Diabetics are a courageous, resilient, and positive bunch.
In the face of such constant adversity we strive to live the best lives we can.
Many move into careers to help and support fellow diabetics like nursing, diabetic educators or dieticians. Some volunteer or raise vital funds for charity.
Why? well, part of the reason may be because it’s very difficult to understand what a diabetic must live with and go through. It’s a very insular disease. So it’s often the patients and their families that get out and support each other because they know the daily struggles.
One of the main threats to a diabetics health is when their disease impacts the kidneys. This vital organ is part of the urinary tract, and is responsible for filtering blood, removing waste and excess water to make urine. They also help to control blood pressure and produce hormones.
So what’s happening?
When we have diabetic kidney disease, our kidney‘s capacity to function is impaired. It can not remove waste products and excess fluid from the body. These wastes build over time and can cause damage to our other organs.
Cause
High blood sugars (Hyperglycemia) - causes damage to the blood vessels in your kidneys. High blood pressure also contributes to kidney disease.
Prevention
As with all diabetic complications, strict glycemic control is the key to preventing kidney disease. (3.5 - 6.7 mmol : 65 - 120 mg/dl).
The following will also help stave off damage to the kidneys:
* Control blood pressure
* Regular exercise
* Don’t smoke
* Keep a healthy weight
* Get enough sleep (7-8 hours )
Symptoms of diabetic kidney disease.
The early stages of kidney disease often don’t show any symptoms. This is why regular, periodical health check-ups are a must. As kidney function decreases patients may feel sick to their stomach, vomit, hiccup, experience weight gain and lose their appetite.
Tests to identify kidney disease.
* Microalbuminuria (protein in the urine)
* Serum Creatinine
* BUN (blood urea nitrogen)
* Creatinine clearance, glomerular filtration rate (GFR)
* Urine albumin.
Treatments
Prevention is always better than cure, but if you’re already affected there are a number of treatments available depending on the progression of the disease.
* ACE Inhibitors: These drugs reduce blood pressure in the body and there’s evidence to suggest they also lower pressure in the kidneys. Patients who take these drugs may have less protein in the urine.
* Cholesterol medication: Often ‘bad’ cholesterol rises in patients of chronic kidney disease and so statins are used to try and bring this down.
* Dialysis: 2 x treatment options: Haemodialysis: needles are used to acces blood, filter and clean it, then return it to the body.
Peritoneal: catheter placed in stomach where dialysis fluid is used to clean the blood.
Kidney Transplant: End stage treatment (is not a cure) - free from dialysis - offers longer and more active life.
94% success rate in 12 months For transplant.
Considerations
The above is positive for diabetics who have end stage kidney disease, but following a transplant, they must take further life-long medications and live as healthy a life as possible, following a strict diet, exercise and medication routine.
The point here is why wait till it reaches this stage?
It’s hard without the power of hindsight, but the reality for diabetics is that a third of all type 1’s will suffer some degree of kidney disease in their life. This is improving all the time with better education around blood glucose control, but it‘s only us that are responsible for preventing this disease.
Freedom from diabetic complications is possible, but it comes from strict glycemic control, and this is a skill worth learning.