kidney disease

[lindora]

I am an RN and my boyfriend has been type I diabetic for 28 years,having had better control for the las 5 years with an insulin pump. His BP is controlled, He's been on Accupril 40mg daily for approx 7 yrs. Hgb A1-c is 7.4. His kidney function test have been ok except for his latest BUN/CREAT ratio result of 29(the lab using 6-25 for norm). Should we be worrying, contacting a renal specialist and is there anything else other than tighter BS control and sodium intake that we can do?

[JDRF-Team-CDB]

Wow, your boyfriend is fortunate to have you in his life.... your medical knowledge surely surpasses mine, because I'm just the mom of a type-1 diabetic and the wife of a type 2. From a diabetes point of view, there's probably nothing else to do besides the continuing effort for tighter BS control. It would seem wise to consult a renal specialist, to find out if a ratio above norm is reason for concern or not, and what if anything can be done about it.

good luck, and sorry I can't provide specific medical advice.

[JDRF Team SGG]

I have read articles that suggest that the numbers can sometimes be affected by things such as simple dehydration, and it has been suggested that people compare the numbers from several tests before getting overly panicky, for one test can be just a fluke. But, having said that, his a1c number does need to come down. Nowadays as opposed to years ago (I, too, am a long-time type 1 diabetic) it is very possible to keep a1c levels very easily well below the magic number of 7. We have new insulins that match digestion times much better than the old ones, and surely there is a possible treatment that can provide better control than he currently has. Many type 1 diabetic adults now can maintain a1c levels right around 6 without danger of severe hypoglycemia, which was the real risk to tight control in previous years. Pumps and 24-hour insulin combined with new quick-acting insulins make control much easier than when he was first diagnosed. I would encourage both of you to talk with his endocrinologist about looking into possible changes that can bring his a1c levels well down below 7. That truly is his best protection not only against kidney disease, but against other complications. If sugar levels are maintained at near normal levels, damage cannot happen.