Determination of XXXX in the urine of diabetics for prevention and control of @entity2316 .

@entity1 @entity8 @entity6 @entity2316 @entity458 @entity633 @entity164
THE ISSUE: @entity6 has become the main cause of @entity8 . The costs for the treatment of @entity6 @entity1 with @entity8 have increased in the last years and have become a relevant economic topic of the health service. The first unspecific predictor of a @entity2316 is an @entity633 . The screening for @entity2316 uses microalbuminuria as a proof. OBJECTIVES: What significance does the determination of @entity633 have on the precaution and course-control of the @entity2316 ?a) in @entity164 1 @entity6 patientsb) in @entity164 2 @entity6 patientsWhich is an appropriate time to determine the @entity633 for the purpose of precaution and course-control of the @entity2316 ?a) in @entity164 1 @entity6 patientsb) in @entity164 2 @entity6 patientsWhich method of testing is most effective concerning economic and medical aspects? METHODS: Published literature from 1998 up to 2004 was identified by searching in the most important databases. Most of the guidelines were found by hand searching in the internet. RESULTS: Of 2,792 citation titles and abstracts examined, 274 articles were retrieved for full-text review. Five metaanalyses and reviews, one review about clearing of guidelines (regarding 18 international guidelines) and four guidelines met the inclusion criteria for screening for microalbuminuria and @entity164 1 @entity6 . Seven metaanalyses, one HTA report, one review about clearing of guidelines (regarding 17 international guidelines), and seven guidelines met the inclusion criteria for screening for microalbuminuria and @entity164 2 @entity6 . At the moment, the determination of @entity633 still has a great significance because it is recommended in most published literature and guidelines. The time to determine the @entity633 depends on the age of the @entity1 and their @entity164 of @entity6 . Type 2 @entity6 @entity1 should start the determination when the @entity6 is diagnosed whereas the determination is recommended five years later when @entity164 1 @entity6 @entity1 are concerned. Most guidelines recommend a screening for microalbuminuria every year. DISCUSSION AND CONCLUSION: All guidelines and most of the literature recommend this screening. However, these recommendations are only based on expert consensus. The specificity of this screening is rather low. False positive tests in @entity164 2 @entity6 @entity1 will cause @entity458 . A positive test leads to the recommendation to achieve "normal blood pressure" and "normoglycaemia" - but this applies to each @entity6 @entity1 . Based on these facts, the screening for @entity633 in @entity164 1 or @entity164 2 @entity6 @entity1 cannot be recommended as long as benefit has not been demonstrated by large, clinical, controlled trials. Without an evidence of the benefit, this screening cannot be economic.
