[Microalbuminuria in diabetes: setting the points for treatment]

Abstract

Both type 1 and type 2 diabetes mellitus have a cumulative risk of 25-40% for the development of microalbuminuria 25 years into the disease. In type 2 diabetes micro- and macroangiopathic complications, and frequently hypertension, may also develop. This means that the risk of a type 2 diabetic with microalbuminuria of developing cardiovascular disease is three times greater than that of a diabetic with no renal involvement. Annual screening for microalbuminuria should therefore be obligatory. An increasing albumin excretion rate (AER) is considered an indication for an elevated cardiovascular risk. Studies have shown that the rate of cardiovascular events in diabetics with microalbuminuria and hypertension can be reduced only by the combined treatment of hypertension, hyperglycemia, hyperlipidemia and microalbuminuria.