Microalbuminuria and clinical correlates in black African patients with type 2 diabetes.

BACKGROUND: Diabetes mellitus is a major cause of morbidity and mortality as a result of its complications. Long-term complications of diabetes mellitus have been linked to poor glycemic control. Diabetic nephropathy is the leading cause of end stage renal disease in the developed world and third leading cause in Nigeria. Various independent risk factors have been identified as predictors of diabetic nephropathy. One of such factors is urinary albumin excretion. OBJECTIVE: This study set out to determine the prevalence of microalbuminuria (MA), glycemic control and the relationship between urinary albumin excretion (UAE) and other known predictors of diabetic nephropathy in type 2 diabetic patients with disease duration greater than 5 years. STUDY DESIGN: Fifty non-proteinuric patients were selected consecutively for this cross-sectional study. Urinary albumin concentration was determined in a timed overnight urine sample by immunoturbidimetry and glycated haemoglobin was determined using boronate affinity method. Comparison was made between the patients with microalbuminuria and those with normal albumin excretion and the most likely predictors of urinary albumin excretion were determined. RESULTS: Fifty-two percent of the patients studied had good glycaemic control (HbA1c < 7%) while 83% had microalbuminuria (UAE 20-200 mg/min). There was no significant correlation between the UAE and the HbA1c. UAE however correlated significantly with the age and diastolic blood pressure (DBP) of the patients. CONCLUSION: Almost half of the patient population had suboptimal glycemic control. There was a high prevalence of microalbuminuria amongst the patients studied. Significant predictors of UAE in this study were the age of the patients and DBP but not HbA1c.