For patients with T1D, a personalized alternative to annual urinary albumin screening can reduce the time spent with undetected kidney disease, according to a study published in Diabetes Care. Bruce A. Perkins, MD, and colleagues used urinary albumin excretion measurements to establish risk profiles and evaluate the optimal frequency of urinary albumin screening in T1D. Individualized screening schedules were identified based on the likelihood of onset of moderately or severely elevated albuminuria. The 3-year cumulative incidence of elevated albuminuria following normoalbuminuric was 3.2% at any time during the study, which was strongly associated with higher A1C and with albumin excretion rate (AER). Compared with annual screening, personalized screening in 2 years for those with current AER of 10 mg/24 hours or lower and A1C of 8% or lower (low risk), in 6 months for those with AER 21-30 mg/24 hours or A1C of at least 9% (high risk), and in 1 year for all others (average risk) was associated with a decrease of 34.9% in time spent with undetected albuminuria and a 20.4% decline in testing frequency.
