Albumin IN Urine IS The Warning For Diabetes

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Albumin.jpgIt has been repeatedly emphasised in these columns that the treatment of diabetic complications should begin before the complications appears. Among the organ that deserve special attention, kidneys, heart and eyes stand on the top of the list since these are liable to suffer the most devastating consequences. As for kidney, Diabetes today happens to be perhaps the commonest cause of chronic kidney failure resulting in an end-stage disease which is often irreversible. Hence the need to pick up diabetic effect on kidney pre-emptively and employ suitable measures to reverse it.
Albuminuria or albumin in urine is known among those suffering from Diabetes. The point, however, missed is that it can be present even in early stages of glucose intolerance long before the manifestation of overt Diabetes. The detection of albumin in urine of any individual, therefore, calls for screening for underlying Diabetes or Pre-Diabetes.
Valuable Evidence
Microalbuminuria or small quantities of albumin in the urine occurs in early stages of kidney involvement in Diabetes Mellitus. In addition, microalbuminuria is now also recognised as a marker of impending or possible future involvement of heart. Infact, many a victim of nephropathy or diabetic affliction of kidney fail to reach the end-stage kidney disease because before that they succumb to a fatal heart attack.
An increased risk for albuminuria or albumin in urine is evident among persons with Impaired Fasting Glucose and newly disagnosed Diabetes suggesting that the development of albuminuria commences early in the onset of Diabetes. Recently published statistics from credible sources now reveal that even before the onset of Diabetes, microalbuminuria is found to be present in persons with Impaired Fasting Glucose and Impaired Glucose Tolerance to the extent of 9% and 10% respectively. It is this latter group of population which can be effectively targeted and saved from going ahead to develop Diabetes and its consequent complications. 
Timely Intervention can help
Early and aggressive control of Blood Sugar and Blood Pressure in presence of Diabetes has been found to have a beneficial effect on albuminuria. This is turn can help reduce the burden of kidney disease as also heart related complications.
Increased urine albumin excretion is not unique to adults with Diabetes Mellitus alone but may also be seen in a substantial proportion of adults without Diabetes Mellitus. If detected in time, such individuals can be helped through medicinal as well as as non-medicinal intervention under the advice of preferably a Diabetologist or a physician.
At the same time, it must be emphasised that screening tests for chronic kidney disease in Diabetics should ideally also include estimation of glomerular filtration rate in addition to urine albumin excretion in order to maximize the sensitivity of screening tests. Be that as it is, to put it in a single sentence, albumin in urine may forewarn about Diabetes.

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