Question:

I have had diabetes type II for 1 and 1/2 years along with other conditions (Hypertension, High Colesteral,Aortic anuerism, bone density loss. I am being followed for all and recently changed providers do to a move from one state to anohter. My new provider did some tests at the first viasit and called me to say everything was normal and o.k. However, when I asked about mt HGB A1C he stated they they the VA use Micro creatinine instead. I have been involved with medicine for 40 plus years and always thoght the the A1C was the best test. Wold you please tell me if this is correct?

Answer:

Congratulations on taking an active role in managing your type 2 diabetes! Because diabetes is a chronic disease that can affect several body organs (like kidneys, heart, eyes, feet, to name some main ones), doctors have several tests to help know how well individual organs are working.

One of the tests that can be done to see how healthy the kidneys are is to measure the number of tiny particles of protein in the urine (microalbuminuria); if there is too much, it can mean the kidneys are not functioning as well as they should.

Another test to see how the kidneys work is a blood test called serum creatinine; it rises as kidney function deteriorates. Another blood test is creatinine clearance and it measures how well the kidneys filter waste from the blood. Generally doctors look at more than a single reading; they want to see trends in the functioning of the kidneys.

Uncontrolled high blood pressure alone can cause kidney damage; uncontrolled high blood sugar is also damaging to the kidneys so it is especially important that these, as well as cholesterol (and other lipids), are well controlled in people with diabetes. In fact, the American Diabetes Association reminds people to ‘mind their ‘A-B-C’s’: A1C test (a blood test that measures the previous 3 months of blood sugars), Blood pressure, and Cholesterol.

How often these tests are done depends upon the results; abnormal results will likely mean the doctor will want to see these tests done more frequently in order to make recommendations on treating. Fortunately, there are many good medications available to manage blood sugars, blood pressure and high cholesterol levels. Your doctor, being familiar with your situation, could advise you on this. If you have not had the opportunity to meet with a diabetes educator in the past, you may want to ask your doctor for a referral. Good luck!

For more information:

Go to the Diabetes health topic.