Hi all,

This is my first post to the board. I have been reading off and on for about a month. I am a female 23 year old Type 1 Diabetic for 13 years now. I have been on an insulin pump for a couple years, and my a1c always runs around 6.

Over the past couple years, my urine protein levels have been increasing. I have had trouble adjusting to ACE meds and got so frustrated with the side effects that I stopped taking them for a time. Six months ago I started one 2.5mg pill of Enalapril/Vasotec before bed with very little trouble. My most recent 24 hour urinalysis revealed another increase in protein. My MA is now up to 150, should be under 30. My endo said there is no significant explanation for this increase since I am in good control and have no blood pressure problems. I actually run on the low side of norm explaining my problems adjusting to other bp meds. Anyway, they suggested I increase my dosage from 2.5 mg once a day to twice a day....in the morning and before bed. They're thinking is either the bp meds haven't been on board long enough or I need a higher dosage. I started the new dose about a month ago which hasn't been much fun. This stuff just wipes me out. I decided to split my second pill in half hoping this might help, but so far, I can't tell any difference. I feel very fatigued during the day and a little light headed which puts me in a foul mood. I know the mood thing could be another side effect. I experienced that with the first med I tried, Lisinopril. I am very frustrated with this stuff, and I'm not sure what to do.


Is the second does lowering my bp too much? Is this wiped out feeling normal? If so, how do you guys deal with it?


Sorry the post was so lengthy.

Any feedback would be greatly appreciated.

Thanks so much!
Hannah

Hi Hannah,

Welcome to the board! I am taking Altace to try to prevent kidney problems. In the past, I have had trouble with a higher dose than I'm taking now. One thing that helped me was drinking a lot of water. I drink about 12-14 cups per day. When I used to get that light-headed feeling, I would drink a glass and feel better. Maybe this can help you. Good luck and I hope you start feeling better soon.

Sharon :)

I take 5mg Altace and have had no side effects except for a slight cough, which went away in a few weeks.

Hannah,

Increasing levels of protein in your urine are certainly a cause for concern. But are you satisfied that you need to be using an ACE inhibitor? Do you have high blood pressure and/or an unsatisfactory lipid profile? Or could protein in the urine be the result of a different problem?

I am asking these questions simply because ace inhibitors, statins and aspirin are often prescribed when they are not really needed.

Cheers,

Mark

Hi again,

Thanks to all who posted. I really appreciate it.


Sharon---Thanks for the tips about drinking water when feeling light-headed. My endo had suggested increasing my dose from 2.5 once daily before bedtime to 5 twice daily so I tried that for a while which wasn't fun. Then I decided to reduce the dose and take a whole 2.5 before bed and a half of one in the morning with no luck. Now, I'm back to 2.5 before bed and I'm feeling much better, so I'm not sure what to do now. I think a visit to a kidney specialist might be a good idea. Thanks again for the advice.


Mark---I have been doing the 24 hour urninalysis test since April 2002. My micoralbumin went over 30 in August 2003 and has risen since then. I began trying to take ACE meds in June 2004 after it had gone up to 79. I have had trouble consistently staying on the medication b/c of the side effects. My most recent test in April revealed my MA is now at 150 even though I had been on Enalapril consistently for at least 4 months. There are other numbers on my lab results, but the MA is what my endo looks at.

I don't have high bp and my lipids are fine as well. I am not sure if the protein is from something else. My endo has never indicated that, but sometimes they don't think out of the box, only focusing on diabetes. I certainly don't want to be on any medication if I don't have to be. That is one thing that bothers me about this world. Everyone seems to be way too medicated. As I said to Sharon, I think I will go see a kidney specialist. They may have a different outlook on all this. Thanks so much for taking the time to respond

Hannah :)

Good luck Hannah! I hope you get a handle on all this soon.

The other thing to keep in mind is that all ACE inhibitors are not created equal. You may have side effects with one and not with the other. I know quite a number of people that had a lot of problems with Vasotec, myself included. In most of us our potassium went very high which caused a lot of problems. If problems persist, see if you can switch to another type of ACE.

Don't get too hung up on the levels of protein in your urine. It is an indicator of problems, but it is not that specific. I went on dialysis in 2001 and I neve had more that a gram of protein in my urine. Some people put out a lot, others don't. The overall results from the 24 hour urine test and the accompanying blood work are much more important, as is your BP.

Good luck.

Cora

Thanks Linda!!!!


Good info Cora....I really appreciate it!!

--Hannah