Microalbuminurie bij patiënten met diabetes mellitus type 2 in de huisartspraktijk

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 ≥ 50 years. 91 (488/539) of the patients ≥ 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.