Diabetes & Kidney Disease

Diabetes is a disease that is caused by the lack of insulin in the body or the body's inability to properly use normal amounts of insulin. If the body lacks insulin or does not use the insulin properly, then this imbalance results in high blood sugar. Insulin is a hormone that is a very important chemical messenger that regulates the level of glucose (sugar) in the blood. The body must have insulin to function.  Therefore, people with diabetes may take medications that can either make the pancreas produce more insulin, or help the body properly use the insulin that is being produced.  

Even with the use of insulin or other medications, people who have had diabetes for some time often suffer from damage to the small blood vessels such as the ones in the filters of the kidneys. 
If left untreated, this could lead to more damage or kidney failure.  If you have diabetes, you should be tested once a year to see if diabetes has affected your kidneys. Your doctor can arrange a urine test for protein (a random urine test for “albumin to creatinine ratio”), and a blood test to check how well your kidneys are functioning (the “serum creatinine”).

When your kidneys are about to fail you might experience tiredness, nausea and vomiting. You could also retain salt and water, which could cause swelling of your feet and hands, and shortness of breath. You may also find that you need less insulin than usual.

How diabetes affects the kidneys

• Damage to blood vessels
  High blood sugar clogs all blood vessels including the filters of the kidney.  This causes decreased kidney function.

• Damage to nerves and infections
  High blood sugars can also damage the nerves that tell you when your bladder is full. A full bladder can cause the urine to back up into the kidneys and cause further damage to kidney filters. This can also lead to increased bladder infection.

How to support your kidney health

• Talk with your doctor or nurse about what your target blood sugar level should be, and when and how often you need to check it.
• Test your blood sugar as often as directed by your health care team.  The A1C blood test tells you what your average blood sugar level was in the past two to three months.  Have this test done every three months (or as often as your doctor suggests) to see if you have control over your blood sugar.
• Maintain a healthy lifestyle and weight.
• Don’t smoke.
• Control your cholesterol through proper food choices and if you are on medications, make sure you take it as directed by your doctor.
• Manage your blood pressure.  People with kidney disease who also have diabetes should aim for a blood pressure of 130/80 mm Hg.
• Take special care to have infections treated immediately.
• Make sure to have your kidney function tested annually (or as often as your doctor suggests) by having blood and urine tests.