Effect of glycemic control on microalbuminuria development among type 2 diabetes with high-normal albuminuria

Chen, Weizhi; Hung, Cheng-Chieh; Wen, Yu-Wen; Ning, Hsiao-Chen; Gau, Bing-Ru; Huang, Yu‐Yao

doi:10.3109/0886022x.2013.832312

Cited by 14 publications

(16 citation statements)

References 26 publications

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“…The FSG in diabetic patients mean value was (12.20±4.64 m mol/L) and HbA1C mean was (8.24±1.84 %) which is significantly higher than the control group (mean FSG 5.12±0.63 m mol/L, HbA1C mean 4.62±0.88%), as summarized in (figure-1). There was no positive correlation between (FSG, HbA1c) and microalbuminuria, in contrast to a study by Chen et al (31) . Considering renal function assessment; the mean values of serum creatinine and estimated GFR were within normal range for both groups (Group A diabetics with positive microalbuminuria and Group B diabetics with negative microalbuminuria as shown in (figure-2) and ( figure-3).…”

Section: Discussioncontrasting

confidence: 98%

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Serum Aldosterone Levels in Patients With Diabetic Nephropathy in Relation to Vascular Calcification

Salih¹,

Ali²,

Al-Lehibi³

2019

IJPS

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Diabetic Nephropathy(DN) is a complex disease manifested by persistence microalbuminuria occurring due to the interaction between hemodynamic and metabolic pathway that activates the local renin-angiotensin-aldosterone system resulting in a decline in renal functions. This study aimed to quantify the associations between serum aldosterone concentration and fetuin- A as a marker of calcification in type 2 diabetic patients with and without microalbuminuria from one side, and study the possible relationship between aldosterone and fetuin-A with glycemic indices, serum electrolyte, renal function and microalbuminuria and body mass index from the other side. A case-control study involved eighty-six adult subjects classified into three groups after testing urine microalbumin including thirty-two diabetics type 2 patients with positive microalbuminuria and twenty-eight diabetics type 2 patients with negative microalbuminuria and 26 healthy subjects during their visit to AL kindy specialized Center for Endocrinology and Diabetes / Baghdad. Those patients were compared to control group of 26 apparently healthy subjects, fasting blood samples was obtained from each of them in one occasion only to measure: fasting serum glucose, electrolyte, aldosterone, fetuin-A, urea, and creatinine. In addition to glycoheamoglobin, glomerular filtration rate and body mass index. Despite the presence of microalbuminuria in thirty-two of the studied diabetics, there was no positive correlation between aldosterone and fetuin- A, besides that no significant variations in serum aldosterone ,glomerular filtration rate(GFR) values, while both groups showed a significant increase in fasting serum glucose and glycaoheamoglobin ,significant decrease in serum sodium and chloride in comparison with the control group , significant increase was detected in serum fetuin-A mean values in microalbuminuric diabetics. Whereas, negative microalbuminuric diabetics measures expressed a positive correlation between both serum sodium and chloride levels and fetuin -A. The conclusion of this study diabetic patient are prone to vascular calcification (VC) might be due to increase in aldosterone level or due to diabetic itself from this study we can conclude microalbuminuria can occur without a decline in renal function or a change in estimated GFR ,no definite correlation occur between aldosterone and fetuin- A, fetuin- A mean values are higher in diabetic patient with microalbuminuria compared to diabetic patients without microalbuminuria and control group and this referred to uncontrolled diabetes ,aldosterone show a correlation with weight and body mass index while fetuin- A does not show such correlation. In general, electrolyte disturbances (hypernatremia) is more obvious in this study , and its occurrence is due to diabetic (osmotic diuresis) or drugs, while sodium retention which is a sign of aldosterone increment does not occur. Hypochloremia that occur in this study is due to chloride and it is in parallel with sodium level.

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Section: Discussioncontrasting

confidence: 98%

“…The level of glycemic control seems to be the strongest factor influencing transition from normoalbuminuria to microalbuminuria (31) . Glycemic control plays as vital role in diabetic microvascular complications.…”

Section: Discussionmentioning

confidence: 99%

Serum Aldosterone Levels in Patients With Diabetic Nephropathy in Relation to Vascular Calcification

Salih¹,

Ali²,

Al-Lehibi³

2019

IJPS

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“…54 A study in Taiwan found that HbA1c is an indicator for microalbuminuria development among T2DM patients. 55 Among T2DM studies, glucose variability showed a positive association with the progression of DR. 54 A ten-year survey follow-up of diabetes patients in Taiwan showed that visit-to-visit glucose variations in both FPG-CV and HbA1c-CV independently predicted ESRD in patients with T2DM duration >30 years. 56 Some data show that glucose variability, namely, fasting plasma glucose variability, and retinopathy in T2DM patients have a possible connection.…”

