Never heard of Microalbuminuria until now. I had to look it up and look up even how to pronounce it. So, from what I gather from my research…it’s not good. Got it.
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Freedom Light (which my OmniPod also uses). Lucked out, I guess, 'cos when I was diagnosed, this was the meter I was given in hospital.
Good luck at your appointment!
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Yes, microalbuminuria is the failure of your kidneys due to vascular damage. It isn’t good.
Also, this data is from the DCCT study, which is the best large study done to date on what happens with diabetics over time. It would be great if they funded another one using the modern treatments, this study was done from 1983 - 1993.
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So many people in that study had been diagnosed in the 1950s and 60s.
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Actually not that many. Primary prevention cohort was diagnosed within last 5 years, and the secondary prevention cohort was last 15 years. So the oldest diagnosis date could have been in the late 1960’s. With that said, because control was harder to judge back then (late 60’s/early 70’s) if anything I would say that the graph provided above may overestimate the risk of complications because patients could have been poorly controlled prior to the study when they got good control.
DCCT inclusion criteria:
To be eligible for the primary-prevention cohort, patients were required to have had insulin dependent diabetes mellitus (IDDM) for one to five years, to have no retinopathy as detected by seven-field stereoscopic fundus photography, and to have urinary albumin excretion of less than 40 mg per 24 hours. To be eligible for the secondary-intervention cohort, the patients were required to have IDDM for 1 to 15 years, to have very-mild to moderate nonproliferative retinopathy, and to have urinary albumin excretion of less than 200 mg per 24 hours.
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Unfortunately, kidney problems are the most common of all D complications. I have read statistics that it ends up affecting 30 to 50% of all people with diabetes 
I keep my son on a high drinking regimen at home, for that reason. But, to tell the truth, I have no idea if it helps. I tried to find scientific evidence for what the doctors tell me on this (that drinking a lot of water is good for kidneys), but I have not found any so far.
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I think retinopathy is actually the most common – something like 75 or 80 percent of people usually develop some signs of it after 30-50 years. But also there are so many treatments that anyone decently controlled with a proactive ophthalmologist can usually prevent blindness or vision loss long-term. So that one bums me out but I try not to worry about it.
But yes, kidney disease is super common. If you are well controlled, maybe your risk dips down to 10 or 15 percent but it’s not negligible, and I’ve seen people on the CWD forum talk about their children having microalbuminaria just a few years out from diagnosis with decent A1Cs. Scary. Of course, the risk of shortened life isn’t necessarily tied to microalbuminaria, which newer studies suggest typicaly precedes macroalbuminaria and CKD, but not necessarily. Microalbuminaria can come and go and poor outcomes aren’t necessarily tied to it as long as it doesn’t progress. Or at least, that was my understanding (need to dig up the studies).
I hate to go into the Debbie Downer rabbit hole but my sense is that it really is about much more than glucose… there are other inflammatory, autoimmune and disrupted signalling processes going on in T1D and we really have only scratched the surface with glucose control. Especially just seeing that T2Ds with the same A1Cs often have a worse rate of some of these complications – clearly other factors play a role.
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This is what I worry about most for my kid I also read about many treatments, and typically mild retinopathy for well controlled PWDs. Heart disease is also at increased risk, but we all know so much about it. To me, kidney disease is the worst concern. Most people waiting for kidney transplants are PWDs.
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It’s my worst nightmare too.
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All of these reasons I switched to the pump and am working on more time in range, etc.
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@Irish I wish you luck at your appointment! I know you’ve got this, because you are smart and working hard at doing the best job you can for yourself. Don’t let the bastards get you down. And know that you are looking out for you, even if your doc isn’t.
I was actually replaying your story in my head, while I was sitting at the first horrible endocrinology appointment that @EricH has ever had, yesterday. Not that I didn’t want to be able to relate to you, but I was marveling at the fact that until yesterday, we have had such good luck. I will say it sucked. I’ll write a little thing up about it soon.
Just remember: you’ve got this!!
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I tried to be a part of this study but wasn’t eligible. I was diagnosed in 75, and when I heard about this study I went to Joslin (a subway ride away) to see if I could be included. I had had diabetes too long to be in the 5 year cohort. They looked at me for the secondary-intervention group, and tried hard but could find no retinopathy so I wasn’t eligible for that group either. Clearly a good-news/bad-news kind of thing - too bad that I couldn’t be included, but I had to feel good about the reason I wasn’t eligible.
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What a great story!
@jag1, I must tell you my son eagerly reads every post you make here (as well as a small number of other long-diagnosed PWDs here). He is in awe of PWDs who were diagnosed a long time ago.
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