July 1, 2000
Complications
Question from Monrovia, California, USA:
My daughter is 11 years old. She was diagnosed with Type 1 diabetes at the age of 8. We consider her to be in good control. Her Hba1c tests have always been between 6.2 and 6.8 for the last 3 years. A recent urine test showed traces of microalbuminuria that was a little high according to her doctor. What does this mean? Is it possible that being under such good control that she could be experiencing early signs of kidney disease, or could the test have been done incorrectly? (She was just asked to pee in a small cup and that was it.) Is there a way to be completely certain that the first results are accurate? We are scared to think that she could already be experiencing early signs of complications.
Answer:
Seems your doctor is aware of the need to screen for microalbumin. The exact process is not standardized. I screen a “spot” urine; if it is negative, great. If it is positive, I then get a “timed” urine, usually 12 hours over night, since it is easiest.
Some doctors want two to be positive before they treat. I treat if the timed urine is positive. ACE inhibitors are very safe. This is my way of work, although others may disagree: I am very aggressive about protecting the kidneys.
LD
