title: Diagnosing microalbuminuria and consequences for the drug treatment of patients with type 2 diabetes: a European survey in primary care.
abstract: OBJECTIVE
  To assess general practitioners (GPs) knowledge of guideline recommendations on diagnosing microalbuminuria (MA) and to evaluate how this diagnosis influences drug treatment of diabetes patients.
  
  
  METHODS
  A postal case-history based questionnaire describing a male patient (previously not tested for MA) with type 2 diabetes who had several risk markers for cardiovascular disease.
  
  
  RESULTS
  2078GPs from nine European countries were included, with response rates varying from 7% to 43%. Almost all GPs recommended annual testing for MA. Forty-five to 77% (depending on country) of GPs required more than one positive test to diagnose MA. The absolute increase in the percentages of GPs who would supplement the patient's drug treatment if MA developed was: for anginotensin converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) 23-50% (depending on country), for statins 0-19%, for acetylsalicylic acid 2-13%, and for hypoglycemic agents (tablets and insulin) 0-33%. The proportion of GPs recommending all four possible treatment modalities was low.
  
  
  CONCLUSIONS
  Guidelines for diagnosing MA were partly followed. ACEIs and ARBs were recommended when MA was present, but the recommended multifactorial treatment of cardiovascular risk markers was not implemented.
authors.affiliation: Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway. kristin.moberg.aakre@helse-bergen.no
authors.forename: Kristin M
authors.initials: KM
authors.lastname: Aakre
authors.forename: Geir
authors.initials: G
authors.lastname: Thue
authors.forename: Sumathi
authors.initials: S
authors.lastname: Subramaniam-Haavik
authors.forename: John
authors.initials: J
authors.lastname: Cooper
authors.forename: Tone
authors.initials: T
authors.lastname: Bukve
authors.forename: Howard A
authors.initials: HA
authors.lastname: Morris
authors.forename: Mathias
authors.initials: M
authors.lastname: Müller
authors.forename: Marijana V
authors.initials: MV
authors.lastname: Lovrencic
authors.forename: Inger
authors.initials: I
authors.lastname: Plum
authors.forename: Kaja
authors.initials: K
authors.lastname: Kallion
authors.forename: Alar
authors.initials: A
authors.lastname: Aab
authors.forename: Marge
authors.initials: M
authors.lastname: Kutt
authors.forename: Philippe
authors.initials: P
authors.lastname: Gillery
authors.forename: Nathalie
authors.initials: N
authors.lastname: Schneider
authors.forename: Andrea R
authors.initials: AR
authors.lastname: Horvath
authors.forename: Rita
authors.initials: R
authors.lastname: Onody
authors.forename: Wytze
authors.initials: W
authors.lastname: Oosterhuis
authors.forename: Carmen
authors.initials: C
authors.lastname: Ricos
authors.forename: Carmen
authors.initials: C
authors.lastname: Perich
authors.forename: Gunnar
authors.initials: G
authors.lastname: Nordin
authors.forename: Sverre
authors.initials: S
authors.lastname: Sandberg
mesh_terms: D000419:Albuminuria / Q000175:diagnosis* / Q000188:drug therapy*; D003625:Data Collection; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires