Ask the Doctor
Questions about kidney disease? Risk factors? Signs and symptoms? Are you concerned about yourself, a friend or family member? Ask Dr. Spry.
Diabetes, a risk factor for kidney disease, is characterized by high levels of blood sugar due to the body's inability to produce insulin or problems with the way insulin is processed by the body. Insulin is a hormone that regulates the amount of sugar in your blood and high blood sugar levels can cause problems in many parts of your body, including the kidneys.
There are two common types of diabetes. The most common ones are Type 1 and Type 2. Type 1 diabetes usually occurs in children and young adults. It is also called juvenile onset diabetes mellitus or insulin-dependent diabetes. In Type 1 diabetes, your pancreas does not make enough insulin and you have to take insulin injections for the rest of your life. Type 2 diabetes is more common than Type 1 diabetes. It is most common in people over 40, but is increasing among younger people, including children and adolescents. 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, physical activity and/or taking medication. Some patients must also take insulin. Type 2 diabetes is particularly prevalent among African Americans, American Indians, Latin Americans and Asian Americans.
Both types of diabetes damage small blood vessels throughout the body and the kidneys have many of these vessels. When the blood vessels in the kidneys are damaged, your kidneys cannot clean your blood properly. This can cause your body to retain more water and salt than it should and waste materials can build up in your blood instead of being removed by the kidneys and excreted in the urine.
Prediabetes is the term that refers to the beginning stage of diabetes, or the precursor stage, when only some of the criteria for diabetes have been met. Blood sugar levels are not normal, but not quite at the point of having diabetes. Most importantly, when a person has prediabetes, it is still possible to reverse the symptoms by making changes to diet and exercise. Lifestyle changes can prevent prediabetes from turning into full-blown diabetes, which can ultimately lead to kidney damage and kidney failure if not properly managed.
Often when people have prediabetes, they do not experience any physical signs of the disease for many years, making regular check-ups very important. Many people don't realize that having high blood sugar can damage the kidneys even before being clinically diagnosed with diabetes, making prevention and screening that much more important. If you do experience physical symptoms, the signs of prediabetes include frequent urination, and excessive hunger and thirst. In reality, though, these symptoms can also indicate other health issues and sometimes these symptoms are hard to recognize or don't occur.
The earliest sign of kidney disease in those with diabetes and prediabetes is protein in the urine. Protein in the urine is easy to detect, but you need to know to look for it. This urine test should be done on an annual basis in all people with diabetes, so ask your healthcare provider about checking your urine for "albuminuria." You should also have your kidney function and blood pressure checked at least once a year. Maintaining control of your blood sugar levels can lower your risk of developing severe kidney disease. Here's a handy kidney health checklist to take with you to your annual physical.
For more information about diabetes and your kidneys, please visit the A-Z Guide.