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December 4, 2001


Question from Burlington, Ontario, Canada: I have diabetes and recently, during a physical exam for insurance, I had a blood creatinine of 0.9 mg/dl (normal range: 0.5 to 1.5 mg/dl) and urine creatinine of 16.9 mg/dl (normal range: 27.0 to 260.0 mg/dl) along with a urine microalbumin of 0.7 mg/dl (normal range: 0.0 to 3.0 mg/dl)). These figures work out to a microalbumin/creatinine ratio of 41.42 (normal range:

The point here is not a low creatinine concentration, but an elevated microalbumin/creatinine ratio. This implies early diabetes involvement of the kidney. In patients with type 2 diabetes, it is also associated with cardiovascular disease.

You need to speak with your physician about specific therapeutic options, such as the use of an ACE inhibitor for its renal protective effects. This is a well-established finding in the follow-up and management of patients with diabetes.