title: Awareness of albuminuria in an Italian population-based cohort of patients treated with hypoglycemic drugs.
abstract: BACKGROUND
  Albuminuria is a powerful predictor of renal and cardiovascular outcomes in type 2 diabetes and a good indicator of the evolution of renal disease. Our aim was to obtain information concerning the identification of albuminuria as well as the utilization of antihypertensive, lipid-lowering and antiplatelet drugs in patients with diabetes.
  
  
  METHODS
  Subjects were enrolled from individuals registered with 3 Italian local health units by querying the drugs reimbursable, hospital laboratory investigation and hospital discharge databases. The determination of albumin to creatinine ratio (ACR) throughout 2007 and 2008 was defined as the index date. Patients who received at least 2 prescriptions of hypoglycemic drugs in the 12 months before the index date were classified as diabetics. We looked also for prescriptions of antihypertensive, lipid-lowering and antiplatelet drugs.
  
  
  RESULTS
  Among a population of 701,133 subjects, we identified 29,350 patients with diabetes (4.2% of the cohort). ACR had been determined in 5,644 diabetic subjects (19.2% of that cohort). The prevalence of determination of ACR in nontreated subjects was 16.0%, while in treated subjects, it ranged from 13.6% to 34.9% according to different schedules of treatment. Drugs acting on the renin-angiotensin system were prescribed in more then 80% of diabetics. The ratio of angiotensin receptor blockers to angiotensin-converting enzyme inhibitors regimen was 0.64 in subjects without determination of ACR, 0.88 in subjects with normal albuminuria, 1.02 in subjects with microalbuminuria and 1.43 in subjects with macroalbuminuria.
  
  
  CONCLUSIONS
  Our methodology can easily be applied to obtain an epidemiological view of albuminuria and pharmacological treatments of diabetics in a general population.
authors: CliCon S.r.l. Health, Economics and Outcomes Research, Ravenna, Italy. luca.degliesposti@clicon.it
authors: Luca
authors: L
authors: Degli Esposti
authors: Stefania
authors: S
authors: Saragoni
authors: Stefano
authors: S
authors: Buda
authors: Alessandra
authors: A
authors: Sturani
authors: Giuseppe
authors: G
authors: Quintaliani
authors: Sandra
authors: S
authors: Bartolucci
authors: Roberta
authors: R
authors: Di Turi
authors: Paolo
authors: P
authors: Lilli
authors: Guido
authors: G
authors: Didoni
authors: Ezio
authors: E
authors: Degli Esposti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D000704:Analysis of Variance; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D001364:Awareness; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D003928:Diabetic Nephropathies / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D018450:Disease Progression; D011307:Drug Prescriptions; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D015995:Prevalence; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D000959:Antihypertensive Agents; D007004:Hypoglycemic Agents; D000960:Hypolipidemic Agents; D010975:Platelet Aggregation Inhibitors