Association of Glycated Hemoglobin and Microalbuminuria with Renal Function Parameters in Type 2 Diabetic Patients
HbA1C: Microalbuminuria Function in Type 2 Diabetic Patients
DOI:
https://doi.org/10.54393/pjhs.v6i5.2988Keywords:
Diabetic Nephropathy, Type 2 Diabetes, HbA1C, MicroalbuminuriaAbstract
One of the most serious complications of type 2 diabetes (T2DM) is diabetic nephropathy, which can eventually lead to kidney failure. While microalbuminuria is commonly used to detect early kidney damage, relying on it alone may not be enough. Additional markers could help improve early detection and timely treatment. Objectives: To look at how HbA1C levels, a key indicator of blood sugar control, relate to microalbuminuria in people with T2DM. Also, to explore how HbA1C correlates with other markers of kidney function, including the albumin-to-creatinine ratio (ACR), serum urea, creatinine, fasting blood sugar (FBS), and random blood sugar (RBS). Methods: The study included 250 participants: 200 patients with T2DM and 50 healthy individuals matched by age and sex. Those with hypertension, kidney disease, urinary tract infections, or other health issues were excluded. Blood and urine samples were collected. Hemoglobin A1C was measured using high-performance liquid chromatography (HPLC), and A1C was calculated. Data were analyzed using SPSS-20, and correlations were assessed with Pearson’s coefficient. Results: Compared to healthy controls, diabetic patients had significantly higher levels of FBS, RBS, HbA1C, serum urea, creatinine, and microalbuminuria. Higher HbA1C levels were linked with worse kidney function, suggesting that poor blood sugar control may signal early kidney damage. Conclusions: It was concluded that monitoring both HbA1C and microalbuminuria offers a better chance of catching kidney problems early in T2DM patients. Adding both markers to routine screenings could help delay or prevent serious kidney issues.
References
Wagnew F, Eshetie S, Kibret GD, Zegeye A, Dessie G, Mulugeta H et al. Diabetic Nephropathy and Hypertension in Diabetes Patients of Sub-Saharan Countries: A Systematic Review and Meta-Analysis. BioMed Central Research Notes. 2018 Dec; 11: 1-7. doi: 10.1186/s13104-018-3670-5.
Abdul Basith Khan M, Hashim MJ, King JK, Govender RD, Mustafa H, Al Kaabi J. Epidemiology of Type 2 Diabetes—Global Burden of Disease and Forecasted Trends. Journal of Epidemiology and Global Health. 2020 Mar; 10(1): 107-11. doi: 10.2991/jegh.k.191028.001.
Asghar S, Asghar S, Mahmood T, Bukhari SM, Mumtaz MH, Rasheed A. Microalbuminuria as the Tip of the Iceberg in Type 2 Diabetes Mellitus: Prevalence, Risk Factors, and Associated Diabetic Complications. Cureus. 2023 Aug; 15(8). doi: 10.7759/cureus.43190.
Arshad MS, Alqahtani F, Rasool MF. The Economic Burden of Type 2 Diabetes Mellitus in Pakistan: A Cost of Illness Study. In Healthcare. 2024 Sep; 12(18): 1826. doi: 10.3390/healthcare12181826.
Azeem S, Khan U, Liaquat A. The Increasing Rate of Diabetes in Pakistan: A Silent Killer. Annals of Medicine And Surgery. 2022 Jul;79. doi: 10.1016/j.amsu.2022.103901.
Nasir M, Razzaque R, Afzal S. Epidemiology of Diabetes Mellitus, Pre-Diabetes, Undiagnosed and Uncontrolled Diabetes in Pakistan. World Journal of Pharmaceutical Research. 2023; 12(9): 162-169.
Campos-Pastor MM, Escobar-Jimenez F, Mezquita P, Herrera-Pombo JL, Hawkins-Carranza F, Luna JD et al. Factors Associated with Microalbuminuria in Type 1 Diabetes Mellitus: A Cross-Sectional Study. Diabetes Research and Clinical Practice. 2000 Apr; 48(1): 43-9. doi: 10.1016/S0168-8227(99)00133-3.
Prakash S and Yadav K. Mi-croalbuminuria in Diabetes. Letters In Health and Biological Sciences. 2017; 2(1).
Basavaraj RG and Malladad R. Correlation of Glycosylated Hemoglobin with Urinary Albuminuria for Early Detection and Progression of Nephropathy in Patients with Type 2 Diabetes Mellitus. Indian Journal of Pathology and Oncology. 2023 Jan; 8(4): 433-6. doi: 10.18231/j.ijpo.2021.090.
Thethi TK and Batuman V. Challenging the Conventional Wisdom on Diabetic Nephropathy: Is Microalbuminuria The Earliest Event? Journal of Diabetes and Its Complications. 2019 Mar; 33(3): 191-2. doi: 10.1016/j.jdiacomp.2018.12.006.
