الفهرس 
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Abstract
The present study included 38 selected patients, with non insulin dependent diabetes mellitus (N.I D.D.) for more
than two years, they were classified into two groups according to the type of treatment. GrouP I : Included 24 patients, receiving cm hypoglycemic sulfonylureas; 14 patients were mule and 10 were female, with age range from 37 to 52 years. GrouP II: Included 24 patients, receiveng conventional
insulin therapy; 9 patients were mile and 5 were female, with age range from 38 to 50 years.
They were first investigated for renal i. exclusion of apparent cause of renal disea causes of microalbuminuria guided by the history, through clinical examination, analysis and serum creatinine.
Apairment with e and other
co..plete medical
urine
The aim of this study is to early detection of’ microalbuminuria in N.I.D.D. Patients and usc as an aid in
monitoring the development of incipient diabet:: nephropathy by radioimmunoassay.
And to compare the degree of microalbuminuria in both groups.
The results showed significant increase in microalbuminuria in patients of Group I receiving oral hypogloycemic sulfonylureas (mean value: 69.63 + 51.50 Ug/min) as compared to Group II (mean value: 31.29 + 25.33 Ug/min) P value < 0.02.
This significant increase may be plausible when we remember these factors:
- The microalbuminuria of diabetic patients is dependent on metabolic control which is clear in this work, since the results showed also significant increase in both Fasting and Post prandial blood glucose in patients of GroupI.receiving oral hypoglycemic sulfonylureas.
- The renal vasodilatory prostaglandins (P.Gs) have been shown to exert dramatic influence and have a protective role to preserve normal glomerular haemodynamics.
- In recent study demonstrate that oral hypoglycemic sulfonylureas produce a reversible impairment of renal function especially in patients with diabetic state more than 10 years.The cause of reversibility of renal function changes may be due to their P.G Synthesis inhibition.
The present study confirms the existence of a new entity, incipient diabetic nehropathy, characterized by abnormally increased urinary albumin excretion. Thus it is now possible to identify, early in the course of diabetes, patients prone to the development of renal disease, those are potentially treatable.
At present the only way of identifying patients at this stage is by screening for microalbuminuria which are already used for evaluating diabetes control.
Since microalbuminuria may be associated with poor metabolic control, at least in some patients , we can conclude that the presence of microalbuminuria will identify high risk patients those in need for both; improvement in metabolic control and careful follow-up for diabetic complication .
Estimation of microalbuminuria should possibly be considered as a routine investigation in the management of diabetic patients and can be considered as an early marker for diabetic nephropathy.