PARIS, September 10, 2003  (STAR) A global campaign to heighten awareness of the importance of screening people with type-2 diabetes for microalbuminuria (MAU), abnormal amounts of protein (albumin) in the urine which can be an early signal of kidney disease and of potentially increased cardiovascular risk, was presented recently at the 18th International Diabetes Federation Congress here.

The campaign is being conducted under the auspices of the International Diabetes Federation (IDF) and the International Society of Nephrology (ISN) in partnership with Sanofi-Synthelabo.

The global campaign, known as DEMAND (Developing Education on Microalbuminuria for Awareness of ReNal and Cardiovascular Risk in Diabetes), began with an initial international screening on June 23-27 and continues with a final screening on Sept. 8-12.

The campaign aims to screen more than 25,000 people with type-2 diabetes in several countries for the presence of MAU, the first warning sign of diabetic kidney disease. This is the first international campaign ever conducted to test for MAU in people with type-2 diabetes.

The campaign is being coordinated by a steering committee comprised of four leading international experts in the fields of diabetes and nephrology: Julia Lewis, M.D. (Vanderbilt University, Nashville, Tennessee); Hans-Henrik Parving, M.D., (Steno Diabetes Center, Copenhagen, Denmark); Mordechai Ravid, M.D. (Sackler Faculty of Medicine, Tel Aviv University, Israel); and Giuseppe Remuzzi, M.D. (Mario Negri Institute for Pharmacological Research and Ospedali Riuniti, Bergamo, Italy).

The results of the international screening will be compiled and analyzed by the steering committee and officially announced on World Diabetes Day (Nov. 14).

"People with type-2 diabetes who have persistent MAU are at high risk of developing serious kidney complications. Once it progresses to proteinuria, further decline of kidney function is inevitable. Unfortunately, life expectancy for patients with chronic kidney failure entering a dialysis program is approximately two years. The need for effective MAU screening in diabetic patients is therefore self-evident as it is critical to identify these patients so that appropriate steps can be taken to slow down this progressive process," said Lewis.

MAU testing

MAU can be measured by simple and potentially routine laboratory test – known as a "microalbuminuria dipstick test" – which is capable of detecting small quantities of urine albumin.

Annual MAU testing is recommended by the American Diabetes Association for all people with diabetes, although it is not widely practiced. Testing for MAU enables physicians to identify people who can benefit from appropriate treatment that slows progression to life-threatening kidney disease or some cardiovascular complications.

"In adults, the presence of persistent MAU suggests not only renal disease but also a heightened risk for heart attack and stroke. Although MAU does not cause cardiovascular disease, its presence does reflect damage of vascular walls. It is therefore a useful tool in determining which individuals require more intensive treatment and monitoring," said Parving.

Diabetes is a common disease. According to IDF estimates, it affects approximately 177 million people worldwide. The vast majority of these people have type-2 diabetes. The World Health Organization (WHO) predicts that this figure will increase to more than 300 million people in the next 25 years.

Type-2 diabetes, also referred to as adult-onset or non-insulin-dependent diabetes, is thought to result from at least two defects: the body’s development of a resistance to insulin and/or its inability to produce sufficient insulin.

Type-2 diabetes may account for about 90 to 95 percent of all diagnosed cases of diabetes. It is often associated with hypertension, obesity and abnormal cholesterol levels.

Type-2 diabetes and hypertension increase the risk of developing kidney disease (nephropathy) and cardiovascular complications, and patients who have both conditions are at even greater risk.

"The DEMAND campaign is a splendid example of how a professional organization, a patient association and the pharmaceutical industry can combine their global expertise and experience to serve the cause of public health," said Remuzzi.

The IDF is the only global advocate for people with diabetes and their healthcare providers while the International Society of Nephrology (ISN) pursues the worldwide advancement of education, science and patient care in nephrology.

Sanofi-Synthelabo is a global R&D-based pharmaceutical company dedicated to bringing innovative therapeutic solutions to patients and physicians worldwide and to addressing unmet medical needs in its core group of four therapeutic areas: cardiovascular disease and thrombosis, diseases of the central nervous system, oncology and internal medicine.

Campaign in Asia

The DEMAND campaign will be actively and extensively performed in Southeast Asian countries during the second week of September under the auspices of local correspondents of the IDF and ISN and other local associations deeply concerned about diabetes and its complications.

On Sept. 13, 31 hospitals in the Philippines, including key hospitals in Metro Manila, Cebu and Davao, are participating in a "Dipping Day" where people with type-2 diabetes will get the chance to have their urine samples screened for MAU for free.

This activity is in partnership with the Philippine Diabetes Association (PDA) and the Philippine Society of Nephrology (PSN).

Last Wednesday, the "Dipping Day" project was launched in a press conference at Annabel’s Restaurant in Quezon City by PDA president Dr. Rosa Allyn Sy, PSN vice president Dr. Albert Chua and Sanofi-Synthelabo Phils. president Peter Dolinsky.

(For a full list of participating hospitals, get in touch with the Medical Department of Sanofi-Synthelabo Phils. at 813-2156. You can also check your nearby hospital for postings or announcements.)

Reported by: Sol Jose Vanzi

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