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 diabetes, a larger number of type 2 individuals are among those with diabetic nephropathy. Diabetic urinary albumin levels are monitored with urinary albumin-to-creatinine ratio (UACR) in a random urine collection. Table 5 lists the interpretation of the results for UACR testing.
Screening for early occurrence and low amounts of albumin in urine detects microvascular disease before impaired renal function and insufficiency occur. Annual screening is recommended for individuals with both type 1 and type 2 diabetes as an early indicator of renal disease. In addition, control of blood pressure and blood glucose concentrations can slow the rate of renal function decline.
Measurement for urinary albumin alone without simultaneously measuring urine creatine is susceptible to false-negative and false-positive results due to variation in urine concentration from hydration. Confirmation by UACR would need to occur, thus, it is more efficient to perform the albumin-to-creatinine ratio (UACR) instead of measuring only the urinary albumin.
Table 5. Albumin-to-Creatinine Ratio (UACR) Interpretation.| Assessment of Albuminuria | Creatinine Result |
| Normal level of urine albumin excretion | <30 mg/g creatinine |
| Moderately elevated albuminuria | ≥30–300 mg/g creatinine |
| Severely elevated albuminuria | ≥300 mg/g creatinine |
4. American Diabetes Association. "Standards of Medical Care in Diabetes—2024."Clinical Diabetes, vol 47, issue 1, January 2024. https://diabetesjournals.org/care/issue/47/Supplement_1.
