Do I have to tell my employer I have type 2 diabetes?

No, there's no legal requirement to disclose it. That said, telling your employer can make it easier to access reasonable adjustments and support if you ever need them — it's worth weighing up the benefits against your own comfort with sharing that information.

What counts as a "reasonable adjustment" for diabetes at work?

It varies by role, but common examples include scheduled breaks to check blood sugar or take medication, a private space to do so, flexible meal or break times, and adjusted hours where needed. Your employer also has a responsibility to make sure managers are aware and that any relevant risk assessments are carried out.

How might diabetes actually affect my working day?

It can show up as energy dips, trouble concentrating, needing short monitoring breaks, fatigue, or changes in vision. None of these need to be career-limiting — most are manageable once you and your employer know what to plan around.

What warning signs should I watch for if I haven't been diagnosed?

Around six in ten people have no symptoms at diagnosis, so it's worth paying attention to persistent fatigue, frequent urination, increased thirst, slow-healing wounds or changes in vision. If any of these sound familiar, it's worth getting checked rather than assuming it's just a busy patch at work.

Where can I get help managing diabetes alongside a demanding job?

A GP or clinician — for example through a service like Doctor Care Anywhere — can offer personalised advice, review your medication, and give practical, work-specific guidance, so you're not trying to figure it all out on your own.

Kidney Function Test: eGFR, Creatinine and Reading Your Results

Your kidney function is assessed using a blood test to measure your estimated Glomerular Filtration Rate (eGFR) and a urine test to check your Albumin to Creatinine Ratio (ACR). Together, these tests show how well your kidneys filter waste and whether any protein is leaking into your urine. Results are grouped into stages to help your doctor monitor your kidney health and guide your care.

Speak to a clinician

Your GP has run a kidney function test, and now you are looking at a report with terms like 'eGFR' and 'creatinine'. It can feel confusing, but understanding these numbers is the first step to taking control of your health.

Kidney function tests are routine blood and urine tests that check how well your kidneys are working. Detecting any issues early is crucial for managing your kidney health and preventing further damage.

You will learn what eGFR, creatinine, and ACR are. We will explore how to interpret the different stages of kidney function, look at the lifestyle factors that can affect your results, and explain how to discuss your report with your doctor.

What is a kidney function test?

A kidney function test is a routine medical screening tool used to assess how effectively your kidneys filter waste products and excess fluid from your blood. By measuring specific markers in your blood and urine, these tests identify early signs of kidney damage and help monitor your overall renal health.

How the kidneys work

A kidney function test measures how effectively your kidneys are doing their main job: filtering waste products and excess water from your blood.

Your kidneys are like a highly advanced sieve for your bloodstream. Blood constantly flows through them. The kidneys filter out the waste products and excess fluid, which then leave your body as urine. At the same time, this complex filter keeps essential substances, such as protein and red blood cells, safely in your bloodstream.

The primary waste product we measure in a kidney blood test is called creatinine.

Who needs a kidney function test?

Kidney function tests are routinely recommended for people who have risk factors for developing chronic kidney disease (CKD).

According to NICE guidance, you should have your kidney function checked if you have diabetes, high blood pressure, heart disease, or a family history of kidney disease. Long-term use of certain medications, such as lithium or non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, can also put you at a higher risk.

You may also be offered a test if you develop symptoms that suggest your kidneys are struggling. These symptoms can include unusual tiredness, swollen ankles, or noticeable changes in how often you urinate. However, it is important to know that early-stage kidney disease often has no symptoms at all. This is why routine screening for those at higher risk is so important.

Key numbers in your blood test report

The key markers on a kidney blood test report include your creatinine level, blood urea nitrogen (BUN), and your estimated Glomerular Filtration Rate (eGFR), which together provide a picture of your kidney health.

Creatinine levels

Creatinine is a natural waste product that comes from the normal, everyday wear and tear on the muscles in your body.

