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Medical Forum / Diseases and Disorders / Diabetes / March 2006Microalbumin Levels
I have Type 2. Going on 1 1/2 years diagnosis. Taking one 500mg of Metformin / day. Testing Blood once a day in the AM. My blood sugar levels are however around 114-118. My GP wants me to stay below 120. However, my microalbumin levels keep going up. I just tested 6.10 and he says normal is 0 - 2. He has me on Captoprul, twice a day, 50mg each. It's not helping. So I ask, what can I do to help. I don't exercise. I watch what I eat. Trying to stay away from carbs and always staying away from sugar. My wife is concerned and wants me to see a specialist. Has anybody battled this issue? Thanks, Bill > I have Type 2. Going on 1 1/2 years diagnosis. > [quoted text clipped - 6 lines] > However, my microalbumin levels keep going up. I just tested 6.10 and he > says normal is 0 - 2. ??? At my lab anything under 30 is normal. A 6.10 would be a great number. But not sure what your lab uses as measurements. Here's a cite that pretty much says what my endo told me: http://www.mayoclinic.com/health/diabetes-lab-tests/DA00104 "Recommended results Normal urine albumin values vary according to the testing method. When the level of albumin in your urine is compared with the level of creatinine in your blood, the desirable value is less than 30 micrograms (mcg) of albumin per milligram (mg) of creatinine. A result of 30 mcg to 299 mcg of albumin per mg of creatinine means you have a condition called microalbuminuria. This means that your kidneys have experienced early damage, and without treatment, you're at risk of kidney failure." >> I have Type 2. Going on 1 1/2 years diagnosis. >> >> However, my microalbumin levels keep going up. I just tested 6.10 and he >> says normal is 0 - 2. > ??? At my lab anything under 30 is normal. A 6.10 would be a great > number. But not sure what your lab uses as measurements. [quoted text clipped - 5 lines] > creatinine in your blood, the desirable value is less than 30 > micrograms (mcg) of albumin per milligram (mg) of creatinine. He said MICROalbumin. My lab also says normal is <2. bj > >> I have Type 2. Going on 1 1/2 years diagnosis. > >> [quoted text clipped - 12 lines] > > He said MICROalbumin. Yes, I know. So was I. Urinary microalbumin levels. > My lab also says normal is <2. Well, then I'm confused. Care to clarify? Here's a couple of more cites that mention <30. http://www.joslin.org/managing_your_diabetes_3114.asp Urinary Microalbumin: To detect the earliest evidence of kidney disease, your doctor should check your urine microalbumin levels at least annually. The normal albumin level in the urine is less than 30 mg. Keeping your A1C and blood pressure at target levels is the best way to prevent and treat albuminuria. Your physician can prescribe specific medications to treat high levels of microalbumin. Also: http://www.webmd.com/hw/diabetes_1_2/tu6440.asp Best, Kurt >> He said MICROalbumin. > [quoted text clipped - 3 lines] > > Well, then I'm confused. Care to clarify? My lab report says: MICROALB..............<0.2 MG/DL.........0.00-2.00 This is in a USA hospital. On a related note, what is UCREAT -- it's given just as result, with no reference range or anything else. bj >>> He said MICROalbumin. >> Yes, I know. So was I. Urinary microalbumin levels. [quoted text clipped - 9 lines] > reference range or anything else. > bj Very strange. Three standard reference guides I checked all use for USA 3.5 - 5.0 g /dl, but for SERUM levels (blood analysis). However, if the analysis was done by way of a urine collection, 2.00 g (20 mg) refers to a safe level of microalbumin for a 24 hour collection. The common limit I saw for a "gold standard" urine collection was less than 30 mg (3 g) in a 24 hr. period. I still think some part of the picture is missing. UCREAT - U for urine analysis, CREAT for either creatinine clearance concentration, or sometimes just creatinine clearance. Creatinine clearance values are different depending on whether they are derived from blood samples or urine samples. Perhaps this is another indication that the microalbumin was determined from a urine sample. Can you tell us whether you gave any urine samples, and what kinds? Dennis (Type 2) > My lab report says: > MICROALB..............<0.2 MG/DL.........0.00-2.00 > This is in a USA hospital. > > On a related note, what is UCREAT -- it's given just as result, with no > reference range or anything else. My lab report from Quest Diagnostics showed creatinine, urine range of 20-370. Microalbumin was shown in mg/L without a range. The measurement converted to dl seems reasonable, but maybe there is duplication involved. A ratio was shown for microalbumin/G creat also without a range. I suppose that G stands for gram. Creatine range in mg/dl was 0.5-1.6. Frank >> My lab report says: >> MICROALB..............