Your reading of urine albumin at 46 means you are having microalbuminaria.Elevated albuminuria (30 to 300 mg/d albumin is the definition of microalbuminuria
) is an early predictor of progressive renal function loss in diabetes.
Microalbuminuria is an important clinical finding because it is not only associated with an increased risk of progression to overt proteinuria (macroalbuminuria) and renal failure
, but also cardiovascular events. In patients who progress to overt nephropathy, microalbuminuria usually precedes macroalbuminuria by an interval of 5 to 10 years.
Large clinical trials have demonstrated that achieving tight glycemic (i.e. HbA1c
It has been seen that lowering of BP with agents that interfere with the renin-angiotensin-aldosterone system, such as ACE inhibitors or ARB is most effective for lowering urinary albumin excretion.
Your goals of treatment should be
Tight blood sugar control
Lowering of BP to below 120/80 with either ACE inhibitors or ARB's
Quitting smoking if any.
Avoiding all nephrotoxic drugs
Prompt control of any urinary tract infection
Low protein and low potassium diet
Avoiding potassium sparing diuretics like spironolactone
Be on regular touch with your diabetologist
as well as nephrologist