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What is the damage to my kidneys due to diabetes ?

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I'm recently diagnosed type 2 diabetic but my glucose is now well controlled. A1c was not done at beginning but 45 days into treatment. It's 7.2, fasting glucose 81. Microalbumin is 22, urine Creatinine is 303. How messed up are my Kidneys?
Posted Thu, 3 May 2012 in Kidney Conditions
Answered by Dr. Robert Galamaga 22 minutes later
Hello and thanks for your query.

First of all, congratulations on aggressively adjusting your lifestyle along with medications to get your diabetes under control. As for kidney damage, I am not concerned that you have any issues with this. This is especially the case with your hemoglobin A1C now coming down quite nicely toward the normal range.

every physician has different targets for the A1C but we generally regard an A1C at 7 or less as good. Somewhere between 6 and 7 should serve you well. As you know, weight loss is a key component to controlling the diabetes and for maintaining good kidney function. Exercise as well is supremely important. What exercise does is that it makes your body more effficient at handling any fluctuations in your blood sugar. If your blood sugar climbs above 100 for example, your body will be able to bring it down to a normal range more efficiently if you exercise regularly.

With continued healthy diet and exercise it is possible that your doctor may consider taking the metformin or victoza out of your daily regimen. For now, however, continues these meds and keep working on achieving your goals.

As you also know, high blood sugar is toxic to small blood vessels - including those in the kidney and heart. Keeping the blood sugar in the 70-90 range will avoid these complications for you and you will live a very long and happy life. Blood pressure control is very important and it looks like yours is under good control there.

From your history here, you are a model patient in my opinion. You have basically turned your life around in getting this diabetes under control and I again applaud you for this.

I again thank you for your query and want to reiterate that your kidney function appears optimal with no evidence of compromised function. If you have additional concerns I would be happy to address them.


Dr. Galamaga
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