Cross-Sectional Study of Microalbuminuria and Glycated Hemoglobin (HbA1c) Screening in Diabetic Patients at Tertiary Care Hospital

Introduction: Diabetes mellitus is a prevalent endocrine disorder characterized by metabolic dysfunctions and long-term complications involving both microvascular and macrovascular systems. Its prevalence is rising rapidly, particularly in developing countries, posing a significant public health challenge. Diabetic nephropathy affects approximately 30% of patients with insulin-dependent diabetes mellitus and about 25% of those with non-insulin-dependent diabetes mellitus. This condition is marked by a progressive increase in proteinuria, especially albuminuria, accompanied by declining glomerular filtration rates and persistently elevated systemic blood pressure, often culminating in end-stage renal disease. This study aims to evaluate the prevalence of microalbuminuria in diabetes mellitus patients with HbA1C > 6.5% and analyze its association with age, sex, and duration of diabetes among patients attending Civil Hospital, Silvassa, DNH. Material and Method: This cross-sectional study was conducted at Civil Hospital, Silvassa, DNH, over six months (February to July 2019) to evaluate microalbuminuria and HbA1c levels in 50 diabetic patients (cases) and 50 non-diabetic individuals (controls). Diabetic patients were diagnosed using ADA criteria, including HbA1c > 6.5%, while controls had normal glucose tolerance. Participants underwent clinical evaluations, and samples were collected for microalbumin and HbA1c analysis using a Siemens EXL-200 analyzer. Data were statistically analyzed, with p < 0.05 considered significant. Result: In our study, diabetic patients (cases) had significantly higher mean microalbumin levels (36.3 ± 23.7 mg/L) and HbA1c levels (8.7 ± 1.7%) compared to non-diabetic controls (11.8 ± 5.5 mg/L and 5.9 ± 0.5%, respectively; p < 0.0001), indicating a strong correlation between poor glycemic control and increased microalbuminuria. Across all age groups, the majority of patients had microalbuminuria < 25 mg/L, though higher prevalence of microalbuminuria > 25 mg/L was noted in older age groups. No significant sex-based differences were observed for microalbumin or HbA1c levels (p > 0.75 and p > 0.76, respectively). The prevalence of microalbuminuria > 25 mg/L increased with longer diabetes duration, rising from 11.5% in patients with <5 years of diabetes to 80% in those with >10 years. These findings emphasize the impact of diabetes duration and glycemic control on renal function. Conclusion: Our study concludes that microalbuminuria significantly correlates with HbA1C levels >6.5% and increases with diabetes duration. However, no correlation was found between microalbuminuria levels and the age or sex of diabetic patients.