Can Kidney Disease Cause Diabetes
Recent research has found that kidney disease may cause high blood sugar and diabetes. When you have kidney disease, your kidneys cannot filter waste products from your blood as well as they should. This can cause diabetes because high blood levels of the waste product urea can prevent your pancreas from making insulin the way it should. Urea is a waste product that your body makes after it breaks down protein.
How Diabetes Affects Your Kidneys
With diabetes being the leading cause of kidney disease, one may ask, how does diabetes affect your kidneys?
It is estimated that about a quarter of the people that have diabetes experience kidney disease. High blood sugar caused by diabetes can damage the blood vessels in the kidneys. The damage done to the blood vessels can lead to diabetic kidney disease. Over time, high blood sugar can cause the blood vessels to become narrowed and potentially blocked. Therefore, there is a lack of blood flow to the kidneys, leading to damage.
Another way diabetes affects your kidneys is through nerve damage. Nerves are essential for transmitting messages between the brain to other parts of the body, including the bladder. Your bladder will signal to the brain when the bladder is full. However, if nerves are damaged, then the signal will not reach your brain, and you may not feel that your bladder is full. When your bladder is continuously full, it can place pressure on your kidneys. The pressure placed on the kidneys can cause damage to them.
In addition to the pressure on the kidneys, a urinary tract infection is more likely to occur if ones bladder is full for too long. Bacteria will grow quickly in urine, especially if the urine has a high sugar level. The bacteria has the potential to affect the kidneys if it spreads.
Effect Of Insulin On Ace2 Activity And Kidney Function In The Non
Abstract We studied the non-obese diabetic mice model because it develops autoimmune diabetes that resembles human type 1 diabetes. In diabetic mice, urinary albumin excretion was ten-fold increased at an âearly stageâ of diabetes, and twenty-fold increased at a âlater stageâ as compared to non-obese resistant controls. In NOD Diabetic mice, glomerular enlargement, increased glomerular filtration rate and increased blood pressure were observed in the early stage. In the late stage, NOD Diabetic mice developed mesangial expansion and reduced podocyte number. Circulating and urine ACE2 activity were markedly increased both, early and late in Diabetic mice. Insulin administration prevented albuminuria, markedly reduced GFR, blood pressure, and glomerular enlargement in the early stage and prevented mesangial expansion and the reduced podocyte number in the late stage of diabetes. The increase in serum and urine ACE2 activity was normalized by insulin administration at the early and late stages of diabetes in Diabetic mice. We conclude that the Diabetic mice develops features of early kidney disease, including albuminuria and a marked increase in GFR. ACE2 activity is increased starting at an early stage in both serum and urine. Moreover, these alterations can be completely prevented by the chronic administration of insulin.Continue reading > >
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Treatment For Diabetic Nephropathy
Early detection and treatment of diabetic nephropathy can not only stop the progression of kidney disease in people with diabetes, but during the early stages can actually reverse it. Treatment involves controlling both your blood glucose levels and your blood pressure.
Blood glucose levels should be kept in the normal range as much as possible to prevent or slow the progression of diabetic nephropathy. Lifestyle measures in combination with oral diabetes medicines or insulin can be used to control blood glucose levels.
People with type 2 diabetes who have microalbuminuria or proteinuria are usually also treated with medicines called angiotensin-converting enzyme inhibitors or angiotensin receptor blockers . These medicines are also used to control blood pressure, but even if your blood pressure is normal, your doctor may prescribe an ACE inhibitor or ARB because they decrease the amount of protein in the urine and can prevent or slow the progression of diabetic kidney disease.
Other medicines may also be prescribed to help control high blood pressure.
What Increases The Risk Of Developing Diabetic Kidney Disease
All people with diabetes have a risk of developing diabetic kidney disease. However, a large research trial showed that there are certain factors that increase the risk of developing this condition. These are:
- A poor control of your blood sugar levels.
- The length of time you have had diabetes.
- The more overweight you become.
- Having high blood pressure. The higher your blood pressure, the greater your risk.
- If you are male.
This means that having a good control of your blood glucose level, keeping your weight in check and treating high blood pressure will reduce your risk of developing diabetic kidney disease.
If you have early diabetic kidney disease , the risk that the disease will become worse is increased with:
- The poorer the control of blood sugar levels. The greater your HbA1c level, the greater your risk.
- Having high blood pressure. The higher your blood pressure, the greater your risk.
- Smoking.
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Risk Factors For Diabetic Nephropathy
There are many factors that can increase your risk of developing diabetic nephropathy. These include:
- the length of time that you have had diabetes
- having high blood glucose levels
- having high blood pressure
- being overweight or obese and
- smoking.
Your risk is also higher if you have other problems related to your diabetes. These include diabetic retinopathy or diabetic neuropathy.
How Do I Reduce My Blood Sugar Level
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What Can Be Done To Manage The Kidney Damage Caused By Diabetes
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Control Your Blood Pressure
Blood pressure is the force of your blood against the wall of your blood vessels. High blood pressure makes your heart work too hard. It can cause heart attack, stroke, and kidney disease.
Your health care team will also work with you to help you set and reach your blood pressure goal. The blood pressure goal for most people with diabetes is below 140/90 mm Hg. Ask your health care team what your goal should be.
