DIABETES

Diabetes And Kidney Disease

Diabetes mellitus (DM) is commonly referred to simply as diabetes. It is a metabolic disorder characterized by either insufficient amounts of insulin being produced by the pancreas or the ineffective use of insulin by the body's cells. It can be classified as either type 1 or type 2.

It is a chronic disease, which means that it develops and persists over a long period of time. Similar to high blood pressure, it has a gradual and silent onset. Many people with this disease may not be aware of its presence because it displays little to no symptoms in the early stages.

During the first ten (10) years or so of this disease there are no symptoms, and it can only be detected by routine testing of the blood sugar levels.

Diabetes mellitus (DM) should not be confused with diabetes insipidus (DI). DI is caused by a hormonal deficiency that affects the regulation of water in the body. This is a completely different disorder from DM, which is a metabolic disorder affecting the regulation of the body's blood sugar. This article refers specifically to DM and not DI. All references to "diabetes" are specific to DM only.

Type 1 Diabetes

Type 1 tends to first occur in young adults and children. It is sometimes referred to as insulin-dependent or juvenile-diabetes and is responsible for approximately 10 percent of all diagnosed cases.

With type 1 diabetes, the body stops producing insulin, or does not produce enough. Patients must, therefore, take daily insulin injections or use an insulin pump. Without daily injections of insulin, type 1 patients will not survive for very long. They must also control blood glucose levels by diet and exercise.

People with type 1 are more likely to develop kidney failure. Up to 40 percent of people with this form of the disease develop kidney failure, between the ages of 30 to 50 years.

Type 2 Diabetes

Type 2 occurs more often in people over the age of 40, however, it can occur at any age... even during childhood. It is sometimes known as non-insulin dependent or adult-onset-diabetes. This is much more common and accounts in about 90 percent of all diagnosed cases.

Many people with type 2 do not respond properly to their own insulin or to injected insulin. This is sometimes referred to as insulin-resistance. In some cases, people with type 2 can control their blood glucose levels with meal planning and physical activity. Others must take pills that not only stimulate the production of insulin, but also reduce insulin resistance and decrease the liver's output of glucose. Others may also require injections of insulin in addition to pills.

Healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco use can prevent or delay the onset of type 2 diabetes.

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How Does Diabetes Affect The Kidneys?

Diabetes mellitus and high blood pressure are among the leading underlying conditions that cause kidney disease. With diabetes, glucose levels build up in the blood and urine, which results in excessive urination, thirst, hunger, and problems with fat and protein metabolism. It causes damage to the small blood vessels in the kidney. When these blood vessels are injured, the kidneys cannot perform their function properly and, consequently, excess water and salt is retained in the body. The excess fluid in the body can result in weight gain and swelling of the ankles.

In some cases, it may take many years for a diabetic patient to develop kidney disease. Sometimes, the filtering function of the kidneys is actually higher than normal, in the first few years of developing this disease. This process is known as hyper-filtration. This happens as the kidneys try to respond to the excess glucose in the blood. Over time, however, this begins to affect the kidneys and their filtering function begins to drop.

Generally, kidney damage rarely occurs within the first 10 years of developing this disease. Sometimes, as much as 25 years will pass before there are any signs of kidney failure. The risk of developing kidney failure decreases, for most people who live with this condition for more than 25 years, without any signs of kidney damage. Other risk factors are obesity, physically inactivity, and having an immediate family member with diabetes.

Symptoms of Diabetes and Kidney Disease

Due to low levels of insulin or the poor response to insulin, the cells are prevented from absorbing glucose. Consequently, glucose builds up in the blood. When this blood (with excessive glucose) passes through the kidneys, these organs cannot absorb all of the excess glucose. This excess glucose accompanied by water, goes into the urine and causes frequent urination, in order to get rid of the additional water drawn into the urine. This, in turn, triggers excessive thirst and hunger, to replace the water and the glucose lost in urination.

Additional symptoms may include:

hypertension,
blurred vision,
unexplained weight loss,
irritability,
weakness,
fatigue, and
nausea and vomiting.

Diabetes is a contributing factor in many deaths from heart disease, kidney failure, and other conditions. Some studies have also suggested that there is a link between diabetes mellitus and kidney stones.

If you are not diabetic... then prevention is the best way to avoid the complications associated with diabetes and kidney disease. Healthier lifestyle choices, including healthy diet, regular exercise, and avoidance of harmful substances (such as tobacco and drugs), will go a long way in preventing and slowing the effects of this terrible disease.

If you have been affected by diabetes it is very important that you work with your doctor to implement and maintain an effective diabetes management program, to effectively control your blood glucose levels.