Abnormal bilirubin in diabetic patient

Patient

Q: A recent urinalysis shows the following comment "Bilirub UR Q1 Strip - Small 1+ ...A (abnormal). I'm 64, male and diabetic, although my diabetes is controlled with diet and exercise after losing 60 pounds over the last year. Last blood test showed FBS at 5.4 mmo/l and A1C 5.7%. Small abnormality in ketones at 1.5 mmo/l. No other major health concerns. All previous urinalysis normal. I had an abnormal liver function test about 20 years ago. The doctor called me at home to tell me about it and said it was probably nothing to be concerned about. All have been fine since then until now. This time my doctor (not the same doctor) did not mention this during my visit as he probably thought for some reason it did not merit follow up. Do you agree?

Symptoms:  No symptoms
Doctor

A:   Hello,
Thank you for your query at AskTheDoctor.com
I understand your concern.
Your HBA1c levels are very good, which indicate that you have attained excellent control on your blood sugar. That is a good sign and itself negates the major diabetic induced complications.

Now, about the bilirubin 1+ is nothing major, but as a specialist I would have asked you to get a LFT and take it from there. This could be because of starting stages of hepatitis ( just a possibility ) or an indication of slight liver damage from medications, e.t.c.

See if you could get both LFT and RFT and follow up with me. Sometimes even if the liver is normal, mild kidney derangements can cause urobilinogen to go up in the blood stream.

Hope this was helpful,
Regards.

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