Screening for microalbuminuria in patients with type 2 diabetes is incomplete in general practice

INTRODUCTION: National Danish guidelines recommend screening for microalbuminuria with assessment of urinary albumin/creatinine ratio at least annually in patients with type 2 diabetes. To which extent such screening is actually performed is not known. MATERIAL AND METHODS: A total of 2,057 patients with type 2 diabetes were randomly selected from 64 general practitioners (GPs) from different geographical areas of Denmark.

Clinical and laboratory data on the individual patients were collected through the GPs' electronic medical patient records; particular emphasis was given to annual screening for microalbuminuria. RESULTS: The mean age of the patients was 66.2 +/- 11.6 years and 58.7% were male. Only 57.2% of the patients had been screened for microalbuminuria with any method within the preceding 12 months period; of these 76.0% had normo- and 21.0% had microalbuminuria, whereas 3.0% had overt proteinuria.

In contrast, 97.6% of patients had had a minimum of one plasma-creatinine measurement within the past year. CONCLUSION: In Danish primary care, screening for microalbuminuria in type 2 diabetes is insufficiently implemented, whereas renal function is evaluated in almost all patients by plasma-creatinine measurements.

The importance of diagnosing microalbuminuria in patients with type 2 diabetes needs to be emphasised.