Incipient Albuminuria in Persons with Newly Diagnosed Type 2 Diabetes Mellitus: A 5-Year Retrospective Cohort Study.
- Author:
Shermin TAN
1
;
Lai Yin WONG
;
Matthias Paul Hs TOH
Author Information
1. Chronic Disease Epidemiology, Population Health, National Healthcare Group, Singapore.
- Publication Type:Journal Article
- MeSH:
Adult;
Age of Onset;
Aged;
Albuminuria;
epidemiology;
Angiotensin Receptor Antagonists;
therapeutic use;
Angiotensin-Converting Enzyme Inhibitors;
therapeutic use;
Cohort Studies;
Diabetes Mellitus, Type 2;
diagnosis;
epidemiology;
metabolism;
Disease Progression;
Female;
Glycated Hemoglobin A;
metabolism;
Humans;
Hypertension;
drug therapy;
epidemiology;
Logistic Models;
Male;
Middle Aged;
Retrospective Studies;
Risk Factors;
Singapore;
epidemiology
- From:Annals of the Academy of Medicine, Singapore
2018;47(12):502-508
- CountrySingapore
- Language:English
-
Abstract:
INTRODUCTION:This study aimed to determine the 5-year incidence of albuminuria among Asian persons with newly diagnosed type 2 diabetes mellitus (DM), and to identify the risk factors at diagnosis for progression to albuminuria.
MATERIALS AND METHODS:A retrospective 5-year closed cohort study was conducted among 1016 persons aged ≥18 years old who were diagnosed with type 2 DM between 1 January 2007 and 31 December 2009 at primary care facilities in Singapore. The cumulative incidence of progression from normoalbuminuria to albuminuria-termed "progression"-was determined. The risk factors associated with progression were evaluated using multiple logistic regression analysis.
RESULTS:A total of 541 (53.2%) participants were men. The mean (SD) onset age of type 2 DM was 54 (11) years. From diagnosis of type 2 DM, the 5-year cumulative incidence of progression was 17.3% and mean (SD) duration to progression was 2.88 (1.23) years. Higher onset age (OR 1.02; 95% CI, 1.00-1.04), history of hypertension (OR, 1.88; 95% CI, 1.32-2.70) and higher glycated haemoglobin (HbA1c) (OR, 1.17; 95% CI, 1.09-1.26) at diagnosis were associated with progression. In addition, being on angiotensin converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) treatment at baseline modified the effect of hypertension on progression.
CONCLUSION:This study highlighted the importance of early screening and treatment of diabetes as well as prevention of hypertension, which could potentially delay the onset of microalbuminuria in persons with type 2 DM. Persons on ACEI or ARB treatment should continue to be monitored regularly for progression to albuminuria.
