Leaky 2

A 60 year old man who was diagnosed with type II diabetes mellitus 10 years ago presents for routine follow up. He is currently on Metformin 850 mg/day only.

His medical and surgical histories are otherwise unremarkable.

A urine dipstick test is positive for proteinuria.

Select Relevant Investigations
HbA1c

Performed

The HbA1c level is 6.9%
Renal Function Tests

Performed

Na+: 139 mmol/l (135 - 145)
K+: 4.0 mmol/l (3.5 - 5.0)
Cl-: 98 mmol/l (95 - 105)
Blood Urea: 14 mg/dl (0 - 50)
Serum Creatinine: 1.2 mg/dl (0.5-1.5)
eGFR: 62 mL/min/1.73 m2
Urinary Albumin:Creatinine Ratio

Performed

100 mg/mmol (normal: < 3.4; microalbuminuria: 3.4 - 34; macroalbuminuria > 34)
Lipid Profile

Performed

Total cholesterol: 240mg/dl (< 200)
LDL: 120 mg/dl (< 130)
Triglycerides: 90 mg/dl (< 150)
HDL: 102 mg/dl (> 40)

Select Relevant Management
ACE inhibitors
Statins
Protein restriction
Add Glipizide