Increased HbA1c and Dyslipidemia with sugar and protein in urine

Hi,
Thanks for your consult at DoctorSpring.com.

Please let me know among the following any other associated symptoms -
Do you have obese or slim physique?
Do you have positive family history of early heart disease? (Early heart disease is considered in female <65 years and in male <55 years).
Do you have an active or sedentary life?
Are you a smoker and an alcoholic?

With the available attached reports and defined disease, 1, 25 Di hydroxy Vit D3, Vit B 12, and folic acid appears to be on lower side while Homocysteine, HbA1c (glycated hemoglobin)on higher side.

Treatment of Dyslipidemia (deranged lipid profile) is decided by presence / absence of risk factors.

Smoking, age > 45 years, sedentary life, first degree relative with positive early heart disease 140/90 mm Hg, Diabetes are considered as risk factors.
Treatment of Dyslipidemia is decided by LDL level and should read ATP III guidelines.
If < 2 risk factors are present then LDL should be < 160 mg%.
If > 2 risk factors with 10 year risk of developing heart disease is <20% then LDL should be <130 mg%.
If > 2 risk factors with 10 year risk of developing heart disease is >20%, diabetes then LDL should be <100 mg%.
You can download calculator from following site: http://www.nhlbi.nih.gov/guidelines/cholesterol
For very high risk patients and diabetic patients, LDL should be < 70 mg%.

Your LDL is 74mg% and showed well almost controlled lipid profile.

Your liver function test, Anti- CCP antibiodies,amylase and lipase, ANA, Serum Ferritin, Lipoprotein A, Testosterone level, Thyroid profile, blood element analysis, urine microalbumin and urine creatinine level, complete hemogram, CRP, APOLIPOPROTEIN - A1, APOLIPOPROTEIN - B, serum sodium, chloride, calcium, complete iron profile, and renal function test appears to be within normal limit.

Your urine analysis showed presence of sugar which favors uncontrolled sugar. Urine also showed trace proteins while urine microalbimin is in controlled range; which favors discrepancy between 2 reports.

Elevated HbA1c showed uncontrolled sugar. deranged sugar, raised homocysteine level predisposes to increased risk of stroke and cardiac ailments.

You should consult with an internal medicine specialist/ endocrinologist and should go for thorough check up.

You should continue lipid lowering medication to keep LDL below 70 mg%, optimal medication for control of deranged sugar, folic acid supplements.

Life style modifications are required in your case, if you have obese physique.
You should take low fat diet and live physically active life.
You should continue brisk exercise 30 minutes per day, at least 5 days in a week.

You should remain in touch with your treating doctor with regular follow up.

Hope that helps.

Take care,
Dr. Mayank Bhargava