Hoogeveen EK. The Epidemiology of Diabetic Kidney Disease. Kidney and Dialysis. 2022 Aug; 2(3): 433-42. doi: 10.3390/kidneydial2030038.
Khan A, Cheema MF, Fatima R, Cheema SS, Butt Z, Gillani S et al. Prevalence of Chronic Kidney Disease in A High-Risk Population in Urban Lahore, Pakistan: A Cross-Sectional Study. Cureus. 2024 Jun; 16(6). doi: 10.7759/cureus.63296.
Munir A, Gulzar S, Afzal A, Zahid MA, Khan MA, Khan NU et al. Prevalence of Diabetic Nephropathy among Patients of Type 2 Diabetes at Tertiary Care Hospital Lahore. Journal of Health and Rehabilitation Research. 2024 Jun; 4(2): 1607-11.doi: 10.61919/jhrr.v4i2.1108.
Sherwani SI, Khan HA, Ekhzaimy A, Masood A, Sakharkar MK. Significance of HbA1c Test in Diagnosis and Prognosis of Diabetic Patients. Biomarker Insights. 2016 Jan; 11: BMI-S38440. doi: 10.4137/BMI.S38440.
Gluhovschi C, Gluhovschi G, Petrica L, Timar R, Velciov S, Ionita I et al. Urinary Biomarkers in the Assessment of Early Diabetic Nephropathy. Journal of Diabetes Research. 2016; 2016(1): 4626125. doi: 10.1155/2016/4626125.
Mukherjee S, Ray SK, Jadhav AA, Wakode SL. Multi-Level Analysis of HbA1c in Diagnosis and Prognosis of Diabetic Patients. Current Diabetes Reviews. 2024 Sep; 20(7): 85-92. doi: 10.2174/0115733998262501231015051317.
Sulaiman MK. Diabetic Nephropathy: Recent Advances in Pathophysiology and Challenges in Dietary Management. Diabetology and Metabolic Syndrome. 2019 Dec; 11: 1-5. doi: 10.1186/s13098-019-0403-4.
Hill NR, Fatoba ST, Oke JL, Hirst JA, O’Callaghan CA, Lasserson DS et al. Global Prevalence of Chronic Kidney Disease–A Systematic Review and Meta-Analysis. PLOS ONE. 2016 Jul; 11(7): e0158765. doi: 10.1371/journal.pone.0158765.
Valencia WM and Florez H. How to Prevent the Microvascular Complications of Type 2 Diabetes Beyond Glucose Control. British Medical Journal. 2017 Jan; 356. doi: 10.1136/bmj.i6505.
Yadav D, Kochar B, Mathur A, Chougle A. Prevalence of Microalbuminuria in Type 2 Diabetes Mellitus: A Hospital-Based Study. International Journal of Research –Granthaalayah. 2017; 5(12): 217-22. doi: 10.29121/granthaalayah.v5.i12.2017.496.
Dereje D. Using Microalbuminuria as Early Screening Tool for Prevention of Renal Disease Progression in Diabetes Mellitus: A Review Article of Current Insights. EC Microbiol. 2021; 17: 35-40.
Sung JY, Chen CI, Hsieh YC, Chen YR, Wu HC, Chan L et al. Comparison of Admission Random Glucose, Fasting Glucose, and Glycated Hemoglobin in Predicting the Neurological Outcome of Acute Ischemic Stroke: A Retrospective Study. PeerJ. 2017 Feb; 5: e2948. doi: 10.7717/peerj.2948.
Chawla S, Trehan S, Chawla A, Jaggi S, Chawla R, Kumar V et al. Relationship Between Diabetic Retinopathy Microalbuminuria and Other Modifiable Risk Factors. Primary Care Diabetes. 2021 Jun; 15(3): 567-70. doi: 10.1016/j.pcd.2021.01.012.
Chowdhury SK, Datta S, Mohith MT, Roy S, Hossain MJ, Zafrin N et al. Study of Relationship Between HbA1c and Microalbuminuria of Diabetic Patients. Annals of International Medical and Dental Research. 2022;8(2):99-108. doi: 10.53339/aimdr.2022.8.2.14.
Mohammed O, Alemayehu E, Bisetegn H, Debash H, Gedefie A, Ebrahim H et al. Prevalence of Microalbuminuria Among Diabetes Patients in Africa: A Systematic Review and Meta-Analysis. Diabetes, Metabolic Syndrome and Obesity. 2023 Dec: 2089-103. doi: 10.2147/DMSO.S409483.
Mohammad P and Khan EH. Unnoticed Microalbuminuria Is Substantially Prevalent in Patients of Type-2 Diabetes Mellitus in Peshawar. Journal of Saidu Medical College. 2019 Jun; 9(1).
Maric C and Hall JE. Obesity, Metabolic Syndrome and Diabetic Nephropathy. Contributions to Nephrology. 2011 Jun; 170:28. doi: 10.1159/000324941.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Pakistan Journal of Health Sciences
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments
