Diabetic nephropathy and relationship with retinopathy and neuropathy among adult Nigerians with non-insulin dependent diabetes mellitus

Abstract

Aim: To establish the baseline extent of diabetic nephropathy in Nigerians with non insulin dependent diabetes and the relationship if any, to other long term complications of diabetes mellitus. Patients and Method: Sixty non-insulin dependent diab-etics who have had diabetes mellitus for seven years or more were screened for proteinuria (using micral stix for microalbuminuria and albustix for macroaibuminuria) on at least 3 consecutive clinic visits at monthly interval. Results: The prevalence of diabetic nephropathy was:- microalbuminuria - 26.67% and macroalbuminuria 23.33%. Prevalence of hypertension, increased with increasing urinary protein excretion (being 30% - normoalbuminuria; 56.25% - microalbuminuria; 78.57% -cicroalbuminuria). Similar trend was also noted for retinopathy being 0% - normoalbuminuria; 12.50% -microalbuminduria, 35.71% -macroalbuminuria for proliferative retinopathy. The prevalence of neuropathy was also noted to increase with increasing urinary protein excretion viz:- 20% -normoalbuminuria; 43.75% - microalbuminuria; 50% - macroalbuminuria for neuropathy. This was however, not statistically significant. Mean creatinine clearance (Crcl) decreased with increasing urinary excretion of protein. It was however noted that diabetic nephropathy was neither age nor duration dependent. Conclusion: This study has shown that a significant number of Nigerian non insulin dependent diabetic patients develop diabetic nephropathy. There is a relationship between abnormal urinary protein excretion and other long term complications of diabetes mellitus.

Keywords

• diabetic nephropathy; niddm; prevalence; hypertension; neuropathy; retinopathy