Methodology: 280 T2DM patients aged 18-75 years irrespective of their A1c, on standard glucose lowering, lipid lowering and BP lowering therapy were divided into 2 groups, group 1N (105 patients normoalbuminuria UACR <30) and group 2M (175 patients microalbuminuria eUACR >30). Both groups were followed-up for 2 years and assessed every 3-6 months for for renal (creatinine, eGFR, UACR) and CV (BP, BMI, Lipid profile, hs-CRP, NTProBNP) parameters. Patients with history of major surgery, coronary intervention, IHD or hospitalization in last 1 year, eGFR <45, potassium >5.3 were excluded. Data was analyzed using PSPP version 1.0.1 and represented as Mean (SD) and paired t-test was used, P-value of 0.01 was considered to be significant.

Results: Baseline treatment characteristics were well matched. For BP, use of ARB was 82.9% (1N) and 96.1% (2M) group, CCB was 35.2% (1N) and 61.2% in (2M) group. At Baseline SBP (2M 139.17±22.35 vs. 1N 131.91 ±14.66, p<0.001), Cr (2M 1.02 ±0.29 vs. 1N 0.91 ±0.23, p<0.001), UACR (2M 429.69 ±1214.86 vs. 1N 11.08 ±5.87), Non-HDL (2M 101.29 ±44.5 vs. 1N 85.83 ±30.87, p-0.001 were higher in 2M group. In both group there was a significant reduction in A1c, TC, LDL, TG, non-HDL, hsCRP. In addition, mean chol remnant 12.56 (95% CI 8.60-16.51 p <0.001) and UACR 215.97 (95% CI 88.70-343.23, p-0.001) reduced significantly in 2M group. At the end of 2 years mean SBP (2M 135.9 ±17.34 vs. 1N 128.58 ±15, p<0.001), potassium (2M 4.63 ±0.5 vs. 1N 4.46 ±0.44, p-0.007), UACR (2M 218.82 ±622.48) vs. 1N 11.80 ±7.54) was higher in 2M group. The NTproBNP was elevated in both groups (1N 136.57 ±202.14 vs. 2M 176.40 ±252.38, p-0.17).

Conclusion: Patients with eUACR had a significantly elevated SBP, non-HDL cholesterol, and creatinine, compared to nUACR at baseline. Despite CV risk factor optimization systolic-BP remained significantly higher in eUACR group. NTProBNP remained high in both groups although it trended to be slightly elevated in eUACR group although it was statistically NS.

Disclosure

V. Gupta: None. V. Teli: None.

© 2019 by the American Diabetes Association.
2019
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