Section: Dovepressmentioning

confidence: 99%

<p>Nomogram for the Risk of Diabetic Nephropathy or Diabetic Retinopathy Among Patients with Type 2 Diabetes Mellitus Based on Questionnaire and Biochemical Indicators: A Cross-Sectional Study</p>

Shi¹,

Niu²,

Wu³

et al. 2020

DMSO

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Purpose: This study aimed to develop a diabetic nephropathy (DN) or diabetic retinopathy (DR) incidence risk nomogram in China's population with type 2 diabetes mellitus (T2DM) based on a community-based sample. Methods: We carried out questionnaire evaluations, physical examinations and biochemical tests among 4219 T2DM patients in Shanghai. According to the incidence of DN and DR, 4219 patients in our study were divided into groups of T2DM patients with DN or DR, patients with both, and patients without any complications. We successively used least absolute shrinkage and selection operator regression analysis and logistic regression analysis to optimize the feature selection for DN and DR. To ensure the accuracy of the results, we carried out multivariable logistic regression analysis of the above significant risk factors on the sample data for both DN and DR. The selected features were included to establish a prediction model. The C-index, calibration plot, curve analysis and internal validation were used to validate the distinction, calibration, and clinical practicality of the model. Results: The predictors in the prediction model included disease course, body mass index (BMI), total triglycerides (TGs), systolic blood pressure (SBP), postprandial blood glucose (PBG), haemoglobin A1C (HbA1c) and blood urea nitrogen (BUN). The model displayed moderate predictive power with a C-index of 0.807 and an area under the receiver operating characteristic curve of 0.807. In internal verification, the C-index reached 0.804. The risk threshold was 16-75% according to the analysis of the decision curve, and the nomogram could be applied in clinical practice. Conclusion: This DN or DR incidence risk nomogram incorporating disease course, BMI, TGs, SBP, PBG, HbA1c and BUN can be used to predict DN or DR incidence risk in T2DM patients. The research team has developed an online app based on a clinical prediction model incorporating risk factors for rapid and simple prediction.

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“…15 Chen et al explained the role of microalbuminria with glycemic control, with his results proving the relationship of high -normal albuminuria and glycemic control on microalbuminuria development among patients with diabetes mellitus type II. 16 Khalid et al showed in his study and proved the positive correlation between increased frequency of microalbuminuria and glycemic control. 17 Memon et al showed that by improving the glycemic control of diabetic patients, maintenance of the blood pressure can be ensured; and early diagnosis of the disease may decrease the risk of development and progression of microalbuminuria and finally end stage damage of kidney and mortality.…”

Section: Number Of Participants (%) Hba1c (%) P-valuementioning

confidence: 89%

Microalbuminuria and its association with glycemic control in patients with diabetes mellitus type II.

Jiskani¹,

Singh²,

Meghji³

et al. 2020

TPMJ

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Diabetes mellitus is chronic condition with defect in regulation of insulin. Microalbuminuria is one of the early appearing markers of overt diabetic nephropathy. Uncontrolled glycemic status has been postulated to be associated with increase urinary albumin levels. Objectives: To find out the association of increased urinary albumin with poor glyemic status of patients with diabetes mellitus type II. Study Design: Cross Sectional study. Setting: Department of Pathology, Indus Medical College Hospital Tando Muhammad Khan. Period: November 2018 to June 2019. Material & Methods: Patients were divided into two groups: Group I (Poor glycemic control, HbA1c >7%) and Group II (Good glycemic control, HbA1c <7%). Glycated hemoglobin and microalbuminuria were evaluated in all patients. Data was analyzed using SPSS 21.0. P – value of <0.05 was considered as statistically significant. Results: Total of 213 patients were included in the study with male ratio (56.8%) slightly higher than females (43.19%). Mean age of patients was 42.3 ± 2.1 years. Mean glycated hemoglobin in Group I and II was 8.12 ± 0.97% and 5.98 ± 0.41% respectively. In Group I, 57.54% patients were detected with microalbuminuria as compared to Group II (12.26%). P value was statistically significant (<0.001). Conclusion: Microalbuminuria was found more frequently in patients with poor glycemic control. Early detection of urinary microalbumin in these patients may decrease the risk of kidney damage and appropriate and adequate management in initial stage.

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Effect of glycemic control on microalbuminuria development among type 2 diabetes with high-normal albuminuria

Cited by 14 publications

References 26 publications

Serum Aldosterone Levels in Patients With Diabetic Nephropathy in Relation to Vascular Calcification

Serum Aldosterone Levels in Patients With Diabetic Nephropathy in Relation to Vascular Calcification

<p>Nomogram for the Risk of Diabetic Nephropathy or Diabetic Retinopathy Among Patients with Type 2 Diabetes Mellitus Based on Questionnaire and Biochemical Indicators: A Cross-Sectional Study</p>

Microalbuminuria and its association with glycemic control in patients with diabetes mellitus type II.

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