The urine microalbumin
of 37 and mild leaking of protein in urine
with absolutely normal BUN and Sr Creatinine
might not be part of diabetic nephropathy
. Reasons like- Some local symptoms, general fever, temporary high sugars, strenous physical exercise can also cause this kind of proteinuria
Let me ask you few things before we conclude that it is diabetic nephropathy:
- What was you blood sugar when you were first diagnosed to have diabetes?
- Does your family member have diabetes, and if yes, does he/ she has diabetic nephorpathy/ proteinuria or high blood pressure
or diabetic retinopathy?
- Have you gotten your eye checkup done to rule out diabetic retinopathy? If yes, what did your Ophthalmologist say?
- you please answer these questions and get a test called ''24 hour urinary protein and creatinine'' done.
The sugars, blood pressure are great and you do not need to panic about your kidneys at this stage.
If at all other reasons are ruled out and it is confirmed that your proteinuria is because of diabetic changes in your kidneys then the steps taken are like this:
- Eat only plant proteins (like dal, milk, whole wheat etc) and no non-veg proteins
- Minimise salt in your diet as much as possible (over time you get used to less salt diet, so try it)
- Minimise fat intake as fat increases load on kidney tissues and blood vessels of the kidneys making it less functional
- Exercise has to be regular just the way any person without diabetic nephropathy does- minimum 45 minutes/day/all 7 days of the week
- Blood pressure has to be targeted below 125/ 75 mmHg. For this if you need to increase the dose of Cardace (Ramipril) or even if you need to add another anti-hypertensive medicine, still it's ok. This will take load from kidneys and they leak minimum proteins then
- Water intake has to be just normal at this stage as you do not have any overt kidney disease at all
- Smoking has to be stopped fully, if you smoke. Smoking has direct link to both diabetic nephropathy and diabetic macrovascular diseases.
- To take Tab Cardace regularly.
- Last but not least perfect blood sugar control is must.
Now your question how long it takes the kidneys to deteriorate to end stage kidney disease from this kind of mild proteinuria: If patient has family history of diabetic kidney disease, if patient does not follow the above mentioned guidelines then it takes less than 5 years, but a perfect implementation of the above mentioned guidelines makes it reversible and the patient might not even develop diabetic nephropathy at all!
After you take all the precautions it will take less than one month for you to get normal proteinuria readings.
I have already explained the dietary restictions and said about water intake. Please anyway follow them for best results.
The foot might have some neuronal irritation due to Diabetic neuropathy
. You need to tell precisely what time you get the burning sensation and which part of the foot. I shall guide you on that. Hip pain is unlikely due to diabetes. If it is mild and not frequent, just ignore for the moment and exercise regularly. It might go off. If not, then let me know.