Evaluation of Microalbuminuria and Loss of Nocturnal Blood Pressure Dipping in Prediabetic Individuals: A Cross-sectional Study

Introduction: Diabetes can lead to serious problems, such as microvascular and macrovascular disorders. Pre-diabetes is a serious condition in which blood sugar levels are high but not high enough to be called diabetes mellitus a critical period for intervention to prevent disease progression. Timely identification of issues like microalbuminuria and changes in nocturnal blood pressure dipping patterns might yield significant insights into the pathophysiology of pre-diabetes and suggest potential therapeutic approaches. Aim: To determine the prevalence of microalbuminuria and abnormal nocturnal blood pressure dipping patterns among prediabetic individuals and to evaluate their relationship with gender. Materials and Methods: The cross-sectional study was conducted at the Department of General Medicine, SRM Medical College Hospital and Research Centre, Kattankulathur, Tamil Nadu, India encompassing both In-patient (IP) and Outpatient (OP) Departments from March 2024 to June 2024, on 110 prediabetic people, aged 18 years or older. The baseline tests were Fasting Blood Sugar (FBS), Oral Glucose Tolerance Test (OGTT), Glycated Haemoglobin (HbA1c), and lipid profile, which included Total Cholesterol (TC), Low-Density Lipoprotein (LDL), High Density Lipoprotein (HDL), Triglycerides (TG), and Very Low Density Lipoprotein (VLDL). The amounts of microalbumin in the urine and blood pressure were monitored for 24 hours to observe night-time BP dipping pattern. The statistical analysis was performed using SPSS (version 22.0). An Independent t-test and Chi-square test for correlation were employed, with p-value <0.05 being statistically significant. Results: The study comprised 110 prediabetic patients, with a mean age of 46.5±8.2 years; of whom 64 (58.2%) were male and 46 (41.8%) were female. No notable variations (p>0.05) were detected between males and females regarding glycaemic indicators (FBS, OGTT, HbA1c). Males had markedly elevated TG and reduced HDL levels; however, these variations were not statistically significant, and other lipid parameters exhibited similarity among genders. Microalbuminuria had a marginally greater prevalence in males (46.9%) than in females (41.3%); yet, this disparity was not statistically significant (p=0.86). A significant percentage of subjects (n=80; 72%) demonstrated either absent or irregular nocturnal blood pressure dropping patterns. Furthermore, microalbuminuria was more prevalent in those exhibiting irregular dipping patterns, observed in 46.5% of non dippers and 32.4% of inadequate dippers, in contrast to merely 16.7% among normal dippers, indicating a possible link between impaired night-time blood pressure regulation and early renal impairment in prediabetic patients. Conclusion: Regular examination of microalbuminuria and BP dipping in those who are prediabetic this may facilitate the early detection of cardiovascular and renal complications. No significant metabolic differences were observed between men and women, indicating that gender may not play a major role in metabolic risk among individuals with prediabetes.