I recently had a six month check-up and all seemed fine with my test results. My A1c was 6.5. I have never had an A1c over 8.0 as my type 1 diabetes was diagnosed at a very early stage during pregnancy. However, I have just been asked by my general practitioner to re-submit a urine sample as he has noted that I had elevated levels of protein during the check-up tests. He stressed, however, that there is no evidence of microalbuminuria. Both he and the consultant feel it is probably an erroneous result and just want to double check. I am confused as to the difference between “protein” and “microalbuminuria”. If this is not shown to be an erroneous result, what are the possible causes?

Albumin is a specific protein and is a subset of all protein found in urine. The size of urine makes it a good screening test as most albumin should be excluded from the urine. Microalbumin refers to the fact that albumin can be measured at levels before the dipstick urine becomes positive. For instance, albumin is elevated in the urine if it is greater than 30 mg/24 hours on a twenty-four hour specimen. The dipstick urine is positive at albumin levels greater than 300 mg/24 hours. Most of our screening now is done yearly with a random urine sample that measures the ratio of albumin and creatinine in the urine. When a simple dipstick urine for protein is done, false positive results may occur with urinary tract infections or menstrual bleeding (the red blood cells can cause false positives). Positive albumin tests may occur with vigorous exercise, high-protein diet, or with elevated blood sugars. Please ask your physician about testing for microalbumin as this is more specific than total protein and can be measured at levels below the usual protein measurements. It can be easily done with a spot urine test given in the office.

JTL