diabetes

What is diabetes?

diabetes is a serious disease. It occurs when your body does

not make enough insulin or cannot use the insulin it makes.

Insulin is a hormone. It controls the amount of sugar (called

glucose) in your blood. A high blood sugar level can cause

problems in many parts of your body.

 

 

 

Are there different types of diabetes?

 

yes.there are two main types:

 

Type 1 diabetes

 

if you have this type of diabetes, your body does not

make insulin.It usually starts when you are a child or

young adult, but it can occur at any age.It is treated by

taking daily insulin shots or using an insulin pump and by

following a special meal plan. About 5 to 10 percent of

cases of diabetes are type 1.

Type 2 diabetes

 

If you have this type of diabetes, your body makes some

insulin but cannot use it properly.Type 2 is partially

preventable and is typically brought on by poor diet

and lack of exercise. Very often heredity plays a part.

It usually starts when you are over age 40, but it can

happen earlier. It is treated with exercise, weight loss, and

special meal planning. People with type 2 diabetes may

need insulin, but in most cases medications given in pills

(called hypoglycemics) are prescribed if diet and exercise

alone do not control the disease.Type 2 is the most

common type of diabetes.

 

 

How does diabetes affect my body?

 

When diabetes is not well-controlled, the sugar level in your

blood goes up.This is called hyperglycemia. High blood sugar

can cause damage to many parts of your body, especially:

 - kidneys

- heart

- blood vessels

- eyes

- feet

- nerves

Diabetes can also cause high blood pressure and hardening

of the arteries (called arteriosclerosis).These can lead to heart

and blood vessel disease.

 

What can people with diabetes do to prevent

kidney disease?

 

Many people with diabetes do not get kidney disease or

kidney failure.Talk to your doctor about your chances of getting kidney disease.The best way to prevent getting kidney disease from diabetes is to:

- Control your blood sugar level

- Keep blood pressure under control

- Check your blood pressure as often as your doctor

  recommends

- Ask your doctor to test you for kidney disease at least

once each year

- Take medicines to help control your blood glucose,

cholesterol, and blood pressure if your doctor orders

them for you

- Follow your diet for diabetes

- Get regular exercise

 

- Avoid alcohol

- Do not smoke

- See your doctor as often as you are told

 

How does diabetes harm the kidneys?

 

Diabetes can harm the kidneys by causing damage to:

- Blood vessels in the kidneys

 

The filtering units of the kidney are filled with tiny blood

vessels. Over time, high sugar levels in the blood can

cause these vessels to become narrow and clogged. Without enough blood, the kidneys become damaged and albumin (a type of protein) passes through these filters and ends up in the urine where it should not be.

- Nerves in your body

 

Diabetes can also cause damage to the nerves in your

body. Nerves carry messages between your brain and

all other parts of your body, including your bladder.

They let your brain know when your bladder is full. But if the

nerves of the bladder are damaged, you may not be able

to feel when your bladder is full. The pressure from a full

bladder can damage your kidneys.

- Urinary tract

 

If urine stays in your bladder for a long time, you may

get a urinary tract infection. This is because of bacteria.

Bacteria are tiny organisms like germs that can cause

disease. They grow rapidly in urine with a high sugar

level. Most often these infections affect the bladder, but

they can sometimes spread to the kidneys

 

 

How do I know if I have kidney damage?

 

Most people with early kidney damage do not have symptoms.The best way to find early kidney damage is to have a urine test once a year.This test checks for very small amounts of protein in the urine called microalbuminuria.

It helps show kidney damage at an early stage in people with diabetes.

 

Not everyone with kidney disease gets kidney failure. With

the right treatment, you can prevent kidney disease from

getting worse.

 

 

What can be done to keep my kidneys working as long as possible?

 

Your doctor should plan your treatment with you and your

family. Some patients may be asked to see a kidney doctor

(called anephrologist). Adietitian may be helpful too.

The following things can help your kidneys work better and last longer:

Controlling your blood sugar

 

The best way to prevent or slow kidney damage is to

keep your blood sugar well controlled. This is usually

done with diet, exercise, and, if needed, insulin or

hypoglycemic pills (to lower your blood sugar level).

A test called hemoglobin A l C should be done every

every three to six months to check your average blood

sugar. Ask your doctor what your test result should be. For most people, the result should be less than 7 percent.

Daily blood sugar levels should also be checked so that your medication doses can be adjusted.

