IMPACT OF HYPERGLYCEMIA AND DIABETIC NEPHROPATHY ON PLASMA N-TERMINAL PRO- BRAIN NATRIURETIC PEPTIDE IN PATIENTS OF TYPE 2 DIABETES MELLITUS

Abstract

Background: This study aimed to assess NT-pro BNP level and its correlation with glycaemic
control and diabetic nephropathy in patients of T2DM without overt cardiovascular disease.
Methods: This study conducted at SMS Hospital, Jaipur by selecting 120 patients of type 2
diabetes mellitus. Information regarding demographic data, clinical symptoms, past medical
history, laboratory parameters, NT pro-BNP and 24 h urine protein collected from selected
sample population.
Results: The mean value of fasting (140.48 mg/dL) and post-prandial blood sugar (206.64
mg/dL), HbA1c (8.18%), NT pro-BNP (748.58 pg/mL), creatinine (1.24 mg/dL), 24 h urine
protein (398.28 mg/24 h) were found to be significantly raised in selected patients of T2DM.
94% patients had underlying proteinuria among which nearly one third of patients had
microalbuminuria while remaining two third had macroalbuminuria. Absolute value of NT-pro
BNP in patients of T2DM had positive correlation with age of patients („r‟= +0.2984,
p=0.0009), duration of diabetes („r‟= +0.3165, p=0.0004), fasting blood sugar („r‟=+0.6841,
p<0.001), post prandial blood sugar („r‟ =+0.2043, p=0.0252), HbA1c („r‟ =+0.6858 and
p<0.001) creatinine („r‟ =+0.4563, p<0.001) and 24 hours urinary protein („r‟ =+0.7921,
p<0.001).
Conclusion: Heart failure in patients with T2DM is a most crucial diabetic complication for
diagnosis as well as management. NT-pro BNP level in blood stream had an important role for
early diagnosis of heart failure. This study suggest that the secretions of NT-pro BNP is
increased in patients with T2DM having poor glycemic control, raised fasting or postprandial
blood sugar and diabetic nephropathy. Therefore, measurement of HbA1c, fasting or
postprandial blood sugar and 24 h urine proteins are the simple screening tool to identify
patients with diabetes at risk for ventricular dysfunction requiring further examination with NT
pro-BNP and echocardiography.