Disappearance of Microalbuminuria in a Patient With Type 2 Diabetes and the Metabolic Syndrome in the Setting of an Intense Exercise and Dietary Program With Sustained Weight Reduction

  1. Sonja K. Fredrickson, MD12,
  2. Thomas J. Ferro, MD2 and
  3. Andrew C. Schutrumpf, MD3
  1. 1Diabetes Health Center, McGuire Veterans Affairs Medical Center, Richmond, Virginia
  2. 2Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia
  3. 3West End Internal Medicine, Richmond, Virginia
  1. Address correspondence to Sonja K. Fredrickson, MD, Diabetes Health Center (151), McGuire Veterans Affairs Medical Center, 1201 Broad Rock Blvd., Richmond, VA 23249. E-mail: sonja.fredrickson{at}med.va.gov

We present a patient with the metabolic syndrome who demonstrated microalbuminuria, an index of cardiovascular risk (1), at the time of presentation. The patient was treated with an intensive regimen of dietary and exercise changes, and all diagnostic criteria for the metabolic syndrome resolved, followed by resolution of the microalbuminuria.

HISTORY AND EXAMINATION

A 43-year-old man presented to his primary care physician for a “new patient evaluation.” Xerostomia, polydipsia, and polyuria, which had been attributed to chronic rhinosinusitis, were noted. A normal fasting blood glucose level had been recorded just before the onset of these symptoms, ∼5 years prior the visit. Physical examination and laboratory evaluation revealed the presence of metabolic syndrome, encompassing the following diagnoses: central obesity, hypertension, type 2 diabetes, hypertriglyceridemia, and low HDL (data below). The patient was started on aspirin at 81 mg once per day and glipizide extended release at 5.0 mg once per day. He was also told to lose weight through a program of exercise and dietary …

| Table of Contents