June 28, 2001
Complications
Question from San Antonio, Texas, USA:
I have had type�1 diabetes for 15 years (I was diagnosed at the age of fifteen). I have maintained really good control (except for a few of those horrible teenage years) with hemoglobin A1c’s never above 7%, but I have suffered from severe lows. I just got on an insulin pump last year, and I am amazed at how much it has changed my life! I am really shocked that more doctors do not support pump therapy. Anyway, I have not had any complications as of yet. All of my lab tests have always come back within range, but last week my yearly 24 hour urine collection showed a high (138) creatinine clearance test (Normal: 71 -121). My microalbumin was less than 5, and my BUN/creatinine ratio was 20. What does this mean? I thought that a had a good doctor, and I called to ask her about the results, but she did not return my message. I can not believe that I was sent these results without any kind of explanation. Now, I have to get through the weekend before I can try to get any info. I am scared to death.
Answer:
I can understand your worries regarding your overall health with a history of diabetes. However, I think I can make you feel better about the results you are describing. First, the change in creatinine clearance of 138 ml/min, which is in the positive direction, is consistent with the year-to-year variability of the test. The BUN/creatinine ratio of 20 may suggest you were “dry” (dehydrated) when the test was performed. In my opinion, these tests do not suggest progression of diabetic nephropathy. However, it is important that you discuss these results with your physician.
JTL