I am a type 2, diagnosed 14 years ago. I have managed with 1000mg Metformin 2x/day and my last AIC was 7.2. All my other test results have been normal, but this time I had a micro albumin of 37. I know that is not terribly high, but it is out of the normal range and so I am nervous. My blood pressure is about 130/80 consistently and my last LDL was 122. I am not able to exercise in any meaningful way because of a prior disability. Is there anything I should be doing that could put me back in the range of <30 for micro albumin. I am trying to eat more responsibly and lose some weight, which I could use, and I am doing that only based on the possibility that it might also lower my BP? Thanks for any advice and words of calming, because I find I am nervous about this.
@eileen10 - Our lab results have this disclaimer:
“The ADA defines abnormalities in albumin excretion as follows:
Category Result (mcg/mg creatinine)
Normal <30
Microalbuminuria 30-299
Clinical albuminuria > OR = 300
The ADA recommends that at least two of three specimens collected within a 3-6 month period be abnormal before considering a patient to be within a diagnostic category.”
Do your lab results have anything similar to this or a different reference range?
Do you have repeat labwork scheduled?
My albumin result was 37, but another urine won’t be tested for about four months at my next visit to my primary. All of my other results are within normal parameters.
Understandable to be nervous. But as you note, this isn’t very high, just barely over normal and could be random variation as well as early sign of problems. So don’t panic. Try to get your A1c down; 7.2 is too high. If you don’t want to take more drugs, then be very careful with your diet and monitor your BG levels. As you say, you might lose some weight as well as helping your kidneys, and the weight loss would help the BP.
I like a low-carb diet, but it’s not possible for everyone. What works for you is the best diet.
Gretchen, Thank you very much for your response. I am trying now to eat a low carb diet, largely because it seems as though anything more than a tiny amount of carbs raises my glucose levels too high. I have been closely monitoring my glucose levels for about ten days (after I found out about the albumin) and now, according to me meter average, have them in the mid-sixes. I do not seem to be able to lower them more than that even by eating nothing more than a salad with a small amount of tofu, but I am hoping as I lose weight perhaps my glucose numbers will also improve? I have cut out all extra salt or salty snacks, much as I love them, in another attempt to lower BP. Thanks so much for writing back. My next urine albumin will be tested in mid-January, and I am really hoping that living the way I currently am will bring about better numbers.
I’ve made this point before about lab results, but it bears repeating.
Let’s say just for the sake of discussion that your personal blood sugar target is 95 or less. Does that mean that you’re in great shape at 94 but in serious danger at 96? Obviously not.
Laboratory results work the same way. The reference ranges are not lines in the sand such that one side of the line is good and the other is bad. They’re points on a bell curve, or continuum, and they’re based on averages. You don’t suddenly fall off a cliff if a number is .1 over what it’s “supposed” to be. Add to that the fact that each person’s physiology is distinct and invidividual, and what is a problem number for one person can be perfectly okay and tolerable for someone else. And add to that the fact that labs aren’t perfect; on rare occasions one will report an outlier number so anomalous that a retest is called for to make certain the result is trustworthy.
Lab results are seldom black-and-white signposts. They need to be interpreted with judgement and in context with everything else that’s going on. That judgement is part of what doctors acquire by training and experience.
If this were me, I would wait for the next test before forming any definite conclusions. In the meantime, keep doing what you’re doing to maintain good BG control. You’d do that anyway.
Exercise is a way to lower your blood sugars. You mentioned you are disabled. Would chair exercise or pool exercise be something you could do? Give it some thought. Nancy
David, thank you for your reply. I am certainly hoping that this was perhaps an incorrect lab test, but the albumin has been rising slowly over the last five years, from 24 to 28, to now 37. My primary doctor doesn’t seem to have paid my attention to this, and to be truthful as long as my previous numbers were in the “normal range” I did not know enough to realize the steady creep. I have been very good in terms of eating in a way that keeps my BG down to less than 160 after meals since this test (a lot less good so before), and hope I can tighten it further to less than 140 as I lose weight. Thanks again!
Thank you for your reply. Yes, pool exercise would be ideal for me, but not likely to happen too often because I would need someone to go with me and it would have to be a lift equipped pool. I know there are some around, and I am going to check the local hotels and YMCA’s to see if they have a lift. I have a friend who bought membership in one of the hotels just to use the pool, so I will ask her what the facilities are like. Thank you!
Pools are now ADA equipped with a lift. I have some friends with MS who exercise with me . They use a flotation belt to walk. Nancy
You’ve already received several helpful remarks. I would encourage you to try and find a way to exercise that accommodates your disability. A little bit of exercise, even 20-30 minutes, on a regular basis works wonders to lower blood glucose.
A 7.2% A1c is equivalent to an average blood glucose of 160 mg/dL. While this is not a a super high number, it still means than you’re likely spending a fair amount of time over 160. Exercise can help with this and will lighten the emphasis on eating alone as a way to cope with blood sugar.
Good luck and good for you to notice your slipping microablumin trend. If this is a real trend then it’s better to catch it earlier than later.
Thank you for your comment. I am doing as you suggested and trying to find forms of exercise that work with my disability. I have received very helpful replies here, and I am most grateful!