A well-known phenomenon associated with type 2 diabetes is the potential damage to kidneys and therefore leakage of protein. One marker of kidney damage is to measure urine levels of the protein albumin. Higher than normal levels of albumin (> 20iμg/min) excreted into the urine in the urine is called 'albuminuria'. Albuminuriain type 2 diabetes have a much higher risk of suffering a heart attack, stroke and heart failure than patients who have normal levels of protein excretion.
However, researchers are now asking if any level of albumin excretion even if it is in the upper range of what is considered normal -- 
might also increase a diabetic patient's risk of developing heart problems. "It would be important to know whether there is a level for albuminuria that differentiates individuals in need of cardio protective intervention from those with a low risk," said Giuseppe Remuzzi, MD, FRCP. Dr. Remuzzi and others evaluated the relationship between albumin excretion levels and heart problems. They found that any degree of measurable albumin excretion bore significant heart risks. For example, for each 1 μg/min in albumin excretion there was a progressive incremental risk of experiencing heart problems during follow-up.
The really interesting feature that the researchers found was that when they looked at the group of patients who were taking drugs to reduce high blood pressure (antihypertensive drugs called ACE inhibitors) from the start of the study and throughout the follow-up period, they found no link between albumin excretion levels and heart risks. This suggests that ACE inhibitors have heart-protective properties that may benefit diabetic patients with albuminuria and norm albuminuria alike. Future clinical trials are needed to identify levels of albumin excretion above which such cardio protective therapy is beneficial.
