Akhil, P C (2010) Study of Microalbuminuria and Retinopathy in Pre-diabetes. Masters thesis, Coimbatore Medical College, Coimbatore.
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Abstract
The present study evaluated the prevalence of microalbuminuria and retinopathy in pre-diabetic patients and correlation between microalbuminuria,retinopathy with age,smoking and aiso levels of fasting blood sugar and OGTT. Prevalence : The prevalence of microalbuminuria in this study was 10% and that of retinopathy was 6.5%.The prevalence of microalbuminuria is more in IGT(15.5%) compared to IFG(6%). A similiar study by WangXL etal showed a prevalence of microalbuminuria as 11.1% in IGT and 5.8 % in IFG.When the blood sugar rises in the pre-diabetic range in IFG and IGT the prevalence of microalbuminuria also rises. The prevalence of retinopathy was also more in IGT(12%) compared to IFG(3-6%). The prevalence was higher in those with higher blood sugar both in IFG and IGT. The DPP Outcome Study(Diabetes Prevention Program) showed a prevalence of retinopathy as 7.6% in those with pre-diabetes using Fasting blood glucose.A higher proportion of patients with retinopathy had microalbuminuria and association prevalence was statistically significant. Sex distribution of microalbuminuria and retinopathy: In the present study, for both microalbuminuria and retinopathy there was no significant difference of prevalence in men and women. In the HUNT study (Norway) a stronger association was observed between microalbuminuria and mortality in men than in women. In this study the interaction between sex and Albumin creatinine Ratio (ACR) was statistically significant (p= 0.003) and supported a sex difference, women had more prevalence. They attributed this difference to the higher incidence of asymptomatic UTI in women. They suggested the need for different ACR cut off values in men and women – because men have greater muscle mass and higher creatinine excretion than women although albumin excretion levels are equal. (HUNT – Nord Trondelag Health Study). The prevalence of microalbuminuria and retinopathy was not statistically higher in the older age groups.The present study also looked into the relation between microalbuminuria and other risk factors for cardiovascular disease like smoking. No significant correlation was observed between smoking and microalbuminuria. This observation is discordant with that seen in previous studies on this aspect. One possible explanation for this variability – may be an error in the classification of smokers and non smokers – this was done on the basis of history. CONCLUSIONS : 1.Pre-diabetes is a mounting health problem in the community early diagnosis and intervention delay the onset of diabetes and the microvascular complications. 2.The microvascular complications like retinopathy and microalbuminuria starts in the pre-diabetic stage itself. 3.Prevalence of microalbuminuria and retinopathy was more in IGT when compared to IFG. 4.There is significant correlation between microalbuminuria and retinopathy in prediabetic patients. 5.The IGT is more important cardiovascular risk factor than IFG. 6.Further studies including large population are needed to know the prevalence of retinopathy and microalbuminuria in pre-diabetic individuals.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Microalbuminuria ; Retinopathy ; Pre-diabetes. |
| Subjects: | MEDICAL > General Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 17 Feb 2018 18:45 |
| Last Modified: | 17 Feb 2018 18:45 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/5837 |
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