From Kansas City, Missouri, USA:
I have had type 1 diabetes for 22 years. My A1c's are around 6.1 to 6.8. I am also a professional athlete, a fitness competitor. My sport, if you are unfamiliar with it, combines bodybuilding with sport aerobics,so nutrition and weight training are crucial. Although my diabetes is in great control, my last microalbumin test was horrible. What all affects the test? I had an intense workout the day before and I also eat a higher amount of calories than the average person, especially the obvious "protein." Do athletes just have higher microalbumin? Do athletes with diabetes have an even higher level? Is there a better condition to take the test? Do we not consume the food needed prior to the test? Do we not weight train prior to the test? The tests are skewed; are they not? What will give me a realistic view of what is going on with my kidneys?
Your high protein diet and vigorous exercise can cause false positive results. However, it is not a false positive if the test continues to show elevated levels. There is a certain amount of intraindividual variability with the albumin test. The test is usually performed by looking at a random urine for albumin to creatinine ratio. It can also be done on a 24-hour urine. I have published a previous paper looking at albumin excretion following exercise at different intensities. Although exercise may be a cause for falsely elevated numbers and is stated in many text books; our data did not show a dramatic rise in albumin excretion in people who had normal albumin excretion prior to the testing.
If your albumin test continues to be high in the urine, I would suggest you speak with your physician about the use of medications that have kidney protecting effects. These medications are from the class of blood pressure lowering drugs called ACE inhibitors or ARBs (angiotensin receptor blockers). There is also the issue of how much protein you are taking in. Those individuals who have persistent elevations in albumin excretion have the highest risk for progression of diabetes-related kidney disease. There are treatments for this so it is crucial you talk with your physician about these results and have a plan for a follow-up of this finding.
Last Updated: Tuesday April 06, 2010 15:10:00
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