Diabetic nephropathy -- kidney disease that results from diabetes -- is the number one cause of kidney failure. Almost a third of people with diabetes develop diabetic nephropathy.
People with diabetes and kidney disease do worse overall than people with kidney disease alone. This is because people with diabetes tend to have other long-standing medical conditions, like high blood pressure, high cholesterol, and blood vessel disease (atherosclerosis). People with diabetes also are more likely to have other kidney-related problems, such as bladder infections and nerve damage to the bladder.
Living well with type 2 diabetes means making certain precautions part of your routine, says Amy Campbell, MS, RD, CDE, manager of clinical education programs at Joslin Diabetes Center in Boston. She offers this advice.
Make a date with a dietitian. "It's a myth that there's a one-size-fits-all diabetes diet," Campbell says. A dietitian can help you develop an eating plan that's right for your age, weight, activity level, and medications, and can also set daily calorie and carbohydrate targets...
Kidney disease in type 1 diabetes is slightly different than in type 2 diabetes. In type 1 diabetes, kidney disease rarely begins in the first 10 years after diagnosis of diabetes. In type 2 diabetes, some patients already have kidney disease by the time they are diagnosed with diabetes.
What Are the Symptoms of Diabetic Nephropathy?
There are often no symptoms with early diabetic nephropathy. As the kidney function worsens, symptoms may include:
Swelling of the hands, feet, and face
Trouble sleeping or concentrating
Itching (end-stage kidney disease) and extremely dry skin
Drowsiness (end-stage kidney disease)
Abnormalities in the hearts' regular rhythm, because of increased potassium in the blood
As kidney damage progresses, your kidneys cannot remove the waste from your blood. The waste then builds up in your body and can reach poisonous levels, a condition known as uremia. People with uremia are often confused or comatose.
How Is Diabetic Nephropathy Diagnosed?
Kidney damage can be detected early by finding protein in the urine. Treatments are available that can help slow progression to kidney failure. That's why you should have your urine tested every year if you have diabetes.
How Is Diabetic Nephropathy Treated?
Lowering blood pressure and maintaining blood sugar control are absolutely necessary to slow the progression of diabetic nephropathy. Some medicines called angiotensin converting enzyme (ACE) inhibitors can help slow down the progression of kidney damage. Although ACE inhibitors -- including ramipril (Altace), quinapril (Accupril) , and lisinopril (Prinivil, Zestril) -- are usually used to treat high blood pressure and other medical problems, they are often given to people with diabetes to prevent complications, even if their blood pressure is normal.
If a person has side effects from taking ACE inhibitors, another class of drugs called angiotensin receptor blockers (ARBs) can often be given instead.
If not treated, the kidneys will continue to fail and larger amounts of proteins can be detected in the urine. Advanced kidney failure requires treatment with dialysis or a kidney transplant.
Get the latest Diabetes newsletter delivered to your inbox!
Your level is currently
If the level is below 70 or you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.
People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.
Congratulations on taking steps to manage your health.
However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.
Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.
Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.
One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.
Thank you for signing up for the WebMD Diabetes Newsletter!
You'll find tips and tricks as well as the latest news and research on Diabetes.
Did You Know Your Lifestyle Choices
Affect Your Blood Sugar?
Use the Blood Glucose Tracker to monitor
how well you manage your blood sugar over time.