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July 21, 2004

A1c (Glycohemoglobin, HgbA1c), Complications

Question from Asia:

One diabetologist has stated that normal criteria for diabetic good control is an A1c less than 8% and a urine glucose of less than 5 grams. Is it true that trace or 1+ sugar occasionally cannot damage the kidneys? Over the course of time, can urine glucose damage the kidneys?

Answer:

Urine glucose is non-specific. It could mean that the kidney is attempting to “clear” glucose from the body. It could be seen in starvation or illness. One must interpret the test in the context of blood levels.

A1c levels should be under 7.0 and preferably 6 to 6.5. In my practice, I put little significance to urine glucose. Urine protein is another story. Early loss of protein in the urine could mean kidney complications.

ABS