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TYPE 2 DIABETES AND KIDNEY DISEASE


Type 2 Diabetics have a significantly increased chance of developing kidney disease. Groups at especially high risk include African Americans, Hispanics, Native and Asian Americans, Pacific Islanders and seniors.

However, better management of Diabetes via increased insulin sensitivity can prevent or significantly delay the onset of kidney disease.

Two pharmacists filling prescriptions.Diabetes damages small blood vessels in the body. When these blood vessels in the kidneys are damaged, the kidneys cannot clean blood properly. As a result, your body retains more water and salt than it should, which can also lead to weight gain and swollen ankles. As well as Diabetes-linked kidney disease causing the possibility of harmful protein turning up in your urine, waste materials will also build up in your blood.

High blood sugar levels are related to high blood pressure. As glucose levels increase in the blood, water leaves the tissues and enters the bloodstream. So reducing blood sugars will help reduce blood pressure and prevent further damage to the kidneys.

Another way for blood pressure to rise in individuals with poor blood sugar control is high insulin levels. The imbalance of blood glucose and insulin called Insulin Resistance has been shown to increase plaque formation and risk of cardiovascular disease. It also stimulates the nervous system which speeds up the heart and constricts blood vessels leading to higher blood pressure. High insulin levels also increase salt sensitivity, which, in turn, raises blood pressure. (1)

High blood pressure can also cause inflammation - the body's defensive response to harmful stimuli. The latter can range from an external example like a splinter in your finger causing reddened, inflamed skin, to a complex internal process in response to a harmful condition like high blood pressure. In the case of Diabetes, the harmful stimuli are thought to be elevated levels of insulin - a classic symptom of Insulin Resistance.

If neglected over the years, inflammation can lead to major damage to the arteries, which can result in kidney disease.

The medical profession is still studying and evaluating the role of inflammation in a wide variety of disorders that can be inter-related, like Diabetes together with the cluster of increased risks for cardiovascular disease called Metabolic Syndrome (Syndrome X) and Polycystic Ovarian Syndrome (PCOS) a leading cause of menstrual irregularity and infertility as well as skin conditions, excess facial and body hair and female baldness. To learn more, click on Inflammation, Insulin Resistance and Diabetes.

Nurse looking at an IV bag.Diabetes also may cause damage to nerves, resulting in difficulty in emptying your bladder. A vicious cycle can develop because the pressure resulting from your full bladder can back up and injure the kidneys. If urine remains in your bladder for a long time, there can be an additional problem – you may develop an infection from the rapid growth of bacteria in urine that has a high sugar level.

The risk of developing kidney disease can be reduced by maximizing your management of Diabetes through increasing your sensitivity to insulin. This can be achieved by reversing Insulin Resistance via a balanced, nutritious diet and regular exercise to lose weight.

The earliest sign of Diabetic kidney disease is an increased excretion of protein, called albumin, in the urine. Albumin is present long before the usual tests carried out by a doctor to discover evidence of kidney disease. So, as a Diabetic, it is important that you have a urine test on a yearly basis.

Other early signs include using the bathroom more frequently at night and a rise in blood pressure. Having your blood pressure checked at least once a year, along with your urine, can lower your risk of developing severe kidney disease. You could also regularly check your blood pressure at home. Some people get nervous when they go to the doctor's office and then get an inaccurate blood pressure reading.

To monitor your kidneys' ability to filter, your doctor may order renal function studies: serum Creatinine and blood urea nitrogen (BUN). As kidneys fail, BUN levels will rise, as well as the level of creatinine in your blood. Creatinine is a waste product produced in your muscles from the breakdown of a compound called creatine. The latter is part of the cycle that produces energy needed to contract your muscles.

Woman surgeon leaning up against a scheduling wall chart in a hospital.The quantity of creatinine produced depends on the size of the person and their muscle mass. For this reason, creatinine concentrations will be slightly higher in men than in women and children. Almost all creatinine is excreted by the kidneys, so blood levels are a good measure of how well your kidneys are working. If levels of creatinine rise, your kidneys may be malfunctioning. Creatinine levels usually rise later than BUN, so it tends to indicate a more chronic condition.

Kidney diseases can also create nausea, vomiting, a loss of appetite, weakness, increasing fatigue, itching, muscle cramps (especially in your legs) and anemia (a low blood count). You could also find you need less insulin because diseased kidneys cause less breakdown of insulin.

If you develop any of these signs, call your doctor, who needs to discover if Diabetes has damaged your kidneys. Other diseases can cause damage to you kidneys, which will work better and last longer if you:

  • Manage your Diabetes with maximum efficiency
  • Control your high blood pressure
  • Get treatment for urinary tract infections
  • Correct any problems in your urinary system
  • Avoid any medicines that may damage the kidneys (especially over-the-counter pain medications)
  • Eat a low-protein diet, which may slow the progress of kidney disease

End stage renal failure, or kidney failure, occurs when your kidneys are no longer able to support you in a reasonably healthy state and require dialysis or transplantation. This happens when your kidneys function at only 10-15% of their normal output. The usual span of time between the onset of Diabetic kidney injury and kidney failure is about five to seven years.

Three very colorful petri dishes.Three types of treatment can be used once your kidneys have failed: kidney transplantation, hemodialysis and peritoneal dialysis.

Diabetics can have a kidney transplant. Once you get a new kidney, you may need a higher dose of insulin. Your appetite will improve so your new kidney will break down insulin better than the damaged one. You will use steroids to keep your body from rejecting your new kidney. If your new kidney fails, dialysis treatment can be started while you wait for another kidney.

Remember: managing your Diabetes more effectively by increasing insulin sensitivity greatly improves your chances of avoiding major kidney disease.

The Insulite Diabetes Advanced Management System is a scientific breakthrough that could improve your health by increasing the insulin sensitivity of your cells. Greater sensitivity can result in a huge improvement in the efficient processing of glucose and insulin, which may reduce the amount of insulin you require to manage your Diabetes.

By lowering insulin intake and dependency through more effective management of your Diabetes, you are likely to experience better long-term health and a greater sense of well being. You may also reduce your risk as a Diabetic of developing such serious, insulin imbalance-linked complications as failing eyesight, kidney and heart disease and the need for amputation.

(1) Insulin resistance, the insulin syndrome, and cardiovascular disease.
Panminerva Med. GM Reaven. 2005 Dec;47(4);210-10.

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Click here to read about Diabetes and Metabolic Syndrome (Syndrome X).



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Article by Dr. Sheri Colberg, Phd, FACSM
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