Pakistan Armed Forces Medical Journal (Aug 2018)
PROGRESSION OF ALBUMINURIA AND RETINOPATHY WITH DURATION OF DIABETES MELLITUS
Abstract
Objective: To determine the progression of proteinuria with duration of type 2 diabetes mellitus, it also aimed at grading DR with duration of diabetes mellitus. Study Design: Cross sectional study. Place and Duration of Study: Duration of this study was 5 months, from Feb 2017 to Jun 2017. Material and Methods: This study enrolled 53 patients with type 2 diabetes mellitus. Duration of this study was 5 months from February 2017 to June 2017. Urinary albumin was measured using the turbidometric method (Roche, Germany). A 3.5V Standard Ophthalmoscope (Welch Allyn) was used to examine the fundus. Statistical Package for Social Sciences (SPSS) version 20 was used for data analysis. Results: In this study, 52.8% (n=28) were males while 47.1% (n=25) were females. Average age was 56.2 ± 11.6 years. Patients were grouped according to duration of diabetes; group1: disease duration less than 5 years, group 2: disease duration between 5 to 10 years, group 3: disease duration more than 10 years. Average HbA1C was 8.53% in group 1, 9.51 % in group 2 and 10% in group 3. In group 1, 22.6% (n=12) had urinary albumin less than 30 mg/dL. 16.9% (n=9) had urinary albumin equal to or more than 30 mg/dL and less than 300 mg/dL while no patient had urinary albumin equal to or more than 300 mg/dL. A p-value was 0.002. In group 2, 5.6% (n=3) had urinary albumin less than 30 mg/dL. Of 20.7% (n=11) had urinary albumin equal to or more than 30 mg/dL and less than 300 mg/dL while 1.8% (n=1) patient had urinary albumin equal to or more than 300 mg/dL. A p-value was 0.002. In group 3, No patient had urinary albumin less than 30 mg/dL. 18.8% (n=10) had urinary albumin equal to or more than 30 mg/dL and less than 300 mg/dL while 13.2% (n=7) patients had urinary albumin equal to or more than 300 mg/dL. A p-value was 0.001. In group 1, 1.8% (n=1) patient had DR. In group 2, 3.7% (n=2) patients had DR while in group 3, 20.1% (n=11) patients had DR. 45.3% of the patients were on oral hypoglycemic medications, 43.4% patients were on Insulin therapy while 9.4% patients were on Insulin and Oral Hypoglycemics both. Conclusion: Patients had poor diabetic control despite being diagnosed for 5 to 10 years. Albuminuria progressed and grade of retinopathy increased with duration of diabetes. Relatively low rate of renal and retinal complications were found in this study.
