Association of Urinary Albumin with HbA1c Levels in Subjects of Type 2 Diabetes Mellitus in Central India

BACKGROUND Diabetes mellitus is a long-lasting illness, frequently getting diagnosed when complications appear. Natural course of diabetic nephropathy can be seen with no rmoalbuminuria to microalbuminuria, then to chronic renal disease through overt proteinuria. Microalbuminuria is a renal marker of generalized vascular endothelial damage and early atherosclerosis. Patients having microalbuminuria are at higher risk of vascular complications of diabetes mellitus like myocardial infarction, cerebrovascular accident and diabetic nephropathy. Poor glycaemic control increases the risk of microalbuminuria. This is the reason why urinary albumin is used as a sensitive marker of diabetic nephropathy. The present study aimed to correlate the HbA1c levels with urinary albumin in subjects of type 2 diabetes mellitus. METHODS A cross sectional study was done at a tertiary care hospital. We studied 200 diagnosed subjects of type 2 diabetes mellitus. Depending on their urinary albumin excretion, they were categorized into 2 groups - groups 1 and 2. Group 1 and Group 2 subjects had a mean age of 43.75 +/- 5.95 years and 51.06 +/- 7.94 years respectively. Group 1 and 2 subjects had 7.06 +/- 0.56 (%) and 8.27 +/- 1.30 (%) of HbA1c respectively. RESULTS HbA1c levels were compared in Group 1 (7.06 +/- 0.56) and Group 2 (8.27 +/- 1.30) and the difference was statistically significant (p value = 0.0001, S). We found positive correlation between urinary albumin and HbA1c in Groups 1 (r = 0.255) and Group 2 (r = 0.417). CONCLUSIONS Constant rise in glycated haemoglobin and micro albuminuria may be considered as risk factors in diabetic nephropathy. Therefore, regular screening for HbA1c and urinary albumin must be done as an early marker of renal dysfunction.