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May 8, 2007

Complications

Question from Lima, Ohio, USA:

My 13-year-old daughter was diagnosed with type 2 diabetes six months ago. She had laboratory work done and the results came back with her microalbumin at 60. Our family physician said this was very high and is referring us to a kidney specialist. My daughter is also doing a 24 hour urine collection this week. Is it normal to see this going on so early in age and diagnosis of diabetes? Also, the doctor mentioned a possible kidney problem not related to diabetes since my daughter's A1c was in the normal range and her glucose levels were good. I'm very confused and worried.

Answer:

We never make a diagnosis of kidney problems without several samples, so repeating the timed urine collection will be important. It should not be done when there has been a lot of exercise and also should not be done near her menstrual cycle since contaminating the sample with any blood interferes with the ability to measure the urinary microalbumin. You did not mention blood pressure or any other kidney factors, so it would be wise to have this evaluated, if not already done. Looking for other causes of protein leakage (i.e., Hashimoto’s, hypothyroidism, glomerulonephritis, etc.) would also be important because such a short duration of type 2 diabetes in a young person would not be expected to cause kidney damage.

SB