If a 46 year old patient, who weighs 95 kg (209 pounds) and has a mild case of diabetes, occasionally has albumin in the urine, is this reversible/curable? Would the albumin cause any incurable damage? The patient’s creatine A1c and lipids are normal. There are occasional high blood sugars. Are there other tests the patient should have?

Consistent with the recommendations of the American Diabetes Association, we monitor albumin excretion at least yearly in all patients with type 2 diabetes. If there is persistent microalbuminuria, that is an indication for treatment with either a medication from the group of medications termed ACE inhibitors or from the group of medications termed ARBs. These medications have shown benefit in clinical trials. In those patients who take the medications with the onset of microalbuminuria, there is protection from progression of diabetes-related kidney disease. It is also known that microalbuminuria may also be a sign for cardiovascular disease in people with type 2 diabetes. This should also indicate that you might be a candidate for good cardiovascular prevention. This would include a cardiac stress test to make sure you can exercise without risk. You should also address smoking cessation, cholesterol lowering, and the use of aspirin.

JTL