Which test detects early renal complications in diabetes?

• A. FBS
• B. HbA1c
• C. 1,5-AG
• D. Microalbuminuria

Answer: (D)

In diabetes, the earliest kidney involvement shows up as small amounts of albumin leaking into the urine, a stage called microalbuminuria. The appropriate test measures these low levels of urinary albumin, typically using a spot urine albumin-to-creatinine ratio or a sensitive albumin assay over 24 hours. When the results are in the range of about 30 to 300 mg of albumin per day (or 30–300 mg per gram of creatinine in a spot sample), it indicates microalbuminuria, an early sign of diabetic nephropathy. Detecting this early allows timely interventions, like ACE inhibitors or ARBs and tighter blood pressure and glycemic control, to slow progression. FBS and HbA1c assess glucose levels and long-term control, not kidney damage, while 1,5-anhydroglucitol reflects short-term glycemic excursions, not renal injury.