Microalbuminuria as a predictor of diabetic nephropathy - Comparison between type I and type II diabetes mellitus

ABSTRACT

This study was done to determine the incidence of nephropathy in both types of diabetes, insulin dependent [IDDM] and non-insulin dependent diabetes mellitus [NIDDM] and its interrelation with arterial blood pressure, metabolic control as indicated by glycosylated hemoglobin and the renal functions as indicated by creatinine clearance. It mainly investigates microalbuminuria using radioimmunoassay as a predictor of early stages of nephropathy and correlate it with different vascular complications of diabetes as hypertension and retinopathy as well as to metabolic control. The study included 50 subjects classified as 10 normal healthy persons as controls, 20 IDDM patients divided into normotensive [10] and hypertensive [10] patients as well as 20 NIDDM patients who also were divided into 10 normotensive and 10 hypertensive patients. All patients showing microalbuminuria had duration of diabetes more than 5 years. Microalbuminuria was more evident in IDDM than NIDDM patients. It was also significantly higher in hypertensive than normotensive IDDM patients. A negative correlation between glycosylated hemoglobin and microalbuminuria in all diabetics was found, which may be due to other factors influencing the glycosylated Hb. Retinal changes were more related to the duration of diabetes than to the type of diabetes, hypertension or to the state of metabolic control. NIDDM patients with retinal changes showed significant increase in microalbuminuria. Every diabetic patient with microalbuminuria must be followed up for other vascular complications