Medicines that lower blood pressure can also help slow kidney damage. Two types of blood pressure medicines, ACE inhibitors and ARBs, play a special role in protecting your kidneys. Each has been found to slow kidney damage in people with diabetes who have high blood pressure and DKD. The names of these medicines end in pril or sartan. ACE inhibitors and ARBs are not safe for women who are pregnant.
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What Are The Symptoms Of Diabetic Kidney Disease
You are unlikely to have symptoms with early diabetic kidney disease – for example, if you just have microalbuminuria . Symptoms tend to develop when the kidney disease progresses. The symptoms at first tend to be vague and nonspecific, such as feeling tired, having less energy than usual and just not feeling well. With more severe kidney disease, symptoms that may develop include:
- Difficulty thinking clearly.
- Needing to pass urine more often than usual.
- Being pale due to anaemia.
- Feeling sick .
As the kidney function declines, various other problems may develop – for example, anaemia and an imbalance of calcium, phosphate and other chemicals in the bloodstream. These can cause various symptoms, such as tiredness due to anaemia, and bone ‘thinning’ or fractures due to calcium and phosphate imbalance. End-stage kidney failure is eventually fatal unless treated.
How Diabetes Can Affect Your Kidneys Functioning
Diabetes is a primary cause of kidney-related problems, it directly harms the small blood vessels around your kidneys which plays a core process in removing chemical intoxicants, pollutants, and other contaminants from the body. Eventually, this increases the level of waste product in your blood which can also bring some serious health problems like- stroke, heart disease, brain tumor, and irreversible kidney problems.
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How Do High Blood Sugar Levels Damage The Kidneys
- Due to high blood sugar levels, the glomeruli get narrow and clogged. This prevents the blood from passing through the blood vessels, thus damaging the kidney. Damaged kidneys allow albumin to leak into the urine, which originally used to pass through the filters.
- Diabetes also damages the nerves which carry messages between the brain and the urinary bladder. Due to the damaged nerves, the person is unable to feel if their bladder is full, which puts extra pressure on the kidneys.
- When the urine stays in the bladder for a long time, it increases the risk of getting a urinary tract infection. The high sugar levels in the urine, allow infection-causing bacteria to grow in the urine at a rapid rate.
What Are The Stages Of Kidney Disease Caused Due To Diabetes
The diabetic kidney diseases pass through the following five stages:
Stage 1: This stage is the one which is often found even before the diagnosis of the diabetic kidney disease. It is concerned with hyper function and the usual features of this stage include albumin excretion through the urine of the patient. This condition is further aggravated at the time when the patient is involved in some or the other type of physical exercise.
Stage 2: In this stage, there is an increased GFR rate experienced by the patient.If diabetes is efficiently managed, during this stage albumin secretion through urine is minimal. However, when the patient indulges in any kind of physical activity, the secretion only increases. Stage 2 of the diabetic kidney diseases is actually the most common of all stages and develops slowly over a period of time. In fact, most of the patients continue in this stage throughout their lives.
Stage 3: This stage is known as incipient diabetic nephropathy. In this stage, a test known as radioimmunoassay is conducted to reveal the excessive amount of albumin excreted during urination. This is the very important phase of the diabetic kidney disease as the blood pressure of the patient also happens to be rising. GFR is considered to be super abnormal at this particular stage.
Stage 5: This is the end stage of the kidney disease and renal failure.At this stage, the patient suffers from uremia.
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What If I Miss A Dose
If you miss a dose of Entresto, be sure to take it as soon as you remember. If the timing is too close to your next dose, just take your next scheduled dose. Be sure not to take more than one dose at a time. Taking multiple doses may increase your risk for more side effects. You should speak with your doctor about any missed doses, if youre concerned.
To help make sure that you dont miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.
Diabetic Disease In Arteries And Arterioles
Diabetes also causes scarring in the walls of arteries and arterioles in the kidneys and other tissues. Arterioles are the smallest arteries that connect to capillaries. Arteries and arterioles bring blood carrying oxygen to the tissues of the body. Sclerosis is scarring in the blood vessel wall that causes thickening of the wall and narrowing of the opening through which blood flows. Diabetes causes scarring of arteries and arterioles. When this happens, not enough oxygen reaches the tissue and injury results. This can injure many tissues. The heart, eyes, skin, nerves and kidneys can be affected.
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How Does Kidney Disease Happen
Each kidney has about one million tiny filtering units, called nephrons, which contain many blood vessels. Any disease or condition that injures or scars the nephrons and damages their blood vessels can cause kidney disease.
The most common causes of kidney disease are diabetes, hypertension and atherosclerosis . Less common causes include:
- A genetic disorder called polycystic kidney disease, which causes many cysts to grow in the kidneys
- Long-term use of certain drugs that are toxic to the kidneys
- Autoimmune diseases, such as lupus or rheumatoid arthritis
The Mechanism Is Unknown
It is clear that diabetes can lead to kidney disease, but just why high blood sugars should damage the glomeruli is unclear. High blood pressure is a known risk factor for kidney disease and people with diabetes are prone to hypertension. The renin-angiotensin system â which helps regulate blood pressure â is also thought to be involved in the development of diabetic nephropathy.Other risk factors include cigarette smoking and family history. Diabetic nephropathy progresses steadily despite medical intervention. However, treatment can significantly slow the rate of damage.
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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
- Muscle twitching
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 and occasionally become comatose.