Diabetes mellitus, usually called diabetes, is a disease in which your body does not make enough insulin (type 1) or does not respond to insulin properly (type 2), so that blood sugar levels increase. Insulin is a hormone that regulates the amount of sugar in your blood. A high blood sugar level will cause problems in many parts of your body.
Are there different types of diabetes?
The most common types of diabetes are type 1 and type 2. Type 1 diabetes often develops in children or juveniles. It is also called juvenile-onset diabetes mellitus or insulin-dependent diabetes mellitus. This type comprises roughly 5% of all diabetic patients. In this type, your pancreas does not make enough insulin and you have to take regular insulin injections. Type 2 diabetes, which is more common, usually occurs in people over 40 and is called adult-onset diabetes mellitus. In type 2 diabetes, your pancreas makes insulin, but your body does not use it properly. The high blood sugar level often can be controlled by following a diet and/or taking medication, although some patients must take insulin. Type 2 diabetes is particularly in elderly and/or overweight patients.
How does diabetes harm your kidneys?
With diabetes, elevated blood sugar levels injure the small blood vessels in the body. When the blood vessels in the kidneys are injured, your kidneys cannot clean your blood properly. Your body will retain more water and salt than it should, which will result in (fluid) weight gain and ankle swelling. You may also lose protein in your urine. Waste materials will build up in your blood. Diabetes also may cause damage to nerves in your body. This can cause difficulty in emptying your bladder or cause paresthesias in your lower limbs. Often feet ulcers may develop which may become infected and pose a threat of amputation. Also, the small vessels in your eyes are prone to damage by diabetes, so that you regularly need to see your ophthalmologist or eye doctor.
How many diabetic patients will develop kidney disease?
About 30 percent of patients with Type 1 (juvenile-onset) diabetes and 10 to 40 percent of those with Type 2 (adult-onset) diabetes eventually will suffer from kidney failure.
What are the early signs of kidney disease in patients with diabetes?
The earliest sign of diabetic kidney disease is an increased excretion of albumin in the urine. This may be present long before the usual tests are done in your doctor’s office showing evidence of kidney disease, so it is important for you to have this test on a yearly basis. Weight gain and ankle swelling may occur. You will use the bathroom more at night. Your blood pressure may increase which also contributes to renal damage. As a person with diabetes, you should have your blood, urine and blood pressure checked at least once or twice a year. This will lead to better control of your disease and early treatment of high blood pressure and kidney disease. Maintaining control of your diabetes will significantly lower your risk of developing severe kidney disease.
What are the late signs of kidney disease in patients with diabetes?
When your kidneys fail, your blood urea nitrogen (BUN) levels will rise as well as the level of creatinine in your blood. You may also experience nausea, vomiting, a loss of appetite, weakness, increasing fatigue, itching, muscle cramps (especially in your legs) and anemia (a low blood count). You may find you need less insulin. This is because the diseased kidneys cause less breakdown of insulin. If you develop any of these signs, call your doctor.
How is kidney failure treated in diabetic patients?
Three types of treatment can be used once your kidneys have failed: kidney transplantation, hemodialysis, and peritoneal dialysis.
Can a patient with diabetes have a kidney transplant?
Yes. Once you get a new kidney, you may need to adopt your anti-diabetes treatment. In the case of type 1 diabetes, a combined pancreas-kidney transplantation is possible in special centers. This avoids the further need for insulin injections. After transplantation you may need to increase your insulin dose since, your appetite will improve, the new kidney will break down insulin better and you will use steroids to keep your body from rejecting your new kidney. To learn more about kidney transplant click here.
How can you control your diabetes in the long run?
- Regular home monitoring of your blood glucose levels
- Adaptation of your oral antidiabetic medication or insulin dose to optimize your blood sugar levels at all times
- Follow your special diabetes diet
- In the case of type 2 diabetes reduce your body weight
- Be active and play sports
- Visit your nephrologist and ophthalmologist regularly