrenal insufficiency, achalasia, alacrimia, and severe motor polyneuropathy. Alacrimia was the earliest feature evident at the age of 8 years. He presented with achalasia and adrenal insufficiency at 12 and 18 years respectively and developed neurological symptoms in the form of severe muscle wasting at the age of 15 years. Patients with Allgrove syndrome usually manifest adrenal insufficiency and achalasia during first decade of life. Our patient manifested adrenal insufficiency and achalasia in the second decade and manifested neurological dysfunction before adrenal dysfunction.