I (a 23 year old) was diagnosed with diabetes at around mid 2014 and my a1c at the time was a 9. At that time there werent any protein in my urine. Then cut to this august when I started to notice that my urine was being foamy. I also realized that I had not been in control of my diabetes that summer for 2 months because before the summer my a1c was at 8.4 and after the summer when I had the protein, my a1c was 9.7. When I first checked the microalbumin spot test, the result was a 78. My physician was concerned but not overly worried. He gave me 10mg lisinopril once per day for a month and then check back. Cut to a month later, and I see that my creatinine was at a .89 but microalbumin had somehow jumped up to 700. That freaked me out because I had been taking ace inhibitors for the whole month and had proper glucose control for that month. My blood pressure is also not high and I do not have any swelling in the extremities. My foamy urine had even gone away the night before but came back the day of the urine test. I am just really freaking out about that 700 and it scares the crap out of me.
Try not to worry so much about the microalbuminurea itself. On the other hand, I’d be worrying more about your overall glucose control, which is likely the cause of your microalbuminurea. I suspect that would likely resolve if you brought your A1c down to the recommended 6.9 or lower.
If you would like advice or information on how to gain tighter control of your BG, we’re all ears and answers.
I would take any advice you can give and also my biggest fear about the macroalbumin is that does this mean I am hurtling towards kidney failure?
The most important suggestions on how to lower your A1c I can make are:
- Get a Dexcom G5 Continuous Glucose Monitor, if you aren’t already using one.
- Consider switching to an insulin pump.
- If you are on MDI and are not interested in pumping, consider switching to Tresiba as your basal insulin. Consider switching to Afrezza inhaled insulin for your primary rapid acting insulin if this is possible.
- If you haven’t already, read the following two books:
Think Like a Pancreas by Gary Scheiner
Sugar Surfing by Stephen Ponder
- Adopt a LCHF (Low-Carb High Fat) eating lifestyle. There are quite a few LCHF recipe books available on Amazon, and TuD has a ginormous number of low-carb recipes.
Your elevated microalbumin level does not necessarily mean that you are “hurtling towards kidney failure”. Especially if you improve your BG control. I truly believe the best way to accomplish this goal is to continue reading everything on this Forum, use Think Like a Pancreas like super-religious people use their bibles, and continue regular follow up with your endocrinologist (unless s/he sucks). If so, find a better endocrinologist more willing to work with you.
You can do this! It can be a lot of work, but it’s well worth the effort.
I can’t speak to the albumin topic, but I do agree with @rgcainmd that good bg control will, in general, produce better overall health.
Depending on what you’re doing now, that list of five things might seem a bit ominous, so it’s okay to start with just a few. I’m on MDI with a fine A1c and for me the most important things for good control are a CGM and a fairly (not super strict) low carb diet.
I’ve read a lot about diabetes, though I haven’t read either of the books mentioned – they’re on my list and I know lots of people on this forum recommend them, my guess is that staying close to this forum has given me a sort of executive summary for both.
I used Levemir as a basal for years, so while you might find some improvement with Tresiba, it’s not a make-or-break choice. Likewise, you can read here about the benefits of Afrezza. I have yet to try it, but I do just fine with the other fast-acting analogs (in decreasing order of “fast”: Apidra, Humalog, Novolog. As always your results may vary…).
Stick with it and good luck!
700 is terrifying, if you only read what you find on the internet. After all, absent other factors, that number alone might look like end-state renal disease.
However, there are mitigating factors. 1) you have not presented with gradually elevating albumin over many years, which would be the failure mode for diabetic nephropathy. 2) you’re quite young. 3) you (apparently) are not showing any other symptoms of genuine kidney failure.
I’ve never heard of lisinopril CAUSING albuminuria, but the high albumin when you have kept good BG control cries out for some investigation, for sure.
BTW, could you characterize more specifically what “proper glucose control” meant above? Here’s the problem: If you’re only testing with a glucometer occasionally, you could be getting deceptive data because the time you test happens to be a good time to get a low number.
Without a CGM you really need to test at least 7 times a day for a while (at least a week), and record all those numbers, to see what’s really going on. Those 7 tests are: Before each meal, 2 hours after each meal, before bed.
If you only test in the morning when you get up, for example, you may see a good number every time because you’ve been fasting all night.
That’s the problem, when I had microalbumin test done, I already tested atleast 4 times a day and the average would be around 190 with the highest peak ever for blood sugar would be at 230. During the month after the albumin test, I tested more often each day and never had my sugars peak past 190 (after eating) and got the average down to 160. That is why I am so confused as to why my albumin jumped so high if my bg is in a downward trend. 2 days before the 700 protein exam, I even noticed that my urine stopped foaming when it directly hit the water.
Lots of excellent advice here and I endorse all of it. Just one thing I would add:
Labs do make mistakes, for reasons mechanical, procedural, and human. When one single reading is so far off the bell curve as to cause alarm, it’s a good idea to get it confirmed by a second test before running off in all directions. Just to be sure.
