Yes I agree and I think the 24 hour test is more likely to show if even small amounts of protein are there. I tend to drink a lot of water and tea etc. and I don't exercise heavily so I doubt that would influence my tests fortunately.
There are protocols for all of our tests. If you want the insurance to pay for extra tests, then your doctor has to have some reason for ordering them. With a low A1C and no signs of any kidney problems, what reason will he give? Maybe you could tell your doctor you are willing to pay out-of-pocket just for peace of mind. Unfortunately, we can't decide our own protocols.
Yeah, guess I will just have to ask and see what happens.. but I won't pay for it.. my ins should definitely pay for it.. and when I asked for the 24 hr test he did it and they paid for it, there was no protein in my urine at that point or signs of anything then as far as I remember... no ins problems there. If we don't ask we will never know.. for instance, the diabetes/pump educator told me she didn't think my ins would pay for more than 10 strips, but when I called them, they said there was no limit as along as it was deemed necessary for me. Thanks!
This just reminded me of something else I have thought of in terms of diagnosis. That it should be standard to test urine for sugar, protein and so on at the gyn as well as do bg finger sticks, if anyone had done that when I had two very severe yeast infections my D would have been diagnosed much earlier avoiding two very expensive hospitalizations and me nearly dying… and now that I think of it, why don't they create inexpensive over the counter self urine tests.. I bet that will come about at some point in time :)
Karen, I think at some offices it is done there, but for some reason I think my endo sends it out although I could be wrong, I will have to ask.. When I came out of the hospital they were doing it at every visit for a while. Because I remember now at my gp, two days before I ended up in the icu, they immediately knew from my urine sample that I had 160++ ketones, 1000++ sugar and 100++ protein.. so they did do it immediately in the office. The nurse kept saying to me are you diabetic? And I was thinking what is she talking about? I had already done my own ketone test at that point too. I think they also had some blood work back immediately too because they have the capacity to do that at their office.
Gee poor you Meee, going on such a rough ride only to find out that you had Diabetes. WoW! Thank God you made it through.
Well, I just saw my Endo in January, so I'll have to wait for my next appointment. I normally get the quick one done at the hospital lab after I have my blood drawn, before I see him upstairs. They send the results to his computer, so we can discuss the results and he gives me a copy for my records. Are you asking for the 24 hr. cllection this time? I think I will since I haven't had it done in years. I'm quite certain that our Insurance will cover it.
Thanks Terrie, Someday I will write a book or a blog about it all, it was such a crazy twilight zone like experience- I often think did all that really happen to me?? I'm not sure, I have the rx for the blood work, no urine test on there and I think it has been a year so I will have to call the office and ask. I may do the 24 hr again. I think you should do that too, the collection part isn't so bad, just dropping it off to my lab is a pain. I normally get my testing done at hospital near me that has a more accurate lab though now. I'm sure you'll be covered :)
Actually, I don't even recall this particular endo of mine testing any urine. It is slightly possible that somebody did it in the hospital without my knowledge. Even .... don't recall my old endo doing it either!! All I know is that a whole bunch of blood tests are regularly performed.
Loia
I have never had the 24h one done, never even heard of it till now. hmmm, when I do my A1C I also have to give a urine sample so every 3m I get that done. also check for cholesterol etc... never happens at the doctors always go to a lab or the hospital.
I am wondering if they should do the 24h one since I do take kidney medication.
will have to ask in April when I see my endo next.
I am involved in a clinical trial at the moment so it will be checked 10 times this year. But as a general rule my endo tests for micro albumin etc once per year and I'm totally ok with that. With no history of proteinuria I don't think there's any reason to test more often.
When I was first dxed I used to have to bring a 24 hour urine sample to every pedi endo clinic appointment and they measured the glucose content. I always made my sisters pee in the container and added some of my own. My blood work never matched the glucose content I'm not sure they ever figured it out. But I never volunteered any information.
lol, Clare, why did you do that?
ok, so is the micro albumin the 24 hr one?
I do have a history of proteinuria when I was in dka, I don't know if that is typical but I assume so.
Hi Dishers, I would get the 24 hr one because I think that shows more. That is what my endo was doing, first every visit which was every few days at first and then every 3 months and then he said 1x per year. I didn't ask why at the time but I will now.
Lois, I would ask your doctor about urine testing because that shows signs of kidney problems earlier than bloodwork does usually.
Albumin is a small sized protein that usually gets spilled first as the integrity of the capillaries in the kidney starts to become compromised.
Detecting micro albumin just means that you are spilling tiny amounts of albumin, which is why detecting micro albumin shows very early signs of kidney damage. It simply refers to detecting tiny amounts of the smallest sized protein.
Both the spot urine exam and the 24 hour urine exam can detect micro albumin. The confusion comes when you consider the units in which the spill is reported since they are reported differently for each test. The 24 hour urinalysis reports the units as micrograms/24 hours. That's just the total amount contained in all the urine collected. The spot urine is looking at the ratio of micro albumin to creatinine, so the results are reported as micrograms albumin/milligrams of creatinine.
The magic number is 30 for either test. So, greater than 30 micrograms of albumin from a 24 hour urinealysis is considered microalbuminuria. greater than 30 micrograms albumin/milligram creatinine is considered microalbuminuria from a spot urinalysis.
Thanks FHS… I don't feel yearly testing is frequent enough because if you do start having evidence of early damage it will be longer until this is determined. Using A1c levels alone may not show the whole picture.
Because when you're a kid you want the gold star from your doctors. The lower the glucose content the better your control. Mine always sucked but I didn't want them to know that.
What’s the 24h one called? The one I usually get is the microalbium one
It is called a 24 hour Microalbumin Urine Collection Test
It is used to check for the presence of a protein called albumin. Albumin is normally found in the blood and filtered by the kidneys. When the kidneys are working properly, albumin is not present in the urine. But when the kidneys are damaged, small amounts of albumin leak into the urine. This condition is called microalbuminuria.
Diabetes is one reason to have this test and most insurance consider it a preventative test so will cover all or some portion of it. Diabetics should do this yearly.