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.

MSB

[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 �g/min
Persistent microalbuminuria is defined in a minimum of two out of three consecutive urine specimens
Albumin excretion rate (AER) 20-200 �g/min in timed overnight urine collections
or
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 exerciseMicroalbuminuria 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
SS]