A microalbuminuria test, a measurement of tiny amounts of protein in a urine specimen, indicates if T1DM is affecting your child's kidneys. Finding excessive levels of microalbumin is a very early and reversible sign of kidney damage due to diabetes. If the test finds abnormal amounts of microalbumin, there's plenty of time and opportunity to do something about this complication (see Chapter 5). The usual test for albumin, which involves a test stick put into a urine specimen, is only positive if there are large amounts of protein in the urine — greater than 300 mg per day. The microalbumin test is positive if the amount of protein in the urine is greater than 30 mg per day. A finding of small but abnormal amounts of protein (albumin) indicates the earliest evidence that diabetes is damaging the kidneys.
This test is first done about five years after your child has a diagnosis of T1DM. A negative test should be repeated annually. A positive test should be rechecked at the next appointment because the test can be falsely positive after strenuous exercise or if the patient is dehydrated. If your child has several positive microalbumin tests, the following actions are taken:
^ The doctor puts your child on a drug called an ACE inhibitor. The microalbumin test can become negative after several months of taking the ACE inhibitor, and it may be possible to stop the drug after a while.
il You take steps to get your child's blood glucose as normal as possible.
The Diabetes Control and Complications Trial showed that normal blood glucose can reverse early kidney damage. Chapters 7, 8, and 9 help you get going on tightening control of your child's glucose.
i The doctor checks your child's blood pressure and treats it if it's not normal. I discuss blood pressure later in this chapter.
I The doctor checks your child's blood fats. High cholesterol can damage the kidneys. I discuss checking cholesterol later in this chapter.
FlexSite Diagnostics, Inc., offers KidneyScreen At Home, a urine-collection kit that you use to send a sample to a lab to test for microalbuminuria (it costs $19.95). The lab sends the result to you and your child's doctor. You can find more information about this kit at www.flexsite.com. The company's other contact information is listed in the earlier section "Testing at home."
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Although nobody gets a parenting manual or bible in the delivery room, it is our duty as parents to try to make our kids as well rounded, happy and confident as possible. It is a lot easier to bring up great kids than it is to try and fix problems caused by bad parenting, when our kids have become adults. Our children are all individuals - they are not our property but people in their own right.