Healthy kidneys filter creatinine out of your blood and pass it into your urine. If your kidneys are not filtering effectively, creatinine builds up in your bloodstream. Therefore, a high level of creatinine in your blood suggests that your kidney function is impaired.

We look for creatinine to fall within a typical range, but 'normal' can vary significantly based on your muscle mass, age, and sex. A young athlete with a lot of muscle will naturally produce more creatinine than an older adult with a smaller frame.

Blood urea nitrogen (BUN)

Blood urea nitrogen is another common waste product that healthy kidneys filter from the blood.

Urea nitrogen is created when your liver breaks down protein from the food you eat. Like creatinine, healthy kidneys filter urea nitrogen out of your blood.

While it is a useful marker, BUN levels can be more easily affected by factors outside of your kidney health. Eating a high-protein diet, taking certain medications, or simply being dehydrated can all cause your BUN levels to rise, even if your kidneys are working perfectly well.

Estimated Glomerular Filtration Rate (eGFR)

The estimated Glomerular Filtration Rate (eGFR) is considered the best single measure of your overall kidney function. It is a measure of how quickly the kidneys filter blood.

Your eGFR is not measured directly. Instead, it is a calculation based on the amount of creatinine in your blood, combined with your age and sex.

According to the NHS, healthy kidneys usually filter more than 90 ml/min/1.73m². An eGFR of 90 or more is generally considered normal.

It might help to think of this number as a percentage of your total kidney function. If you want to understand how your result compares to others your age, you can read our guide on What is a good eGFR level for my age?

Understanding the albumin to creatinine ratio (ACR)

The albumin to creatinine ratio (ACR) is a simple urine test that checks for protein leaks, offering one of the earliest warning signs of kidney damage.

Protein in your urine

The ACR test looks for a specific type of protein called albumin in your urine.

A healthy kidney filter should not let albumin pass from the blood into the urine. If albumin is present in your sample, it can be early indicator that the kidney's filter is damaged. If it is only present in a one off sample or very small quantity this is not a clear indicator of kidney damage. NICE recommends using both the eGFR blood test and the ACR urine test to properly assess and monitor chronic kidney disease.

Reading your ACR results

Your ACR result is measured in milligrams per millimole (mg/mmol). We group the results into three categories to understand the level of protein leakage:

Stage	ACR Level (mg/mmol)	What it means
A1	Less than 3	Normal to mildly increased
A2	Between 3 and 30	Moderately increased
A3	More than 30	Severely increased

A high ACR score can indicate kidney disease even if your eGFR blood test is still reading in the normal range. This is why your doctor will usually ask for a urine sample alongside your blood test.

Reading results: G and A stages

Doctors combine your eGFR (G stage) and ACR (A stage) results to classify the stage of your kidney health and assess your risk of the disease progressing.

The 5 G-stages of eGFR

Chronic kidney disease is classified into five main stages based on your eGFR result. These are known as the 'G' stages, standing for GFR.

Stage	eGFR Level (ml/min/1.73m²)	What it means
G1	90 or above	Normal or high eGFR. Kidney disease is only diagnosed if other signs of damage, like a high ACR, are present.
G2	60 to 89	Mildly decreased function. Similar to G1, this is only considered kidney disease if there are other signs of damage.
G3a	45 to 59	Mild to moderate decrease in kidney function.
G3b	30 to 44	Moderate to severe decrease in kidney function.
G4	15 to 29	Severely decreased kidney function.
G5	Below 15	Could suggest kidney failure, may require dialysis or a transplant.

The 3 A-stages of ACR

Your ACR urine result adds another vital layer of detail. This is classified into three 'A' stages, standing for Albuminuria (protein in the urine).

Stage	ACR Level (mg/mmol)	What it means
A1	Less than 3	Normal to mildly increased
A2	Between 3 and 30	Moderately increased
A3	Over 30	Severely increased

Combining G and A stages

In my virtual consultations, I find it helps to look at the G and A stages as a grid. Doctors use both results together to understand your overall risk and to decide on the best monitoring or treatment plan.

