The rates and associations of albuminuria in pregnant women with type 2 Diabetes (T2DM) have not previously been described in Australian Indigenous women, a population at high risk of diabetes and chronic kidney disease.
To assess rates of albuminuria and define clinical characteristics of Indigenous and non-Indigenous women with T2DM in pregnancy.
We report preliminary data for 74 pregnant women with T2DM (from 465 pregnant women with any type of diabetes) from the prospective and ongoing Pregnancy and Neonatal Diabetes Outcomes from Remote Australia (PANDORA) Study. Albuminuria (first available Urine Albumin-Creatinine Ratio, ACR) was analysed as microalbuminuria (3.5 -25 umol/L) and macroalbuminuria (> 25 umol/L). ACR results were available for 50 Indigenous and 15 non-Indigenous women with T2DM in pregnancy. The non-Indigenous group included Europid women and those from other high risk groups (Indian Sub-continent and Asia). Women with type 1 diabetes mellitus and gestational diabetes were excluded from this analysis.
Of the 74 women with T2DM 59 were indigenous and 15 non-Indigenous. The proportion of T2DM in pregnancy (32.8% vs 5.2 %) was higher among Indigenous women. Indigenous women with T2DM had poorer first-trimester glycaemic control (median HbA1c 7.0 % vs 6.1 %), higher rate of smoking (35 % vs 0 %), higher first-trimester BMI (30.7 vs 28.6 kg/m2), were more likely to live in regional/remote NT (73% vs 0%) than non-Indigenous women. Among 59 Indigenous women, 22 % had microalbuminuria, 32 % had macroalbuminuria; whereas of 15 non-Indigenous women, 6.7% had microalbuminuria and 20% had macroalbuminuria. Baseline and subsequent creatinine levels were comparable between the groups.
Recruitment to PANDORA is on-going. Preliminary data reveal higher rates of T2DM in pregnancy among Indigenous than non-Indigenous women. Both micro and macroalbuminuria were common in Indigenous women with T2DM in pregnancy.