Son just had elevated microalbumin test result....how worried should I be?

[anniem47]

My son is 20 years old, and has type 1 diabetes since he was 3 years old.  The dr. ordered a 24 hour urine test this time since it has been over 15 years since he was diagnosed.  The test came back at the high end of normal, being 144 mg protein for his height and weight vs 24 hour period.  The dr. already had him on Alstace caps of 2.5 mg each.  Danny should have been taking them all last year, but he couldn't remember to take them when he was at college. However, while at home this summer he has been pretty good at remembering every day after the re-emphasization of the importance this medication can have for his long term health.  Every other test result was good, his cholesterol good and bad, his blood pressure had always been good, thyroid, etc.  What I'd like to know, is how concerned should I be that this is the beginning of Kidney disease for him, and what is the likelyhood that it can be stopped or contained?  After getting these results, the dr. has raised his alstace to 5mg per day.  I have also done quite a bit of searching on the internet to determine what the normal values were, which I finally found to be up to 165.  There was also several sites that recommend a "random urine test" to check for microalbumin, and they suggested it is more effective than the 24 hours test, and certainly the dip stick.  Should I be persuing my son doing the Random test also?

My son also plays sports regularly.  How likely is it that him playing indoor soccer the night before the 24 urine test was done could have affected that test result?

anniem47

[JDRF Team SGG]

I have been a type 1 diabetic for 35 years and have no complications thus far, so a healthy long-time prognosis is very possible for your son. I am chuckling over SS's comment: "trying to control diabetes is like trying to control a natural disaster". I think we all feel that way sometimes, and it is good to see the humor in it when we can. I am not a doctor, and of course only can offer thoughts from personal experience and from my own reading. But have some thoughts base on many years of seeing various doctors while moving around the country every 1-3 years with a military spouse.

I do believe that many endocrinologists do like to do preventive treatments these days, such as treating cholesterol even when in the normal range with drugs or of course the baby aspirin therapy, and treating for microalbumine when the test results are still in the normal range. This sort of prevention is smart and doesn't mean that your son is in trouble, just that his doctor is using the very popular preventive medicine theory to KEEP him heahtly. I would suggest a random urine test on a day when he has NOT had excessive exercise the day before, for extreme exercise does affect the body in lots of ways for even days after the exercise.

Also, his control may have been a little lax during the last few months, too, and tightening up control can of course revitalize the blood vessels feeding his organs. So these kinds of things don't necessarily mean that he is in trouble. They just give us added incentive to do what we can to keep tight control in order to let the body take care of itself properly. Many problems caused by diabetes can be reversed by tight control if caught before damage has occurred. The body has an amazing way of regenerating its cells and healing itself if glucose levels are brought to normal limits. So look at the a1c number and if he needs to tighten up, he can do so. If not, then he is probably fine with the preventive treatments his doctor is ordering.

[JDRF-Team-SS]

Hello again,

It sounds like you are very intelligent and Internet savvy.
We have also been with the same endo since my son was diagnosed.

I apologize again that I could not be helpful in answering your questions.

You have helped me from your post.  I am really curious how often Type I diabetics should have blood drawn to have a series of tests performed.  I am going to ask my son's doc.  Last time we saw him (about a month ago) I asked him if Charlie needed testing done and he said, no, so we did the usual Hemoglobin A1c.

It sounds like you are on top of things.

My son's endo once said that trying to control diabetes is like trying to control a natural disaster.

I hope someone posts that can answer your questions.  It sounds like you have a great doctor, but I know that as a Mother we still worry.

Keep us posted.

[anniem47]

In regard to some of the information you posted, yes, I have done research on this subject all day since the test result was given to me.

I have the uptmost faith in my son's endocrinologist.  He has been with the same dr. since he was diagnosed.  At that time, the dr. was very involved in not only treating juvinile diabetes, but also very extensively involved in research.

Danny's test was at the upper end of normal, I guess the key word here being normal.  This leads me to believe that he is definately being assertive in his treatment of Danny, not wanting him to have this advance to a more dangerous level.

However, I am going to ask him if Danny should do the "Random Urine Sample" test since that is getting higher marks than the 24 hour one.  I will trust his judgement on this one.  

My internist, who is also now my son's dr. too, suggested the same course of action as his endocrinologist, which gives me more confidence that his endo is where he should be.  Last year at my son's sport physical he recommended the Alstace and baby aspirin each day.  I decided to wait until he saw his endo to see what he would say, and without prodding from me, the endo had the exact same recommendation as the internist.

I will never hesitate in getting a 2nd opinion if I ever think the doc is behind the eight ball.  I follow my son's health very closely, and read almost every book on the disease when he was diagnosed.  I am very health care literate, and have no problems addressing issues, problems or questions with the doctors.

Thanks for putting this out there, and your response.  Sounds like you yourself are getting your share of experience with this dreadful disease.  No one who hasn't dealt with someone closely with this disease understands the absolute control it has over their lives.

My son Danny has always been in great control.  Only when he went off to college in 2001 did his numbers go about 8 on the glyco.  His last glyco was finally back down under 8 again this past visit.  College is a big issue to deal with regarding his schedule, what he can eat, drinking, etc.  Though I feel my son has been above average in this concern, he is still a 20 year old who wants to be as close to non diabetic as he can.  It is a tough issue.

Thanks for your research and advice.  I look forward to any other comments people may have on this issue.

anniem47

[JDRF-Team-SS]

Hello anniem47,

First I want to tell you that I am not a medical professional, nor can I give medical advice, I can only give you input from my knowledge and own personal experience.

My son was also diagnosed at the age of 3 with Type I, ...he is now 9 1/2.  My sister is also a Type I diabetic.

I am sorry to hear that Danny's microalbumin test came back elevated.  I am not too familiar with this test, but I did some searching, as well.  Here is a little info. that you may have already found:

What if my test result is not normal?
Test results are only one part of a larger picture that takes into account your medical history and current health. Sometimes a test needs to be repeated to check the first result. Or your provider may order other tests to check your kidney function if the microalbumin is high. Talk to your provider about your result and ask what it means for you.

If your test results is not normal, ask your health care provider:

if you need additional tests
what you can do to work toward a normal value
when you need to be tested again.


annie, have you been with the same endocrinologist since Danny was diagnosed or at least for quite sometime?  Just curious....Did he suggest to repeat the test?  Sometimes when we are at an appointment all of the questions do not come to mind.  Then we think of them later at home.  (make a list of questions for your son's endo)

If I was in your situation, I would ask my son's endo the questions above.  If I felt uneasy, I would then get a 2nd opinion.  However,I have complete faith and trust in my son's doc, so I would proceed however he saw fit.

I am going to pass your question(s) onto some other volunteers for their input since I do not have much knowledge about this particular test.  

Please do keep us informed about your son.