Microalbuminuria Among Patients with Diabetes Type 1 and Type 2 at the Armed Forces Hospital in Jubail

Abstract

Nephropathy is one of the common complications of diabetes, and can lead to end-stage renal failure. The number of diabetic subjects accepted for renal dialysis treatment is increasing yearly.1 Nephropathy takes several years to develop after the diagnosis of diabetes, but if it is diagnosed early, the process can be aborted or even reversed by strict metabolic control. 2Nephropathy presents first as intermittent microalbuminuria (incipient), progressing to persistent microalbuminuria, and then to macroalbuminuria. A useful method of early detection of albumin in urine is by quantifying microalbuminuria. The usual way to do this is by measuring albumin in a 24-hour urine sample. But the patient's compliance is a limiting factor. An easier method is to measure the concentration of albumin in urine at the patient's regular visit, especially the concentrated morning sample.Several investigators used this method and reported comparable results. 3,4 In fact it has been recommended as a screening test for early detection of nephropathy.5 In this study, the investigator tried to identify the extent of microalbuminuria among the regular diabetic patients attending the primary health care clinic. Patients and MethodsMore than 300 diabetic patients are seen regularly at the diabetic clinic in the Primary Care Department of the Armed Forces Hospital in Jubail, Saudi Arabia. A full history, physical examination and the necessary investigations were done for most of the patients attending this clinic.One random sample of urine was obtained (from 104 patients with diabetes, randomly selected from the Primary Care Clinic) for quantifying albumin concentration in urine. This method is superior to the excretion rate 6 and an accurate method for screening of micro-and macroalbuminuria. 7 The method used was the urinary protein (UP) method developed for aca™ discrete clinical analyzer. In this method, the turbidimetric method of Iwata and Nishikaze, 8 as well as the benzethonium chloride method for precipitating urinary protein in a basic medium, were used for quantifying microalbuminuria. The specimens were analyzed within one hour in the same hospital laboratory. The urine samples were random single-sample (i.e., not a 24-hour sample) collected from the patients as they were seen at the clinic. The single-sample method was also used before by several authors. 3,9,10

Association of Insulin Based Insulin Resistance with Liver Biomarkers in Type 2 Diabetes mellitus

“…A/G ratio was lowered in an extremely significant manner in diabetics 19 . Comparatively elevated total proteins observed in our present study is supported by various reports 20,21 . This could be due to the elevation of various acute phase proteins, fibrinogen, and globulins in T2DM which in turn rise plasma proteins.…”