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From Tobyhanna, Pennsylvania, USA:

My eight year old son, diagnosed with type 1 diabetes three years ago, has a hemoglobin A1c of 6.9%, and his microalbumin was 2.4 mg/dl with a microalbumin/creatinine ratio of 39.0 mg/g which is high. His endocrinologist is going to check this again in about a month. What does this mean for my son?


I would need much more information to make any judgements about these lab values. If you have continued questions about these lab results, I would suggest discussing them with your pediatric endocrinologist.


[Editor's comment: According to the 2000 ISPAD Consensus Guidelines for the Management of Insulin-Dependent (Type 1) Diabetes (IDDM) in Childhood and Adolescence:

  • The 95th centile for albumin excretion in non-diabetic children is 7.2-7.6 µg/min
  • Persistent microalbuminuria is defined in a minimum of two out of three consecutive urine specimens
    Albumin excretion rate (AER) 20-200 µg/min in timed overnight urine collections
    AER 30-300 mg/24 h in 24-h urine collections
  • Alternative definitions
    Albumin/creatinine ratio (ACR) 2.5-25 mg/mmol (spot urine) (Europe)
    [3.5-25 mg/mmol has been proposed in females because of lower creatinine excretion] ACR 30-300 mg/g (spot urine) (North America)
    Albumin concentration 30-300 mg/l (early morning urine)

Other causes of microalbuminuria need to be excluded, e.g. glomerulonephritis, urinary tract infection, intercurrent infections, menstrual bleeding, vaginal discharge, orthostatic proteinuria and strenuous exercise
Microalbuminuria screening
  • Screening may be performed by early morning urine albumin concentration or spot urine ACR or by timed urine collection
  • Abnormal screening values should be confirmed by repeated sampling to demonstrate persistent microalbuminuria

Original posting 7 Apr 2003
Posted to Complications


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Last Updated: Tuesday April 06, 2010 15:09:44
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