Type 2 Diabetes Symptoms An Overiew of Albuminuria in Diabetes By Debra Manzella, RN linkedin Debra Manzella, MS, RN, is a corporate clinical educator at Catholic Health System in New York with extensive experience in diabetes care. Learn about our editorial process Debra Manzella, RN Medically reviewed by Medically reviewed by Ana Maria Kausel, MD on September 06, 2020 facebook twitter Ana Maria Kausel, MD, is a double board-certified endocrinologist affiliated with Mount Sinai St. Luke's/Mount Sinai West in New York City. Learn about our Medical Review Board Ana Maria Kausel, MD Updated on October 15, 2020 Print Albuminuria, also called proteinuria, is a condition in which albumin—a type of protein found in blood plasma—leaches into the urine. Although very small amounts of protein in urine can be normal, high levels of albumin is one of several indicators of chronic kidney disease (CKD), a common complication of both type 1 and type 2 diabetes. Because albuminuria doesn't cause noticeable symptoms, people at risk of kidney disease typically are advised to be tested regularly for protein in their urine in order to detect the condition. This way measures can be taken right away to reduce the amount of protein in urine and protect the kidneys from further damage. Type 2 Diabetes Symptoms and Diagnosis IAN HOOTON / Getty Images Symptoms The only outward signs of excess protein in urine are those that develop in conjunction with chronic kidney disease. There are many symptoms of CKD that can be mistaken for other problems, which is why screening is vital. Common symptoms of CKD include: Intolerance to coldFatigueDIzzinessThe scent of ammonia on the breath (uremia fetor)Dysgeusia (a metallic taste in the mouth)Dyspnea (shortness of breath)Easy bruisingEdema (swelling) of the faceTrouble concentratingPruritus (Itching)Loss of appetiteFoamy urineDifficult or frequent urination (including at night)Pain in the kidneys, legs, or upper back What Are the Classic Signs of Kidney Disease? Causes There are two reasons a person with diabetes might develop proteinuria. The first is long-term hyperglycemia—higher-than-normal levels of glucose (sugar) in the blood. Excess glucose can damage capillaries in the kidneys called glomeruli. These tiny blood vessels are bundled together to form the glomerular membrane, the structure that filters waste from the blood into the urine while at the same time preventing vital substances such as albumin and blood cells from leaking out. Albuminuria in diabetes also can result from hypertension—high blood pressure that's a common complication of diabetes. High Blood Pressure and Diabetes Diagnosis Although albuminuria alone does not cause symptoms, diagnosing it is a simple matter of a urine test (urinalysis) that typically is part of a routine health checkup. For this familiar test, a patient is asked to provide a small sample of urine by peeing into a clean specimen cup. Only a couple of tablespoons of urine are necessary. Usually, it will be tested right away using a small plastic dipstick that will change colors in response to the presence of protein. (This initial test also can detect other suspicious substances in urine, such as bacteria, glucose, and blood cells—any of which can be a sign of a medical problem.) A dipstick test isn't sensitive enough to detect very small amounts of protein in urine that could indicate the beginning stages of kidney disease—a condition known as microalbuminuria. Therefore, the urine sample will be sent to a lab for further analysis—an ACR (albumin-to-creatinine ratio) test. Most doctors do a urinalysis as part of regular checkups, but it's especially important that people with diabetes have their urine checked frequently—ideally at least once a year, according to the American Diabetes Association (ADA). What to Expect When Having a Urinalysis Treatment Because albuminuria is not a disease itself but rather a side effect (of diabetes or hypertension, for instance) or a symptom (of kidney disease), there's no treatment per se for the condition. Rather, dealing with the excess protein in urine will depend on the specific situation. In the case of diabetes, that means following a treatment protocol designed by a doctor. For most people, managing diabetes involves a combination of adhering to a medically-approved diet, embarking on a regular exercise routine, taking medication to help control blood sugar, and self-testing glucose levels regularly. Lifestyle Changes for Type 2 Diabetes Treatment for chronic kidney disease associated with diabetes also includes controlling blood glucose levels, as well as taking measures to lower blood pressure, such as losing weight, eating less salt, cutting out alcohol, quitting smoking, and increasing activity levels. Medication is sometimes necessary to treat hypertension; according to the ADA, ACE inhibitors are the safest choice for treating hypertension in people with diabetes. The ADA also says that a low-protein diet is sometimes effective for treating kidney disease. If these measures do not head off kidney failure, dialysis or a kidney transplant will be necessary. What You Should Know About Kidney Transplant Surgery A Word From Verywell If you have diabetes and your urinalysis reveals you have protein in your urine, you have reason to be concerned. However, you also should feel empowered by the fact that you've caught what may be the beginning of chronic kidney disease well before it has progressed to the point of causing symptoms of end-stage kidney disease. With your doctor's guidance, you can make lifestyle changes and take other measures to keep your kidneys healthy and functioning normally. Was this page helpful? Thanks for your feedback! We know healthy eating is key to help manage diabetes, but that doesn't make it easy. Our free nutrition guide is here to help. Sign up and receive your free copy! Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Cleveland Clinic. Urine protein test. Last reviewed February 23, 2020. Centers for Disease Control and Prevention. Chronic kidney disease basics. February 7, 2020. Karalliedde J, Viberti G. Proteinuria in diabetes: Bystander or pathway to cardiorenal disease? J Am Soc Nephrol. 2010;21(12):2020-2027. doi:10.1681/ASN.2010030250 National Institute of Diabetes and Digestive and Kidney Diseases. Albuminuria: Albumin in the Urine. October 2016. American Diabetes Association. Kidney disease (nephropathy). Additional Reading MedlinePlus. Protein in urine. Sept 5, 2017. National Institute of Diabetes and Digestive and Kidney Diseases. Diabetic kidney xisease. Feb 2017. National Kidney Foundation. Why are patients asked for urine samples?