Association of Microalbuminuria with Glucose Levels, Microvascular and Macrovascular Complications in Relation with Blood Pressure in Diabetes Mellitus Type 2

Objectives: Determine the association of Microalbuminuria (MAU) with glucose markers, micro vascular and macrovascular complications in relation with blood pressure in patients with type 2 diabetes mellitus. Material and Method: This study was cross sectional study and data collected in Chemical laboratory of pathology department of Dr Akbar Niazi Teaching Hospital. It carried out during the time period of December 2021 to January 2022. Patients were divided into 2 groups which fulfill the inclusion and exclusion criteria patients having diabetes mellitus type 2 with good glucose control, HbA1c < 7% (n=33) patients having diabetes mellitus type 2 with bad control HbA1c ≥7% (n=33) each group were further divided into 2 sub-groups Patients with Pre-hypertension (n) and patients with HTN (n). The sampling technique of this study was non-probability convenience sampling was done. Data/Documentation was collected by Performa and laboratory investigation. Spss version 21 used to analyze the data. Normality of data was assessed by KS test. Quantitative test was measured as mean and standard deviation. Qualitative variables were calculated as number percentage. ANCOVA test and chi square test were used for comparison of quantitative and qualitative variables respectively. Pearson correlation was applied to determine the association of MAU with glucose levels and diabetes related complications. Result: Among total 66 patients, the sample of patients were included 47 males (71.2%) and 19 females (28.8%). Patients of type 2 diabetes mellitus in HbAlc ≥7% group showed higher levels of Blood Glucose level, MAU, Systolic BP and Diastolic BP as compared to HbA1c < 7% group. The comparison of the variables between 2 groups showed statistical differences in nephropathy and cardiovascular complications. In HbA1c ≥ 7% group, correlation of MAU with Systolic BP, Diastolic BP, Fasting Blood Glucose (FBG), HbA1c, Nephropathy, and Cardiovascular events were statistically significant. In Pre-HTN group, MAU was significantly correlated with Fasting blood glucose level, HbA1c, Nephropathy and cardiovascular complications. Patients of HTN showed more significant association with blood pressure (BP), Blood Glucose, HbA1c, Cardiovascular events with MAU as evident by higher r-values as compared to pre-HTN group. Regarding nephropathy, r-value was slightly higher in Prehypertensive group. Conclusion: Patients with uncontrolled diabetes mellitus have increased risk of developing HTN, MAU as well as diabetes related complication including nephropathy and cardiovascular events. More over MAU showed significant positive association with BP, blood glucose levels, nephropathy and cardiovascular events. Both pre- hypertensive and hypertensive patients showed significant positive association of MAU with blood glucose levels and diabetes related complication including nephropathy and cardiovascular events. This study suggested that Prehypertensive and hypertensive patients with altered blood glucose levels have increased risk of MAU, that why proper evaluation and treatment of MAU may lead to early diagnosis and decrease progression of HTN, diabetes mellitus type 2 and its related complications.