<0.2 MG/DL.........0.00-2.00 [quoted text clipped - 11 lines] > > Frank Oh!Oh! I know this one! ;-) Microalbumin shown as mg/L without a range is for sure a urine analysis. It refers to the total albumin in a sample of urine, possibly timed. They often do not give a range because there can be many causes for a "high" reading that many have nothing to do with any kidney disease. It could have been a small sample reflecting an "at the moment" transitory problem. Any suspicious reading in anything other than a 24 hour collection would be cause to re-test. The ratio is used to see if there is filtration problem in the kidneys, ie., they are not working properly. The ratio involves two test results and is units of microalbumin to units of creatinine. G is for grams. Again, the range is often not shown because different problems have different ranges to watch for. Creatinine, urine - range 20 - 370 is again a total count from a urine sample, possibly also timed. This plus the microalbumin from the same sample is where the ratio calculation comes from. Creatinine range mg/dl of 0.5 - 1.6 is the normal reference range for a blood sample (serum) of creatinine. Did you give blood samples and urine samples? Was the urine sample a small container, or a 12 hr or 24 hr sample? Dennis (Type 2, Kidney Transplant 1995) Since you asked two question I suppose you want an answer. > Did you give blood samples and urine samples? Both. Was the urine sample a > small container, or a 12 hr or 24 hr sample? Small container. Frank >> I have Type 2. Going on 1 1/2 years diagnosis. >> [quoted text clipped - 24 lines] > have experienced early damage, and without treatment, you're at risk of > kidney failure." Uncle Enrico and your wife are correct. Get more tests, more clarity, or request a consult with a specialist. If they think you have a problem, don't fool around. I did and so did my last GP (12 years ago), and we both didn't notice my impending kidney failure until too late. As far as the lab values go, one needs to ask for hard copies of all your blood tests. I keep mine and enter the values on a simple spreadsheet, so that I can see trends over the years. People move, people change jobs and insurance and doctors, and people just change doctors or get new specialists. If you have copies, it can save time, misunderstandings, and mistakes. You need to know the exact name of the test and whether it was a straight test of albumin, total protein, or as a comparison. The values are different. Sometimes it is called microalbumin, and sometimes just albumin, and sometimes the test was actually total protein. Straight albumin (microalbumin) in the USA is 3.5 - 5.0 g/dl whereas in the rest of the world it is 30 - 50 g/L http://www.merck.com/mrkshared/mmanual/tables/296tb2a.jsp (shows both) http://en.wikipedia.org/wiki/Reference_ranges_for_common_blood_tests#Other_enzym es_and_proteins (metric) http://www.med-help.net/Blood-Tests-Electrolytes.htm#Lab%20Values: (USA) Bottom line: get more answers, more tests, or more doctors. Dennis (Type 2, Kidney Transplant 1995) I just checked my recent lab results. Normal is below 30. Mine was 17.34. I take diovan for that one half mg twice a week. Loretta -- In tribute to the United States of America and the State of Israel, two bastions of strength in a world filled with strife and terrorism. Bill, I think your wife is right. Kidneys are too important to do anything less than the very best you can. I'd see that specialist and follow his/her advice with unbounded enthusiasm. Be good to your kidneys. PS...to be on the safe side, I'd test more often to see what your post meal numbers are running. You may need some tightening up on diet and meds. By the way, the Assoc. of Endos. believes you should keep your fasting numbers below 110. Despite my diet, weight loss and daily exercise, the only way I got a good handle on my fasting numbers was with that miracle synthetic hormone that begins with I and ends with n. >I have Type 2. Going on 1 1/2 years diagnosis. > [quoted text clipped - 18 lines] > Thanks, > Bill >I have Type 2. Going on 1 1/2 years diagnosis. > [quoted text clipped - 18 lines] >Thanks, >Bill Hi Bill I'm a little confused too on the albumin levels - my ranges are the same as Kurt's. So I won't comment there. I think your wife is correct; get a qualified second opinion from the specialist. You mention that you only test once daily, and that is your fasting test. While you wait for your specialist's appointment, read this, you may find it interesting: http://www.alt-support-diabetes.org/NewlyDiagnosed.htm Cheers, Alan, T2, Australia. d&e, metformin 2x500mg  SignatureEverything in Moderation - Except Laughter. |
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