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July 30, 2001

Complications

Question from Whitestone, New York, USA:

I have had type 2 diabetes (diet controlled) for about a year, and my hemoglobin A1c has been around 5.3% for nine months, but my microalbumin was recently 135 and it was 53 at the time of diagnosis. I am going to a 24-hour urine protein test. What could cause such a jump? Could eating extra protein be the cause? I am supposed to have three to four per meal, but I have been cheating and eat about six ounces. I also don't drink a lot of water as I'm almost never thirsty.

Answer:

I am at a disadvantage because I do not know what form of urine lab test was performed to evaluate the protein level in your urine. Lab results are usually expressed as milligrams per 24 hours or as a concentration of microalbumin per milligram creatinine in a random urine. Normal values for random urine collections are usually less than 30 micrograms per milligram creatinine. In patients with type�2 diabetes, elevated urine albumin levels may also express increased vascular disease.

There is a significant amount of intra-individual variability in urine albumin sampling. That means that urine collections from the same person may vary from one collection to another. However, elevated blood sugars and elevated albumin levels in the urine should be addressed for possible therapy with medications called ACE inhibitors. Please talk to your physician about this. Causes for false positive urine protein determinations include increased dietary protein, heavy exercise, and markedly elevated blood sugars at the time of the urine collection.

JTL