Brief Answer:
She needs further evaluation.

Detailed Answer:
Hi Mr. XXXXXXX Sarkar,

Thanks for your question.

I can understand your concern.

Albumin creatinine ratio is one of the predictor of progression of renal disease in Diabetic patient.
Interpretation of result as follow:
Normal: < 30 mg/g
Microalbuminuria: 30–299 mg/g
Macro (clinical) albuminuria: > 300 mg/g.

Its level is affected by-
- Diabetes control.
- Blood pressure control.
- Physical exertion.
- Presence of fever.
- Urinary infection.

So I would like to advise to do-
1) Blood sugar level fasting and post prandial.
2) HbA1c level it will tell blood sugar level over a period of last 3 to 4 months.
3) Regular BP check up.

If blood sugar control and blood pressure is in normal limits do following tests because high blood sugar or uncontrolled blood pressure may affect the result

1) Renal function test and Creatinine clearance it is another predictor of progression of kidney disease in diabetes.
2) Lipid Profile.

As you have mentioned there is no abnormality seen except little skin problem at her shoulder.
Her shoulder problem most likely not related to her kidney status.

So there is no hurry to visit doctor immediately.

You should monitor her diabetes and blood pressure control.
If blood sugar level and/or blood pressure is not under control then consult your treating doctor.
Once the level of blood sugar and blood pressure stabilized do the tests as mentioned above along with albumin creatinine excretion ratio and consult your doctor with test result.

Screening for other complications of diabetes like fundoscopy for diabetic retinopathy, foot examination for diabetic neuropathy and vasculopathy, ECG and 2DEcho of heart, ultrasound of abdomen and pelvis should be done with consultation with your doctor .


Hope I have answered your question.
I will be happy to answer your follow up questions, if any.
Otherwise close the question and rate the answer.

Regards,
Dr. Abhay Mali.
Diabetologist.

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Brief Answer:
Fairly controlled diabetes.

Detailed Answer:
Hi,

Thanks for follow up question.

After going through test results you have mentioned, there is fairly good control of diabetes.
Blood pressure and TSH is also within normal limit.

Lack of compliance with medicine Citapin for 3 to 4 days may not affect her urinary albumin creatinine ratio.

But it is advisable to recheck it with early morning (first) urine sample.
Along with it check her serum creatinine and creatinine clearance.
Combination of these tests will give better idea of her kidney status.

Hope I have answered your query.
Please close the question and rate the answer.

Regards,
Dr. Abhay Mali.
Diabetologist.

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