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Suggest Treatment For Type 2 Diabetics
On a 3 hr. gtt, at hour 2 my urine glucose level was 500. The test showed that I have type 2 Diabetes. I have at least a 7 yr. history of neuropathy. In that time Neurontin has been increased to 3600 mg. I also have extreme fatigue, sore joints and muscles, serious cognitive issues (slowing in eeg), my head swims, I have a numb, but still painful feeling on the left side in the middle of my back, and my father died with kidney failure. I have more testing scheduled with a neurologists, but I am growing more concerned the more I read about glucose in the kidneys that i might need to see a nephrologist. I need a professional opinion.
Fri, 18 Jul 2014
Thank you for the query.
I would like to know your age, gender, duration of your diabetes and the control of your diabetic status.
As per the information provided, you have neuropathy for 7 years (on Gabapentin 3600 mg i.e. Neurontin) and family history of renal failure (you father). Glucose is not normally found in urine. When blood sugar levels rise well above a target range the kidneys attempt to release the excess sugar from the blood into the urine. Urine glucose level of 500mg% is moderate glucosuria, and this implies your blood sugar was quite high. I would advise you to do a the following tests if not done already - Fasting blood sugar, Post Prandial Blood sugar and HbAic.
Regarding your query regarding nephropathy, you can get the following tests done - Urine for spot Albumin Creatinine Ratio (ACR) or 24 hrs urine for proteinuria. Renal function tests like urea and creatinine are not very sensitive to pick up early nephropathy. If proteinuria (protein in urine) is detected you need to be started on medications like ACE inhibitors and ARBlockers after consulting your physician. Since you are diabetic with glucosuria, you have to be careful regarding development urinary tract infection.
Please get your eye check up done (to rule out any diabetic changes), since you already have an evidence of microvascular changes (neuropathy).
Your physician can provide you further information in this regard.
Hope this helps you out.
Regards
Dr. Ayusmati Thakur
I would like to know your age, gender, duration of your diabetes and the control of your diabetic status.
As per the information provided, you have neuropathy for 7 years (on Gabapentin 3600 mg i.e. Neurontin) and family history of renal failure (you father). Glucose is not normally found in urine. When blood sugar levels rise well above a target range the kidneys attempt to release the excess sugar from the blood into the urine. Urine glucose level of 500mg% is moderate glucosuria, and this implies your blood sugar was quite high. I would advise you to do a the following tests if not done already - Fasting blood sugar, Post Prandial Blood sugar and HbAic.
Regarding your query regarding nephropathy, you can get the following tests done - Urine for spot Albumin Creatinine Ratio (ACR) or 24 hrs urine for proteinuria. Renal function tests like urea and creatinine are not very sensitive to pick up early nephropathy. If proteinuria (protein in urine) is detected you need to be started on medications like ACE inhibitors and ARBlockers after consulting your physician. Since you are diabetic with glucosuria, you have to be careful regarding development urinary tract infection.
Please get your eye check up done (to rule out any diabetic changes), since you already have an evidence of microvascular changes (neuropathy).
Your physician can provide you further information in this regard.
Hope this helps you out.
Regards
Dr. Ayusmati Thakur
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