Urine Testing Question

I was wondering how often you all get your urine testing done for protein etc? My endo was doing this much more frequently at first and now says he will only do it once per year. Is this often enough in your opinion?

I only get it done once a year.

How is your control/what is your A1c?

My A1c (between 5.5 and 6.1 for the past 3+ years) and no former indication of any kidney issues at all are the reasons my dr. only checks this annually.

If you have a high A1c (let's say...over 8?) or have had any other former issues with protein in the urine or other kidney issues, I'd think it'd be best to test more often...but that's just my unprofessional opinion.

My doc checks about once per year, too. I imagine if you start spilling protein, then they'd check more often.

Hi Kari and Terry,

My A1c has been low for a long time, in the high 4-5 range so maybe that is why he is doing it only once per year- I will ask. I just worry that if something is going on, even with a lower a1c, they will not know for a long time if it is only done once per year., since it is always better to catch these things early on.

Thanks!

I get checked every three months when I get my A1C but they are also keeping an eye on my kidneys and I take med's for it. but I think it is standard for all of my Endo's patients

Thanks Dishers- I think I would prefer to have it more often just to be safe so I will discuss it with him next time.

no problem Meee,

My Endo orders it once a year also, although I wouldn't mind every 6 months, for your reasoning Meee. Those are the tests I'm more concerned about: my eyes and kidneys even though my tests come back normal for the most part. I have had kidney infections on occasion most of my life due to the drugs I've been on through the years plus the weak/non-existing immune system.

Certainly ask your Endo. It would ease your mind moreso. Let us know what he says Meee. Good Luck!

Thanks Terrie, I think we should both ask our endos about it… I think at least 2x per year is best. I will let you know, I'm going in 2 weeks finally presuming I don't get another bad cold, still fighting this one off.

May I ask what kind of urine testing is being done? My doc does a 24 hour urine collection each year and I don't want to do this more than once a year. It is called a microalbumin test and it's a hassle.

I haven't had diabetes for long so they told me I probably won't be tested for that until I've had it for 3-5 years? Depending on how my A1C is within that time. My a1c's have been really good (5.5% being my most recent) . So far I've only had blood tests related to it . But I was told once I start on those it's an annual test unless I have problems then it might be more frequent.

Hi Karen, normally he just does the urine collection at the office, not the 24 hr test. I did request to do a 24 hr test after reading about that in Dr. Bernstein's book though and that one was ok. I'm wondering if I should request that one again or just do the normal ones?

Hi Sensorium, I think you should have one done, do the 24 hr test and then go to the normal test. I believe diabetes starts long before we're diagnosed so there could be some damage and it is better to find out earlier and to keep a close eye on things. I also take losartan, a bp med, to prevent kidney damage. That's great your A1c is good :)

IDK...I have always done the 24 gig. If there is one done in the office I'd much rather do that! If the office one can offer an albumin/creatinine ratio without collecting a day of pee then I'm all for it!!

Hi Karen,

I think they send the office one out too, not sure, but it is just that specimen while the 24 hr one will really show if you have any protein leaking because it takes samples over 24 hours. So imo, the 24 hr should be done 1x per year and the other one every time or every other time you go and so on. Even with a good A1c you can still have complications and since we're the ones who will end up living or not living with them better to find out sooner than later. You can ask for the other one, but it won't give as much info.

Hi meee,

Thanks for the info. I will admit I thought the office one was an immediate answer for some reason. My A1c is excellent, and my urine tests have been excellent for a lot of years. So I just thought if there was a way to get it faster without the hassle I'd go for it. My doc is awesome, so I just do as directed and get on with my bad self. You seem like you want to do the same... and I have no doubt you will :)

yw :) yes.. I will ask for more urine tests and see what he says, he usually agrees with whatever I feel is best for me fortunately.

The pee-in-a-cup, spot urine test for creatinine/microalbumin ratio is such a painless no-brainer for most people. I have it done twice a year. I was having it done 4 times a year back when I was spilling microalbumin. It's much more sensitive to false postives than the 24 hour urine test, but with a few pre-test precautions, it's a very good substitute test.

Since it requires back to back positives 3 months a part to confirm a diagnosis of microalbuminuria, I'd rather have an easy to conduct test with a higher chance of a false positive if done improperly, than a PITA test like a 24-hour urine test with a higher chance of a false-negative if done improperly.

Thanks FSH, I had heard that the 24 hr test is actually more accurate but I guess that can be disputed. I guess if you do both maybe then you will be sure. Mine has been negative in both tests after my hospitalization. I did have protein in my urine, a large amount, when in dka so they followed it more closely afterward.

Yeah, the 24-hour urine test, for the most part, is still considered the gold-standard. It stands to reason that if you can collect every drop of urine over a 24 hour period, then you will be sure you are collecting all the protein spilled over a 24 hour period. That gives you a better shot at being both accurate and precise. It's just that collecting every drop of urine produced over a 24 hour period is also a major undertaking. If you miss a sample, you will be underestimating the amount of protein spilled.

The spot urine test is, at best, an approximation of the amount of protein that would have been spilled over a 24. It's based on the relationship between the amount of protein spilled and the amount of creatinine normally passed. That being said, it's a pretty good approximation. Lot's of things can screw with that ratio though. Heavy exercise before the test squeezes out more protein relative to the amount of creatinine and will giv you a false positive. Dehydration can give you a false positive.

It pays to be careful in the time leading up to a spot urine test to get the most precise and accurate results.

You're right though. I would definitely follow up a positive spot urine wit ha 24-hour urine test if at all possible.