Association Between Microalbuminuria And Severity Of Diabetic Retinopathy In Type 2 DM

1. Shankar Khanal¹
2. Jeevan Kumar Shrestha²
3. Sagun Narayan Joshi²
4. Dibya Singh³

¹Geta Eye Hospital, Kailali, Nepal
²B.P.Koirala Lions Centre For Ophthalmic studies, Tribhuvan University
³Institute Of Medicine, Tribhuvan University

Purpose
Diabetes is an important cause of blindness in adults. Early detection of vision threatning retinopathy can significantly decrease blindness. Current study aims to see the association between severity of diabetic retinopathy and microalbuminuria and if microalbuminuira can be used as an indicator for diabetic retinopathy in type2 DM.

Methods
It was a hospital based cross-sectional study. Diagnosed cases of Type 2 diabetes mellitus were included. Patients with recent UTI hematuria, renal, hepatic, cardiac disease, pregnancy, were excluded . Severity of diabetic retinopathy was graded according to ETDRS based International clinical diabetic retinopathy severity scale. Urine microalbumin assessed by turbidimetric immunoassay. Patients were subdivided into 3 categories as normal albuminuric,microalbuminuric and overt albuminuric according to urinary albumin. Cross tabulation was done between level of albumin and severity of diabetic retinopathy. Chi square test was applied to check for the significance.

Results
A Total no of 187 patients (374 eyes) were included in the study. Mean age was 53.87 yrs. Mean duration of DM was 4.52 yrs. 60% of patients had normal albuminuria, 31% had microalbuminuria and and 9% had overt albuminuria. 48.5% of the eyes had retinopathy changes at the time of examination.There was positive association between severity of diabetic retinopathy and microalbuminuria (p<0.01).

Conclusion
Microalbuminuria is positively associated with severity of diabetic retinopathy and it can be used as an early indicator of diabetic retinopathy.