When should microalbuminuria be checked

As mentioned earlier, microalbuminuria is present in 10-42 percent of Type 2 diabetic patients at diagnosis, since the disease has most likely been silently present for many years before its clinical manifestation. For this reason, measurement of albumin excretion rate is recommended at the initial diagnosis of diabetes, and then yearly, if it is within normal limits initially.

As regards Type 1 DM, a check of the albumin excretion rate is recommended five years after the initial diagnosis - since microalbuminuria is rare at shorter durations of the disease - and yearly thereafter, if the initial results are within normal limits. If the result is positive for microalbuminuria, given the great variation of albumin excretion from day to day, it is recommended to repeat the test another couple of times within the next 3-6 months. If two of the specimens are positive, microalbuminuria is considered present. At the same time it is essential to consider - depending on specific indications - and possibly treat, the other conditions that are associated with microalbuminuria/proteinuria mentioned above, before the condition is attributed to diabetes. Ophthalmoscopy is always necessary, since, as mentioned, it strengthens the diagnosis of diabetic nephropathy.

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