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The page below is a sample from the LabCE course Diabetes: Diagnosis, Laboratory Testing, and the Current American Diabetes Association Guidelines (2018). Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Urinary Albumin and Testing for Microalbuminuria

Because of the risk of nephropathy, monitoring renal function is critical in diabetes management. Renal failure occurs more often in type 1 diabetes, but because of the greater incidence of type 2 diabetics, a larger number of type 2 individuals are among those with diabetic nephropathy. Diabetic urinary albumin levels are monitored with urinary albumin excretion (UAE); these assays are referred to as microalbuminuria testing.
Screening for early occurrence and low amounts of albumin in urine detects microvascular disease before impaired renal function and insufficiency occur. Regular screening of urinary albumin excretion (UAE) is recommended for individuals with both type 1 and type 2 diabetes as an early indicator of renal disease. It is recommended at the time of initial diagnosis and annually thereafter for patients with type 2 diabetes and commencing annually five years after the initial diagnosis of type 1 diabetes. In addition, control of blood pressure and blood glucose concentrations can slow the rate of renal function decline.
Microalbumin is not a measurement of a small size albumin molecule, but measurement of low concentrations of urinary albumin in diabetes to identify early renal impairment. Microalbuminuria tests measure concentrations of albumin that are lower than levels that can be detected with routine urine dipstick tests for protein.
Timed, overnight, and first morning specimens can be screened for microalbuminuria. Quantitative measurements are also utilized for screening of renal impairment and for monitoring treatment.