Hello. So, I’ve had type 2 for at least 7 years. I suffer from bipolar disorder with serious depression. So I did not take any control of it admittedly for years. Of course I’ve had symptoms for years that are similar to symptoms of depression. About 3 months ago, I finally saw an endocrinologist. My last blood work before this app. was about a year before this. My a1c was at 10 back then. And I was told I had no kidney damage at that time. But this was just from a blood test, no urine test was done.
So fast forward a Year. At this endo appointment 3 months ago, my A1c was over 12. I had been having blood sugars as high as 523 etc… So, I was put on insulin 40 units a day plus metformin building up slowly to 2000 mg a day. My next app with the endo is Feb. 10th. This past Friday I went to my gp for a follow up/check up. She decided to give me a micro albumin test. The next day she called to say there was protein in my urine 129.2 mg/ or something. She said she was faxing it to my endocrinologist. I haven’t heard anything else since then. I’m going crazy! What does this mean? Thanks! Oh, btw I have no eye damage, I get that tested every year. No retinopathy
When your kidneys are damaged they start to leak protein. The microalbumin test is a very sensitive test to detect that leakage. If you start to leak protein, that is an indication of kidney damage. It doesn't mean your kidneys are imminently failing, only that there has been damage. There are other tests that indicate how much remaining kidney function you have (the EGFR test). That being said, there are reasons why the microalbumin test might be inaccurate such as exercising before the test or high blood sugars. I believe that high blood sugars (> 200 mg/dl) may cause constant dumping of glucose in your urine and along with that you may get protein leaking. Many doctors consider repeated tests of high microalbumin without other indications to be indicative of kidney concerns. Your doctor will give you good guidance, and while you really, really need to get your blood sugar under control, you are unlikely to be in immediate kidney danger.
Thank you Brian, now I understand it more.. So They'll be more testing to confirm anything. My sugars are now running around 170 to a little above 230, so that could be why.... Again, Thanks so much for answering! :)
Dawn
Brian, brilliant as always, is absolutely right. One test showing micro albumin is no cause for alarm, yet it cannot be dismissed and needs further follow-up.
I know of many cases where people were spilling protein and then stopped after improved control.You also need to be sure your blood pressure is in range.
Please have a detailed discussion with your endo about this. You must be your own advocate.
Do NOT put your head in the sand. Take action!!!
My best to you.
Blood pressure can definitely be a part of it too.
Also, one time I had about that same amount of microalbumin (protein) in my urine, and it freaked me out! But I think I had a mild urinary tract infection, because my numbers were in control, and the microalbumin was negative at the next test. My endo also thinks it was a UTI that resolved itself. Had any UTI symptoms lately? They are more common in persons with diabetes that are not as in control.
Hi Dawn, I believe as Brian said, the test doesn't mean there is permanent damage, high bg can cause that result, but because you have had a very high a1c for a period, if it were me I would do more extensive testing like the EGFR to see if there is damage which is what I hope your doc will recommend. You can do a 24 hour urine collection too which will show more of what is going on. I would start doing everything you can to lower your a1c because at 12 you will get complications for sure- I would not lower it too quickly though because that can cause retinopathy in some people. I think insulin is going to help you a lot to do this. Another thing you should do is to get on a bp med to help prevent kidney damage. I'm on losartan to prevent damage even though I have normal bp. Just post questions here for different meds that people take for this. Good luck :)
Dawn, as several here have pointed out, chronic high BG will cause microalbumin in the urine, well before there is any serious damage.
Chronic high BG will send your blood pressure up tremendously, and it will stay high, until you get your BG under control and keep it there for a while.
I was exactly where you are now, six months ago. T2, ignoring my condition, A1c 11.5. This had been going on for about a year and a half.
Skipping the rest of the story, I got everything under control in June. My BP dropped from 170/120 to 115/75, and has stayed there. I had lots of microalbumin in my urine -- not any more. I had all sorts of peripheral neuropathy issues -- mostly gone, and continuing to gradually improve.
In short, I dodged a bullet. However, doing so meant getting very serious about my disease, deciding to go all out and control it with insulin. Today, I have a CGM and am using the Omnipod pump to deliver my insulin.
My BG is as good as, even better in some cases, as a non-diabetic. Fasting, I maintain it around 80 mg/dl. I try to dose insulin in such a way for meals that I don't spike over 140, and achieve that goal probably 75% of the time.
It has changed my life! I am so much happier, clear-headed, energetic, more youthful. Chronic high BG is a significant causative factor in depression -- both as a direct biochemical effect, and the secondary effect of just feeling physically sick, which brings you down mentally.
At those sugar levels, let me guess: You have no apetite -- food is generally unappealing. You may be getting dizzy and sick, even vomiting now and then. You feel like you're "sick" with a cold or something all the time. Psycologically, you just can't work up motivation for, well, just about anything.
All of this will go away with good BG control. Understand, however, that some of it will take time -- weeks (BP, albumin, etc.) or months (neuropathy).
Finally, though, you really have no choice. If you don't take care of this, at those levels of sugars, you are near certain to be facing some or all of blindness, amputations, dialysis, heart disease, strokes -- and with 100% certainty just feeling like crap all the time for the rest of your life.
Please get this under control, and reach out for help if you need to.
I had one high albumin test and my dr didn’t seem concerned at all and said we would retest in 6 months as all my other levels were good and my A1C had actually come down.
Should I be concerned?