Coping with the monkey...

[Tropical83]

Hey everyone, today I feel really lost/confused. For the past 6 months I've been working really hard along with my fiancee to get my diabetes under control but it's been really hard. I am on the 515MM and they've changed my ration from 1 unit covering 15g carbs to 1 unit covering 10g carbs and that's helped a lot. I'm not sure why I've had to go up, I'm 25 and I guess my metabolism is changing? I've gained some weight (~25lbs) and it's been a such a pain to lose the weight. I try not to worry about my weight and concentrate on getting my numbers back in check first because if I don't get that controlled then I won't have anything else controlled either. I've started noticing that some of the diabetic side effects are starting to come out of nowhere (which sucks :( ) but I guess after 16yrs what can I expect??

The last time I went to see my Dr my A1C came back 7.5% which is not good but it's way better than 11% so claps for me :congrats:!! The only bad thing is that she sent me a letter saying that I have protein in my urine and it is really starting to worry me. I looked up microalbumin and it's not looking any better because it only told me that it's first signs of kidney disease and I'm terrified!! I'd like to have a family with my - soon to be husband in 26 days - but I'm scared that I won't be able to give him any babies. We've talked about that and we've agreed to adopt if it came to it but I'd like to at least have one baby.

What causes microalbumin anyway??? I know high blood sugars is probably the leading cause but is there anything else that could cause it?

Thanks!

[ihd1111]

From WebMD:

"A microalbumin test checks urine for the presence of a protein called albumin. Albumin is normally found in the blood and filtered by the kidneys. When the kidneys are working properly, albumin is not present in the urine. However, when the kidneys are damaged, small amounts of albumin leak into the urine. This condition is called microalbuminuria.

Microalbuminuria is most often caused by kidney damage from diabetes. However, many other conditions can lead to kidney damage, such as high blood pressure, heart failure, cirrhosis, or systemic lupus erythematosus (SLE). If early kidney damage is not treated, larger amounts of albumin and protein may leak into the urine. This condition is called macroalbuminuria or proteinuria. When the kidneys spill protein, it can mean serious kidney damage is present. This can lead to chronic kidney disease. A microalbumin urine test can be done on a sample of urine collected randomly (usually after the first time you urinate in the morning), a sample collected over a 24-hour period, or a sample collected over a specific period of time, such as 4 hours or overnight."

I would ask to be retested. Also, see your doctor to talk about exactly what your test results mean and what you should be doing to help prevent further kidney damage. Hopefully it is in the very early stages and not much damage has been done. Hang in there and remember you are not alone.

[Erin]

Also see if you can work with a CDE to get your blood sugars in check. They are often more helpful than the doctors.

Be happy that you got your A1c down to 7.5, yes you want it to be better, but you made great progress.

[Tropical83]

Thanks guys! I will ask her to re-check my urine. I haven't been 'the best diabetic' ever the last 3 years but I can't give up and I won't. Since I've joined DF I've noticed that I have a lot more to work on than just re-adjusting my pump all the time. I need to work on my dieting, exercise, and so much more. I want to do the low-carb thing because I've noticed good change in my basal/bolus/sugars when I don't eat as many carbs like I have been doing for lunch for the past 2-3 weeks. Not to mention all the support that anyone can get here it's only another booster to do better.

Thank you for pointing that out Erin! It was a giant relief when my nurse told me the results of my last A1C! I was at work jumping up and down because I was so excited! I'm gonna get it lower next time,:thumbsup:!!:D

[owlyn]

A 7.5 A1C for a T1 isn't horrible. Some T1s here claim to have A1Cs in the 5s and 6s, but I've never been able to acheive that. My A1C consistently runs in the 7s, and this has been true for the last 16 years. So far, no complications. My family doctor and my endo both are not panicked about it. The problem is that with T1s, to get below 7 usually means more frequent and/or severe hypos. But- everyone is different.

Ask your doctor about taking ramipril, lisinopril, or some other ACE inhibitor for your kidney issue. It has been well-documented that these help to prevent kidney damage in diabetics. If you doctor doesn't know about this, get a new doctor, as this is old news now. I had microalbuminuria years ago(in two different tests to eliminate the possibility it was just a random thing), my doctor put me on lisinopril, and I have had no reoccurrence.

My ratio was 15:1 for years, but has recently changed in the morning. So much so, that I had to split my Lantus and take extra *log with breakfast. Your body changes over time- it's nothing abnormal. It just makes it take extra work to figure it out.

[Tropical83]

Thanks Owlyn! She just recently put me on lisinopril, about two weeks ago and I'm taking 2.5mg/day so I'm not sure if she'll go up to 5mg now since I probably might need to.

As for the A1C, I am trying to get it lower but like you said, I'm getting a lot more hypo's than before but I'm still going to try. There are a few other things that I haven't tried doing yet so I hope that I can at least get it to 7.0%.

Thank you for replying! :)

[Psycho Penguin]

To be honest, I would rather have a 7.5 and few hypos as compared to 6.5 and a lot of them. The hypos put a lot more strain on the body than that 1 point of AIC percentage does.