Albuminuria, cardiovascular risk factors and disease management in subjects with type 2 diabetes: a cross sectional study

Background: Epidemiological studies have shown that
microalbuminuria is an important risk factor for arteriosclerosis,
coronary heart disease and other vascular diseases in persons with
type 2 diabetes. In the present study we examined the prevalence
and risk factors for micro- and macroalbuminuria and examined
glycemic control as well as treatment of modifiable cardiovascular
risk factors in persons with known type 2 diabetes in Germany.
Methods: The presented data were derived from the `KORA Augsburg
Diabetes Family Study', conducted between October 2001 and
September 2002. Participants were adults aged 29 years and older
with previously diagnosed type 2 diabetes (n = 581).
Microalbuminuria was defined as an albumin-creatinine ratio of 30
to 300 mg/g, and macroalbuminuria as an albumin-creatinine ratio of
more than 300 mg/g. Results: Microalbuminuria was revealed in 27.2%
and macroalbuminuria in 9.0% of the 581 included diabetic persons.
Multivariable regression analysis identified HBA1c, duration of
diabetes, systolic blood pressure, serum creatinine, smoking and
waist circumference as independent risk factors associated with
albuminuria (micro- or macroalbuminuria). Relatively few persons
with type 2 diabetes achieved treatment targets of HbA1c < 7%
(46.6%), total cholesterol < 200 mg/dl (44.1%), and LDL
cholesterol < 100 mg/dl (16.0%). Optimal HDL cholesterol values
(> 45 mg/ dl in men, > 55 mg/ dl in women) were found in
55.8%, and blood pressure values < 130 and < 85 mmHg in 31.3%
of the persons Conclusion: Albuminuria is common among German
persons with known type 2 diabetes. Despite evidence-based
guidelines, only a small proportion of type 2 diabetic persons
achieved the recommended levels of glycemic control and control of
cardiovascular risk factors.