The predictive power of microalbuminuria in diagnosing diabetic retinopathy in adults with Type II diabetes mellitus

Abstract

Introduction: Diabetes Mellitus is one of the most common metabolic disorders, resulting in hyperglycemia and is associated with micro and macro vascular complications. Diabetic retinopathy (DR) is a widely accepted cause of blindness in adults. The duration of diabetes, glycemic control and microalbuminuria (MA) have been implicated in the onset and progression of DR. Materials and Methods: The aim of our study is to correlate FBS, PPBS, HbA1c and microalbuminuria with diabetic retinopathy and to find out MA as the predictor of DR in T2DM patients. Our study included, 50 T2DM patients with DR, 50 T2DM patients without DR and 50 controls of both sex in the age group of 40 -60 years. Fasting blood sugar (FBS) and post prandial blood sugar (PPBS) were estimated by Glucose Oxidase method, glycated hemoglobin (HbA1c) by Ion Exchange Resin Method and urine samples were assayed for Microalbumin by Immunoturbidimetric assay and DR was diagnosed using Fundoscopy. Results: In our study, levels of urinary microalbumin, FBS, PPBS and HbA1c in T2DM patients with DR is increased than T2DM patients without DR than the control group, which is highly significant (p <0.001). HbA1c and Microalbuminuria in T2DM are positively correlated. All the parameters (FBS, PPBS, HbA1c and microalbuminuria) in group A cases are positively correlated with grades of Diabetic Retinopathy. Conclusion: Microalbuminuria and diabetic retinopathy are closely associated in T2DM patients and is a reliable marker which can predict the risk for the development of DR. All patients with MA should undergo regular retinal evaluation.

Association of Microalbuminuria with the Severity of Diabetic Retinopathy in Patients with type II Diabetes Mellitus.

“…16 Ashrit P et al concluded that poor glycemic control, long duration of type II diabetes resulted in an advanced stage of diabetic retinopathy and also increased level of microalbuminuria with each stage. 17 It also showed that the mean microalbuminuria in mg/day increased from 141.62±10.04 in grade 1 diabetic retinopathy to 278.56±11.26 in grade 4 diabetic retinopathy. 17 The study termed microalbuminuria as a reliable marker for the risk of onset and progression of proliferative diabetic retinopathy.…”

“…17 It also showed that the mean microalbuminuria in mg/day increased from 141.62±10.04 in grade 1 diabetic retinopathy to 278.56±11.26 in grade 4 diabetic retinopathy. 17 The study termed microalbuminuria as a reliable marker for the risk of onset and progression of proliferative diabetic retinopathy. 17 Cui J et al also concluded that higher albumin levels is a risk factor for the severity of diabetic retinopathy and can be used for early detection.…”

“…17 The study termed microalbuminuria as a reliable marker for the risk of onset and progression of proliferative diabetic retinopathy. 17 Cui J et al also concluded that higher albumin levels is a risk factor for the severity of diabetic retinopathy and can be used for early detection. 18 Another study by Goudinho SJ et al revealed that the percentage of people having microalbuminuria in very mild NPDR was 42.10% which increased to 85.70% in very severe NPDR and 90.90 % in PDR.…”