For example, a person with Stage G2 (mildly decreased filtration) but Stage A3 (severely increased protein leak) is actually at a much higher risk of their kidney disease progressing than someone who is Stage G3a (lower filtration) but Stage A1 (no protein leak). The Royal College of Physicians confirms that clinical decisions are always based on a combination of both your eGFR and your albuminuria level.

Factors affecting kidney test results

Kidney test results can fluctuate due to temporary lifestyle factors such as hydration levels, diet, intense exercise, and certain medications or supplements.

Temporary lifestyle factors

A single blood test result is just a snapshot in time. In my practice, I frequently see people worry about an unexpected drop in their eGFR, only to find it has returned to normal a few weeks later.

Several everyday factors can temporarily influence your kidney function results:

Dehydration: Not drinking enough water reduces the volume of your blood. This can temporarily concentrate waste products, raising your creatinine and lowering your eGFR.
Diet: Eating a large portion of cooked meat the night before your test can briefly increase the creatinine levels in your blood.
Intense exercise: A heavy workout, such as lifting weights or running a marathon, within 48 hours of your test can cause a temporary spike in creatinine due to muscle breakdown.
Medications: Certain drugs, including some antibiotics and high-dose ibuprofen, can alter how your kidneys filter waste and affect your results.
Supplements: Creatine supplements, widely used for muscle building and sports performance, can increase your blood creatinine levels and artificially lower your eGFR.

Evolution of the eGFR calculation

Medical guidelines frequently evolve to ensure care is safe, accurate, and fair.

In the past, the eGFR calculation included a modifier for ethnicity, which adjusted the final score for Black patients. This is no longer recommended in the UK. The Royal College of Physicians notes that removing the ethnicity modifier ensures a more equitable and accurate assessment of kidney function for everyone. Your eGFR is now calculated using your blood creatinine level, age, and sex.

Conclusion

Your kidney health is assessed using two essential tests: a blood test for eGFR and a urine test for ACR. Your eGFR measures your kidneys' filtering capacity, while your ACR checks for structural damage that causes protein to leak into your urine.

Doctors stage these results together to understand your level of function and your overall risk. Always remember that a single unusual result is not necessarily a cause for panic; everyday factors like hydration, diet, and exercise can cause temporary changes in your numbers.

The most important step you can take is to never interpret your results in isolation. Schedule a follow-up appointment to discuss the full picture with your doctor. If you need to review your results or discuss your kidney health in more detail, you can book an appointment with a Doctor Care Anywhere GP at a time that suits you.

Your creatinine can be normal but your eGFR is low because the eGFR equation adjusts for age-related changes. The Specialist Pharmacy Service (NHS) explains that older adults naturally lose muscle mass and produce less creatinine. Therefore, an older person might have a 'normal' blood creatinine level, but a lower eGFR reflecting natural kidney ageing.

You can improve your eGFR score and protect your remaining kidney function by taking specific steps to slow any decline. While physical damage to the filters often cannot be reversed, NICE information for the public highlights that strictly managing your blood pressure and keeping your blood sugar in range are great protective measures.

The difference between eGFR and creatinine is that creatinine is a direct measurement of waste, whereas eGFR is an overall estimate of your filtering ability. The NHS notes that creatinine confirms a physical waste product is in your bloodstream, but eGFR uses that level to calculate a practical percentage of your kidney function.

You should worry about your kidney test results and seek medical advice if they consistently fall outside the normal range. This will also depend on whether this is chronic and reduce over time or this a new change. A new change and drop usually needs urgent review to assess the cause.

A urine test for kidney function is just as important as a blood test. NICE recommends using the urine ACR test because it can detect very early signs of kidney damage. A urine test identifies structural damage causing protein leaks often long before your eGFR score on a blood test starts to drop.

Kidney Function Test: eGFR, Creatinine and Reading Your Results