I am 35 years old, have had type�1 diabetes for 22 years, and I am planning on having a baby. In the past, I have had a microalbumin of 110 with an hemoglobin A1c of 8.0%, but when I cracked down and got my A1C down to a 6.0%, my microalbumin dropped to 26. My doctor has told me that microalbumin levels can go up during pregnancy, even if a prior kidney problem did not exist. Can elevated microalbumin levels come back down after pregnancy if sugar levels are normal? Does a pregnancy cause permanent (more) damage to the kidneys that is irreversible?

In patients with microalbumin in the urine, the amount of albumin excreted can increase with pregnancy. However, at least one study demonstrated a return to prepregnancy levels about 12 weeks after delivery and the DCCT suggested that pregnancy did not worsen the long term progression of albumin excretion.

Be aware that women with microalbuminuria may have an increased risk of developing preeclampsia (reports vary between 10 and 40%). Additional factors may cause variation in the risk.

OWJ

[Editor’s comment: You didn’t mention this, but to point out to our readers — If someone in your situation happened to be on ACE inhibitors therapy (either for microalbumin or other reasons), it is recommended that the ACE inhibitor should be discontinued.

WWQ]