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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Hypertension, Diabetes, Tests Show High HbA1c. Sign Of Kidney Failure?

My 50 years wife is hypertensive and diabetic since last 9 years. Her Hb A1C is 10.7%, and Urine Report has shown following: Glucose 28mmol/L Urobilinogen 3-2 umol/L Hemoglobin Small (+) Leucocytes 2 /HPF RB Cells occasional/HPF Bacteria few She takes Getryl, Glucophage for Diabetes and A2A for High Blood pressure. Does it mean that her kidneys are failing and what to do in this situation?
Wed, 9 Jan 2013
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Internal Medicine Specialist,  's  Response
Diabetes of 9 years duration at 50 years of age with HbA1c of 10.7% suggests that there is a NEED to IMPROVE CONTROL of Blood Sugar and bring A1c to TARGET of 7% or BELOW
The Urine report does NOT show Micro Albuminuria test or value which is a must to know Kidney Involvement by Diabetes so She needs to Undergo Urine Micral test and if abnormally high then needs to be put on ACE Inhibitor drugs to reduce proteinuria.Also proteinuria suggests involvement of Retina of the eye and so it is a good idea to get Retinal Check by Eye surgeon if not done in last one year.
Get back if need be by follow up question for clarification after the report
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Endocrinologist,  Dr. Om Lakhani's  Response
Hi,

Thanks for writing in.

HbA1c 10.7 % for your wife is very very high. The medications she is taking for diabetes is not enough and the control is very poor.

As far as the question of kidney failure goes , we need to do the following two tests to determine whether the kidney is failing or not...

1. Urine albumin/creat ratio (urine microalbumin)
2. Serum creatinine

Please get back to us with these reports. We will be happy to advice further management.

Hope I have answered your query.

Regards
Dr. Om Lakhani
Consultant Diabetologist
http://www.healthcaremagic.com/doctors/dr-om-lakhani/60313 (online expert diabetes care consultantion)
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Hypertension, Diabetes, Tests Show High HbA1c. Sign Of Kidney Failure?

Diabetes of 9 years duration at 50 years of age with HbA1c of 10.7% suggests that there is a NEED to IMPROVE CONTROL of Blood Sugar and bring A1c to TARGET of 7% or BELOW The Urine report does NOT show Micro Albuminuria test or value which is a must to know Kidney Involvement by Diabetes so She needs to Undergo Urine Micral test and if abnormally high then needs to be put on ACE Inhibitor drugs to reduce proteinuria.Also proteinuria suggests involvement of Retina of the eye and so it is a good idea to get Retinal Check by Eye surgeon if not done in last one year. Get back if need be by follow up question for clarification after the report