Diabetes is the leading risk factor for kidney disease and the number one cause of kidney failure. More than 29 million Americans have diabetes, and almost half of all kidney failure cases are caused by diabetes. Learn more about diabetes, how it damages your kidneys, and what you can do to help prevent or control diabetic kidney disease.
What is diabetes?
Diabetes is a disease that causes your body to have trouble making or using insulin. Insulin is a hormone (a chemical your body makes) that helps your body turn the sugar you eat (also called glucose) into energy. When your body doesn’t use insulin the way it should, too much sugar stays in your blood.
Your kidneys are full of tiny blood vessels (glomeruli) that help to clean your blood. Too much sugar in your blood can hurt these blood vessels. When your kidneys are damaged by having high blood sugar, you have diabetic kidney disease (also called diabetic nephropathy).
What is the difference between type 1 and type 2 diabetes?
There are two types of diabetes: type 1 and type 2.
Type 1 diabetes
Type 1 diabetes, which used to be called juvenile diabetes, is an autoimmune disease that causes your body to make either no or very little insulin because the body attacks specific cells in the pancreas that make it. Type 1 diabetes cannot be prevented but can be treated by injecting insulin into the body.
Type 2 diabetes
In type 2 diabetes, the body does not recognize or respond to the insulin it makes. Type 2 diabetes is caused by a combination of genetic and lifestyle factors. Obesity and overweight are the leading causes of type 2 diabetes. Type 2 diabetes is more common in adults but can also happen in children. With the rise of childhood obesity, the number of children diagnosed with type 2 diabetes has been increasing in recent years.
Many of the signs and symptoms of diabetes are similar for type 1 and type 2. Talk to your doctor if you notice any of the following symptoms, which could mean diabetes.
- Increased thirst
- Increased hunger
- Urinating more than normal
- Blurry vision
- Crankiness or being easily irritated
- Extreme tiredness
- Unexplained weight loss (symptom of type 1 diabetes)
- Tingling, pain or feeling numb in the hands and feet (symptom of type 2)
Diabetic kidney disease
Once your kidneys have been damaged by diabetes, they cannot be fixed. If diabetic kidney disease is not treated early, it can lead to kidney failure.
Diabetic kidney disease does not happen fast. Sometimes it takes many years. This means that you can take steps now to help protect your kidneys. Even if your kidneys are already damaged, you can control your diabetes to help keep them from getting worse.
You will not be able to feel if diabetes has harmed your kidneys. The only way to know is to be tested. Learn more about the tests for kidney disease here.
How can I prevent diabetic kidney disease or keep it from getting worse?
The steps to prevent diabetic kidney disease are the same as the steps to keep it from getting worse. You will need to:
- Control your blood sugar
- Control your blood pressure
- Control your cholesterol
- Follow a diabetic diet
- Do not smoke or use tobacco
- Exercise most days of the week
- Keep a healthy weight
Controlling your blood sugar
Keeping your blood sugar in a healthy range can help protect your kidneys. A special diabetic diet, exercise and medicines can help you keep a healthy blood sugar level. You will need to check your blood sugar often to know how you’re doing.
When you have doctor appointments, you will probably have a blood test to check your hemoglobin A1C. This is a blood test that tells your doctor how your blood sugar has been doing over the last 2 or 3 months. Ask your doctor what your A1C result should be. Most people with diabetes should have an A1C less than 7 percent.
To check your blood sugar at home, you will use a blood glucose meter (also called a glucometer). You can get a meter at your local drug store, hospital, clinic or online. Your doctor can help you find a meter that is right for you. Most insurance policies will help pay for your testing supplies.
Your doctor can show you how to use your meter. Ask your doctor how often to check your blood sugar and what your blood sugar level should be.
In most cases, your blood sugar level should be:
- Between 70 and 130 BEFORE eating;
- Less than 183 about 2 hours AFTER eating;
- Between 90 and 150 at bedtime.
Print this chart to track your blood sugar levels.
Tell your doctor if your blood sugar is often too high or too low. If your blood sugar is low, eat a glucose tablet, raisins, hard candy or honey. You can also drink fruit juice, milk or a sugary drink. Check your blood sugar again after 15 minutes to make sure it is getting higher.
Tell your doctor if this happens more than once.
Control your blood pressure
High blood pressure is the #2 cause of kidney failure. Having both diabetes and high blood pressure makes it more likely that you will have kidney disease and heart disease.
A healthy blood pressure is less than 120/80 (or 120 over 80). Ask your doctor how often you should have your blood pressure checked.
Control your cholesterol
Cholesterol is a waxy, fat-like substance in your blood. Having high cholesterol and diabetes makes it more likely that you will have kidney disease, heart disease or a stroke. High cholesterol can also make your diabetic kidney disease get worse faster.
There are two types of cholesterol you should pay attention to: HDL (“good” cholesterol) and LDL (“bad” cholesterol). For most people, normal cholesterol levels are:
- Total cholesterol: less than 200
- HDL (“good” cholesterol): more than 40
- LDL (“bad” cholesterol): less than 100.
Your triglycerides are also important. Triglycerides are a type of fat in your blood. For most people, a healthy triglyceride level is less than 150.
Talk with your doctor about what your cholesterol and triglycerides levels should be and how you can control them.
Follow a diabetic diet
What you eat and drink affects your blood sugar. Ask your doctor, dietitian or diabetes educator about:
- What to eat
- How much to eat
- How often to eat.
Picking healthy foods, eating smaller meals and eating more often can help you control your diabetes and prevent problems. Medicare and many private insurance policies will help pay for appointments with a dietitian or diabetes educator. Check with your insurance provider to find out if your policy covers medical nutrition therapy (MNT).
Do not smoke or use tobacco
Using tobacco (smoking or chewing) can make kidney problems worse. If you use tobacco, quitting can help lower your chance of getting kidney disease or help prevent your kidney disease from getting worse if you already have it.
Exercise most days of the week
Exercise can help your body use insulin better. This makes it easier to keep a healthy blood sugar level. Exercise also helps control your blood pressure and cholesterol.
To get the most benefit, exercise for at least 30 minutes, five days a week. If that seems like too much, start slowly and work your way up. Look for fun activities that you enjoy. Try walking with a friend, dancing, swimming or playing a sport. Adding just a little more activity to your routine can help.
Be sure to talk to your doctor before starting any exercise program.
Keep a healthy weight
Keeping a healthy weight can help you control your blood sugar and lower your chances of getting kidney disease. Talk to your doctor about how much you should weigh. If you are overweight, losing just a few pounds can make a big difference.
A diabetes educator can help you learn how to control your blood sugar. Ask your doctor to help you find a diabetes educator in your area. You can also get a list of diabetes educators from the American Association of Diabetes Educators at www.diabeteseducator.org. Medicare and many private insurance policies will help pay for appointments with a diabetes educator.