Sunday, May 5, 2013

60 years old, HbA1c7.5, Creatinine 1.3 Symptomless

One of my patients is Mr King, who has Diabetes for 22 years. His HbA1c level is 7.5 and serum creatinine level is 1.3 in the latest test report. Now he is symptoms. He is 60 years old this year. Mr King asked me what he should do now.
Firstly, HbA1c level is really a valuable index which can show how diabetes patients control their blood sugar for it can at least show the blood control of 8 to 12 weeks. In most of time, patients with diabetes should control the blood sugar, which is known to all of us. Monitoring blood sugar is very necessary as well. At present, the range for normal person is under 4 to 5.5. Patients with diabetes should control their HbA1c level under 6. If the HbA1c level is 7 to 8, it shows that it is not high. If it is 8 to 9, it indicates that patients should control it. So for Mr King, his HbA1c level is OK and he does not need to worry.
Diabetes is a kind of disease which makes the blood in a high level of sugar, so the dense blood will damage blood vessels, especially the micro-blood vessels, including micro-blood vessels in the kidney. With time passing by, there will be damage in the kidney. Serum creatinine is an index which shows the kidney function. The normal range of serum creatinine is under 1.2. So as for Mr King, his creatinien level is higher, which indicates that the kidney is damaged. We can also get a conclusion that Mr King has developed into Diabetic Nephropathy.
In the early stage of Diabetic Nephropathy, there is no symptom because of the strong compensation stage of kidney. However, if not controlled well, proteinuria will appear in the third stage of Diabetic Nephropathy.
From the above, we can get a conclusion that although there are no symptoms, Mr King should take effective measures to treat. He should not only treats diabetes but also kidney disease. He is suggested to adopt immunotherapy in our Hospital, which has treated thousand of patients and helped them recover.

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