Q: My father, 64 years old, has been having diabetes for the last 15 years and using Insulin for the last 8 years. He had a complete health check-up and found that he has a creatinine of 1.57 and HbA1c of 8.1%. Later, he started controlling his blood sugar levels and has been keeping it in control for last two months. Two days back, he again checked the creatinine and HbA1C and found it to be 1.8 and 8.5% for A1C. How should this creatinine level be controlled? Is there any medicine to control it? Will controlling the blood sugar bring down the creatinine percentage? Right now, he has a good control on blood sugar and your help will help me in keeping up the good health.

A:Issue in your fathers case is diabetes mellitus (DM) and kidney disease. With long standing uncontrolled DM patients get different complications like eye disease(s), kidneys and nerve involvement. High levels of creatinine levels suggest that your father has got involvement of kidneys. A1C levels denote last three months sugar control high means blood glucose not under control. We have to keep it under 6.5%. There is no short term relation between A1C and creatinine levels but long standing yes. The patients with long standing A1C levels are likely to get more complications including kidneys. Get following done: 1. Urine routine 2. If positive for protein get his 24 hrs urinary protein if negative then get urine for microalbumin. 3. Control BP <120/75. 4. Diet should have 30 gm protein and low salt. 5. Control sugars F 80-120 and PP<140 mg. These measures can reduce the progression of kidney failure.