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Tuesday, March 11, 2014
Quality Health Care and You - Diabetes
Though A1c never over 7.2 and now 6.6
Microalbumin/Creatinine ratio is 31
Urea Nitrogn 19 Creatinine 0l8 GFR Estimated Greater than 60 BUN/Creatinine ratio 16
Just learned I have been on incorrect dosage of thyroid med for 6 months (.025 vs .125). Could this affect these levels as well?
What do I do regarding the above factors to improve? Thanks.
A hemoglobin A1C of less than 7% is considered to represent excellent diabetic control. The microalbumin/creatinine ratio is very slightly elevated, which is a sign of early damage to the kidneys. The blood creatinine is also slightly elevated, meaning that the kidneys are not doing a completely normal job of getting rid of waste products. So you have some signs of early kidney damage.
The thyroid medication dose should have no harmful effects on your kidneys.
The best things that you can do to help preserve and possibly improve your kidney function are:
- Continue to maintain excellent blood sugar control.
- Keep your blood pressure well-controlled. If it's high, you should be on blood pressure medications called "ACE inhibitors" (such as lisinopril, trandolapril, enalapril) or "angiotensin receptor blockers or ARBs" (such as valsartan, losartan, or candesartan) -- these two classes of meds will reduce blood pressure and also reduce the microalbumin/creatinine ratio.
- Do not smoke.
- Lose weight if you are above your ideal body weight.
- Take cholesterol-lowering drugs if needed.
Diabetes and hypertension are the most common causes of chronic kidney disease. However, with the proper management and medications damage can be prevented or kept to a minimum, especially when caught in the early stages. Go for it!
Mildred Lam, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University