 

 

Controlling high blood pressure

 

High blood pressure can increase your chances of getting kidney failure. For most people with diabetes and kidney disease, blood pressure should be less than

130/80. You will probably need a medication called

an ACE (angiotensin converting enzyme) inhibitor or an

ARB (angiotensin receptor blocker) to control your blood

pressure. In many cases, more than one high blood pressure medicine may be needed to reach this target. Studies have shown that the use of these medicines can slow the loss of kidney function in all people with diabetes—even if your blood pressure is normal. They

also help reduce heart disease in people with diabetes.

In addition, your doctor may prescribe a diuretic (water pill)

to help remove salt and water from your blood.

 

 

Protecting kidney function by taking ACE inhibitors or ARBs

 

Your doctor may have you take high-blood pressure

medicines (called a ACE inhibitors or ARBs) even if your

blood pressure is normal. Research suggests that these

medicines can slow the loss of kidney function in all

people with diabetes—even those with normal blood

pressure.

Limiting how much protein you eat 

 

People with diabetes and kidney disease should eat

enough protein for good health, but avoid overeating it.

Research suggests that eating less protein can slow kidney

damage.You should talk to your doctor about this.

If you need to go on a low protein diet, you must plan this with a dietitian who specializes in kidney disease.

Do not go on this type of diet without talking to a dietitian so that you have a healthy approach to dietary changes.

Promptly reporting to your doctor any difficulty passing urine

 

Early treatment for urinary tract infections is important.

Some signs of urinary infection could be: frequent need to

urinate, burning or pain with urination, cloudy or blood-

spotted urine, or a strong odor to your urine.

Limiting the amount of salt in your diet to help control high

blood pressure and reduce body swelling

Not using medicines that may damage the kidneys

(especially anti-inflammatory pain relieving medicines such

as ibuprofen)

Checking with your doctor before taking any herbal

supplements

n

Preventing further damage to larger blood vessels (such as

those in the brain and heart) by keeping cholesterol and

lipid levels under control.

 

 

What about cholesterol and lipids? 

 

Many people with diabetes and kidney disease have high

levels of lipids in the blood.Lipids are fatty substances like

cholesterol. High blood lipid levels can cause the blood

vessels to become clogged. This lessens the blood supply to

the heart and brain, and raises your chance of having a heart

attack or stroke.You doctor will check your cholesterol and

lipids at least once a year.If they are too high, you may need

drugs called statins to help lower them. 

 

 

What about pregnancy?

 

Having both diabetes and kidney disease is serious.

It can affect your health and the health of your unborn child.

If you are thinking about becoming pregnant, talk to your health care team. If you become pregnant, you should be under the care of a specialist in high-risk pregnancy and a specialist in kidney disease. Some women may also have a higher risk for kidney failure during pregnancy.

you should:

- Keep your blood sugar levels at target

- Ask your doctor about using insulin to control your blood

 sugar while pregnant

-Tell your doctor about any medicines you are taking,

especially medicines for high blood pressure or cholesterol

With good health care and careful blood sugar control, it

is possible to have a healthy pregnancy

 

 

 

 

Key points to remember about diabetes and the kidneys

 - About a third of people with diabetes may develop kidney

  failure.

 

- Because diabetes may harm the blood vessels in the

  body, it can cause kidney damage.

- Early kidney damage from diabetes can be found by

a test that checks for a tiny amount of protein (called

microalbuminuria) in the urine. A test called GFR tells your doctor how much kidney function you have.

- Treatment with some high blood pressure medicines

called ACE inhibitors or ARBs can slow the loss of kidney

function in people with diabetes, even in people with

normal blood pressure.

- Reducing the amount of sodium (salt) in your diet may be

needed if there is kidney damage or high blood pressure.

The most common form of sodium is found in table salt.

- Other things that can cause kidney damage and affect

kidney function are: blocking of urine flow, urinary

tract infection and certain medicines (especially anti-

inflammatory pain relieving medicines such as ibuprofen).

- Early kidney disease rarely has symptoms.That is why

it is so important to be tested regularly by your doctor

for kidney damage.An early sign of kidney damage is

protein in the urine.

- If chronic kidney disease causes kidney failure, you

will need hemodialysis, peritoneal dialysis or a kidney

transplant to replace the work of your kidneys.

The type of treatment that is best depends on overall health, lifestyle and personal preference.

- Diet is a very important part of the treatment of all patients

with diabetes even if they do not have chronic kidney

disease.