Diabetes is one of the biggest factors that increases your risk for kidney disease and the number one cause of kidney failure. About 30 million Americans have diabetes, and almost half of all kidney failure cases are caused by diabetes. It is important to manage your diabetes to prevent high blood sugar from damaging your kidneys.

What is diabetes?

Diabetes is a disease where your blood sugar (also called glucose) is too high because your body does not make or use insulin the way it should. Insulin is a hormone, which is a chemical your body makes. It helps your body turn the sugar from the food you eat into energy. When your body does not use insulin the way it should, too much sugar stays in your blood.

There are two types of diabetes: type 1 and type 2.

Type 1 diabetes

Type 1 diabetes is an autoimmune disease, which is a type of disease where your immune system mistakenly attacks your body. In type 1 diabetes, your body makes little or no insulin because your body attacks the cells in your pancreas that make it. The pancreas is an organ in your upper belly area that makes insulin, as well as the digestive juices that help you digest food. You cannot prevent type 1 diabetes, but you can treat it with regular insulin shots.

Type 2 diabetes

In type 2 diabetes, your body makes insulin, but does not use it the way it should. You are also more likely to have type 2 diabetes if you are overweight or if someone else in your family has the disease. It is more common in adults but can also happen in children. In recent years, more children have type 2 diabetes due to the rise of childhood obesity.

The symptoms of type 1 and type 2 diabetes are very similar. Talk to your doctor if you notice any of these symptoms:

  • Being more thirsty or hungry than normal
  • Urinating (peeing) more than normal
  • Blurry vision
  • Crankiness or being easily irritated
  • Being very tired
  • Unexplained weight loss (symptom of type 1 diabetes)
  • Tingling, pain or feeling numb in your hands and feet (symptom of type 2 diabetes)

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What is diabetic kidney disease?

Diabetic kidney disease, also called diabetic nephropathy, happens when high blood sugar damages your kidneys. Your kidneys are full of tiny blood vessels called glomeruli. These blood vessels help clean your blood. Too much sugar in your blood can hurt these blood vessels. Once your kidneys have been damaged by diabetes, they cannot be fixed. If diabetic kidney disease is not treated early, the damage can get worse over time and it can lead to kidney failure.

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.

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How can I prevent diabetic kidney disease or keep it from getting worse?

To prevent diabetic kidney disease or keep it from getting worse, you can:

  • Control your blood sugar
  • Control your blood pressure
  • Control your cholesterol
  • Eat healthy
  • Quit smoking or using tobacco
  • Be active most days of the week
  • Stay at a healthy weight

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.

Control your blood sugar

Keeping your blood sugar in a healthy range can help protect your kidneys. Healthy foods, being active, and certain medicines can help you keep a healthy blood sugar level. However, you will need to check your blood sugar often to know how you are doing.

When you have doctor’s 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 levels have been over the last two or three months. Ask your doctor what your A1C number should be. Most people with diabetes should have an A1C less than 7%.

To check your blood sugar at home, you will use a blood glucose meter (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 and show you how to use it. Many insurance policies will help pay for your meter and other testing supplies.

In most cases, a healthy blood sugar level is:

  • Between 70 mg/dL and 130 mg/dL before eating
  • Less than 180 mg/dL about two hours after eating

Ask your doctor how often to check your blood sugar and what your blood sugar level should be. 

While your blood sugar may be too high, it can also be too low. If your blood sugar is too low, you can increase it by:

  • Eating a glucose tablet, raisins, hard candy or honey
  • Drinking fruit juice, milk or a sugary drink

Then, use your meter to check your blood sugar again after 15 minutes to make sure it is getting higher. 

Tell your doctor if your blood sugar is often too high or too low.

Control your blood pressure

High blood pressure is another very common cause of kidney failure. Having both diabetes and high blood pressure can make you more likely to get kidney disease and heart disease.

A healthy blood pressure is less than 120/80 mm Hg (120 over 80). 

Ask your doctor how often you should have your blood pressure checked.

Read more about blood pressure and kidney disease.

Control your cholesterol 

Cholesterol is a waxy, fat-like substance in your blood. Having high cholesterol and diabetes can make you more likely to get 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, healthy cholesterol levels are:

  • Total cholesterol less than 200 mg/dL
  • HDL more than 40 mg/dL
  • LDL less than 100 mg/dL

Your triglycerides are also important – these are a type of fat in your blood. For most people, a healthy triglyceride level is less than 150 mg/dL.

Talk with your doctor about what your cholesterol and triglycerides levels should be and how you can control them.

Eat healthy

What you eat and drink causes your blood sugar to change. Eating a variety of healthy foods can help you keep your blood sugar at a healthy level. Also, instead of eating one big meal, try eating smaller meals and eating more often. This can help you control your diabetes and prevent other health problems. 

Medicare and many private insurance plans will help pay for dietitian or diabetes educator visits. Check if your plan covers medical nutrition therapy (MNT), which is a way to treat diabetes with a special eating plan just for you. You will learn more about what you should eat, how much and how often. 

Quit smoking or using 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 keep your kidney disease from getting worse.

Be active most days of the week

Being active can help your body use insulin better, which makes it easier to keep a good blood sugar level. Activity can also help control your blood pressure and cholesterol.

Set a goal to be active for at least 30 minutes, 5 days a week. 

If that seems like too much, start slowly and work your way up. You do not have to go to the gym! Try adding just a little more activity to your routine, such as:

  • Take the stairs instead of the elevator
  • Go for a walk after dinner
  • Look for fun activities that you enjoy, like dancing, swimming or playing a sport

Be sure to talk to your doctor before starting any exercise plan.

Stay at a healthy weight

A healthy weight can help you control your blood sugar and lower your chances of getting kidney disease. Talk to your doctor about what a healthy weight is for you. If you are overweight, losing just a few pounds can make a big difference.

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Find a diabetes educator

A diabetes educator can teach you how to control your blood sugar. Your doctor can help you find a diabetes educator in your area. You can also use the American Association of Diabetes Educators online locator to find a diabetes education program in your area. Medicare and many private insurance policies will help pay for these visits.

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