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[Microalbuminuria in patients with type 2 diabetes mellitus in general practice]
L J Ubink-Veltmaat1, H J G Bilo, B Meyboom-de Jong
1Rijksuniversiteit, disciplinegroep Huisartsgeneeskunde, Groningen. l.j.veltmaat@isala.nl
Objective:
Determine the prevalence of microalbuminuria in patients with type 2 diabetes mellitus (DM) in general practice, as an independent risk factor for cardiovascular diseases.
Design:
Prospective, descriptive.
Method:
Data were collected on patients with type 2 DM in the Zwolle region of the Netherlands, all of whom were being treated by their general practitioner. The inclusion period was 1 February 2000-31 January 2001. The study formed part of a larger investigation, in which the albumin concentration in a urine sample and the albumin-creatinin ratio were determined once per year. A total of 32 general practitioners took part in the study.
Results:
In the general practices studied, 2094 patients were known with type 2 DM and 1653 (79%) were treated exclusively by the general practitioner. Of these 1653 patients, 67 (4%) were excluded and of the 1586 invited patients remaining, 1441 (91%) participated. Microalbuminuria was present in 33% of the patients and macroalbuminuria in 7% of the patients, and the prevalences increased with age: < 50, 50-70 and > 70 years. 18% (6/33) of the patients aged < 50 years with microalbuminuria were treated with an ACE inhibitor or angiotensin II antagonist compared to 33% (183/548) of patients > or = 50 years. 91% (488/539) of the patients > or = 50 years with microalbuminuria had hypertension and/or lipid profile abnormalities and 82% (402/488) of them were not treated or did not receive adequate treatment for this condition.
Conclusion:
Microalbuminuria and macroalbuminuria were present in respectively 33% and 7% of the patients with type 2 DM in primary care. The treatment of hypertension and lipid profile abnormalities was often inadequate. Therefore, screening patients aged 50 years and older with type 2 DM for albuminuria is justified.
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