Nephropathy in patients with recently diagnosed type 2 diabetes mellitus in black Africans

Abstract

Background: Albuminuria is long recognised as a sign of renal disease in diabetes. In type 1 diabetes, renal disease occurs after a longer duration of diabetic state. In type 2 diabetes, it is more variable. Objective: To determine the prevalence and any risk factors of albuminuria in short¬term (:Q yrs) type 2 diabetes. Design: Cross sectional, descriptive study. Microalbuminuria was assessed using micro II strips. Setting: Outpatient diabetic clinic at Kenyatta National Hospital, Nairobi. Subjects: Patients who were newly diagnosed or had had type 2 diabetes for two years or less. Main outcome measures: Microalbuminuria, lipids, glycated haemoglobin, fasting blood glucose and blood pressure. Results: One hundred and thirty nine patients who had type 2 diabetes mellitus for :Q yrs were seen, but only 100 patients were included in the study over a six month period. Their mean (SD) age was 53.7 (9.3) years. Mean (SD) duration of diabetes was 10.3 (7.5) months. Fifty per cent of the study patients were hypertensive. Only 48% had HbAIe <8% while 36% had HbAIc >9%. The lipid profile of total, LDL _ HDL¬cholesterol and triglycerides were predominantly within normal limits. Twenty six per cent were established to have albuminuria of which one patient had macroalbuminuria. Blood pressure, glycated haemoglobin and lipid parameters were not significantly different from patients without albuminuria Conclusion: Albuminuria occurred in a significant proportion of patients with short term type 2 diabetes. Comparable to studies done elsewhere on short-term type 2 diabetes, albuminuria is both a sign of nephropathy and a cardiovascular risk factor. It should be looked for in all patients with type 2 diabetes attending this clinic, even at diagnosis.