My six year old daughter was diagnosed with type 1 diabetes a year ago. Her A1c results have consistently been between 5.1 and 6.1%, with her last result being 5.4%. At her last visit, I noticed that her lab results showed 1+ for protein in urine where the normal range should be negative. I also noticed that at the previous visit she showed 50 for BUN/creatinine ratio where 0-25 should be normal. Our endocrinologist has never mentioned anything about these particular lab results. (I have not received results from her last visit this week as of yet.) What could be causing this? Is this any indication of future kidney problems? Should I be concerned?

You have clearly been doing a splendid job in maintaining almost perfect control of your daughter’s blood sugars, so I am quite sure that the laboratory findings that you report have nothing to do with diabetes. Indeed, it is very unusual to develop diabetic nephropathy under the age of 15. Without having had indifferently controlled diabetes for at least five years, the finding of 1+ proteinuria could well have been due to the way in which the urine specimen was collected or possibly to a recent subclinical urinary tract infection. Your daughter’s doctor will probably want to repeat the test at the next visit. As to the serum BUN/Creatinine ratio, this is above the usual figure, but it is a test which can be greatly affected by urine flow and the amount of protein in the diet. It would perhaps be more reliable to ask the doctor to check and see whether the serum creatinine itself was elevated. I suspect that it was not.

DOB