Q: (1) I am 58-yr old male with and a Type II Diabetic. I take no medication and my Dr. Assures me that my disease is controlled. My typical fasting glucose ranges from 86-97 and my 14-day average of all is 103. My last A1c was 6.2.
(2)I am very concerned about my kidneys; my last serum creatnine was 3 (our lab normal is 1-3)but my GFR was 60. Urine creatnine is 185. I have no evidence of proteinuria or microalbuminaria (last test was 6 on scal of 0-30) and creatnine to albumin ratio was 3).
(3) PROBLEM: My urine is always frothy and has been for years, I now findout through my own research that this is always a bad sign. What could it be if my protein readings are normal?
A: Your sugar control appears excellent and your hgbA1c is at the ideal range of less than 7. I cant comment on your lab values because normal value ranges may vary slightly among different laboratories. But what I can tell you is that it is reassuring that you don't have mircroalbuminuria since this is the earliest evidence of kidney disease. I'm not sure what you mean by frothy. Urine frequently has a foam appearance in the toilet. If you mean 'cloudy' then that is sometimes a sign of a urinary tract infection which I'm sure you've been checked for since you have had a urinalysis. You may just have concentrated urine.
In general, it is recommended for diabetic patients to be started on medications called ace inhibitors (unless there are contraindications), as studies have shown that they offer protection of kidney function and slow the progression of any kidney disease. Controlling your blood sugars- which it sounds like you are doing and controlling your blood pressure are also important factors that reduce your risk of kidney disease. Best of luck.
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