Thank you all for the amazing tip and advice. I really appreciate the support I felt from this community. I just recently got hold of my lab results. The 700 was in units of micrograms per ml when the standard units is in mg per dl so I believe my doctor didn’t check the units. It’s actually 75 not 700. I don’t know how to deal with the doc now, his carelessness put or family in emotional distress.
Did the doctor interpret your results and get back to you or are you trying to interpret them yourself?
I’m not able to make sense of them as stated. If your creatinine is 89 (which make sense in the conventional units (mg/dl), .89 does not make sense) and your albumin is 700 mcg then your microalbumin/ creatinine ratio would be 700/89 =7.86 with anything less than 30 being considered normal.
This is why it’s problematic to try to interpret your own lab results-- that’s why doctors go to school for so long.
Microalbumin / creatinine labs are always confusing that’s why a doc has to interpret them instead of a patient…
Ps-- I am not a doctor. Do not consider anything I say as medical advice.
but my doctor didnt interpret ACR or anything. He just based it all on the 700 microgram albumin. I know he mistook the micro for miligram because he straight up told me that I had overt proteinuria and that I should immediately go to a nephrologist.
Then I would go to a nephrologist. You can also just ask for a printout of your lab results and see what the lab did or didn’t flag… but be leery of trying to interpret results yourself. If doctors get it wrong sometimes, imagine how easy it is for patients to
That’s the thing: doctors are people and they DO make mistakes. Yours just did. Another reason why we really have to be responsible for our own well being, and question things that sound suspicious. Even if the answer turns out to be that all is well, the question still need to be asked.
where do I find the LCHF recipes on TuD? are they under Recipes or Food? or is the best way to search by using the magnifying glass and type : “LCHF recipes” ?
A good place to start is the category Food/Recipes. You can also search within that forum for specific recipes.
I’m a bit late, but…Think of it as dodging a bullet. you could take this as a wake-up call. To get your act together and look after yourself.
no offense, but with your BG levels, one day it may be true. hopefully they are getting better.
most would suggest your start with a basal test and get that right first.
Every once in a while I have a high microalbumin result, but this has been 3 or 4 times over 28 years, so nothing consistent. I know my doctors will tell me they will keep an eye on results to see if they stay consistent or if it’s a fluke result.
For years I kept my bg comfortably in the 180s or so, with a corresponding A1C in the 8s, because that was what happened fairly naturally for me without much effort and because I was scared of getting lows at work (I don’t disclose except when necessary that I’m T1D).
Getting a CGM that I trusted and constantly keeping an eye on my bgs throughout the day, and adjusting accordingly (with corresponding fingersticks before treating), had a dramatic drop in my average bg and A1C in just 3 months. Then I switched to LCHF and that had another major drop in my A1C. So I agree with the value of the CGM - I don’t know that it has to be a particular one. I had Minimed for years but an older version than what they have now and would get frequent alarms and never found the results to be spot on, so I didn’t use it often. I got a Dexcom G4 a year ago and have worn it nonstop and found it to be very reliable and without the issues I used to have with my old CGM. I know others who are very happy with their MInimed CGMs (and I know they’ve made big improvements with it). So find what works for you.
But definitely, I’d recommend having a primary focus on dropping your average bg. That took me a lot of monitoring and then trial and error, but I feel so much better now. Hopefully you’ll see some improvements over the coming months!
Hi Brian I am fan of ur dedication .
I have microalbumin levels of 35 mg/DL
I am very scared I had 44 mg/dl yesterday which was in afternoon,
Today 35 mg/dlwas in early morning , I am type 2 diabetic age 35 diagnoses a two months ago with 200 and 290 sugar levels,
I am on glucomate meta 850 sr I take a tablet a day
Now my sugar levels Are 110 and 120 pre and post and I don’t have bp
I am hell scared plz suggest me some medication and valuable suggestions
And one more thing my creatinine serum level is 1.0mg/DL
Hi mate is ur microalbumin are OK now
The microalbumin is a very sensitive test. You had two tests in a row suggesting that you are dumping some protein. And you have had high blood sugars, possibly for a long time. But it sounds like you have gotten much better control. Ideally you should consult a nephrologist (a kidney specialist) who can look into things. He could do more tests and see whether you have some kidney issues (which are likely to be mild as your microalbumin was not way high). He might even tell you that nothing is wrong. If you don’t have a nephrologist you could still see you regular doctor and ask him about running other tests including getting an eGFR which is used to see if you have reduced kidney function. If you do have some damage you can ask your doctor about how to manage it and it is a reason to aggressively control your blood sugar (even if it means more medication).
And finally, remember that diabetes doesn’t harm your kidneys, uncontrolled diabetes harms them. Get your blood sugar under control and keep it there and you will likely be able to get your kidneys back into normal order even if they have started to have some issues.