Uninary aibumin excretion rate in patients with type 2 diabetes mellitus and retinopathy

ABSTRACT

To determine whether a relationship between retinopathy and nephropathy in patients with type 2 diabetes mellitus; 47 subjects with type 2 diabetes mellitus and retinopathy, and a control group formed of 65 subjects with type 2 diabetes mellitus but without retinopathy were examined for urinary albumin excretion per 24 hour, fasting blood glucose, 2 hour post prandial blood glucose, glycosylated HbA1c, fasting serum cholesterol, fasting serum triglycerides, blood urea, serum creatinine and glomerular filtration rate The two groups of patients were matched for age and sex. They were above 5 years diabetes duration and had a within normal renal function. Results of this study showed that subjects with diabetic retinopathy had mostly nonprolifertive type [41 [87.23%]] and there was an increase in their urinary albumin excretion per 24 hour [19 [40, 43%]] which was mainly in the form of microalbuminuria. Comparing the frequency and mean values of micro albuminuria and macro albuminuria in the two groups of patients, there was a significant increase in the diabetic subjects with retinopathy. Also, these patients had a significant increase in the mean values of fasting blood glucose, post prandial blood glucose, fasting serum cholesterol, fasting serum triglycerides, glycosylated HbAlc, diabetes duration and both systolic and diastolic blood pressure. For the other studied parameters, there was a non significant increase in the mean values of fasting serum insulin, blood urea, serum creatinine, glomerular filtration rate, body mass index and age of the patients in the diabetics with retinopathy in comparison to those without retinopathy. These results suggest that patients with type 2 diabetes mellitus and retinopathy have an increase in the rate of urinary albumin excretion and there is a strong association between background retinopathy and microalbuminuria. Consequently microalbuminuria can be considered as a risk factor for diabetic retinopathy as well as fundus examination can be a useful and rapid bed side diagnostic tool for diabetic nephropathy