It’s never fun to think about kidney disease (or any type of diabetes complication, for that matter), but taking steps now can go a long way in helping you to prevent it.
Diabetes is the leading cause of kidney disease, and it’s estimated that about one in four adults with diabetes has kidney disease. People with type 1 diabetes (as well as those with type 2 diabetes) are at risk. Your kidneys are vital organs — their job is to filter waste out of the blood, along with extra water, to make urine. The kidneys also help to control blood pressure and make certain hormones that the body needs to stay healthy.
High blood sugar levels can damage the millions of small blood vessels inside the kidneys, and high blood pressure levels can also cause these vessels damage. When your kidneys are damaged, they can’t do their job very well. Further, kidney damage can cause blood pressure to go higher; it can also raise your risk of getting heart disease.
If kidney disease progresses, dialysis or a kidney transplant will be needed.
Type 1 diabetes is an autoimmune disorder in which the immune system attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the pancreas produces little or no insulin. Type 1 diabetes is also characterized by the presence of certain autoantibodies against insulin or other components of the insulin-producing system such as glutamic acid decarboxylase (GAD), tyrosine phosphatase, and/or islet cells.
When the body does not have enough insulin to use the glucose that is in the bloodstream for fuel, it begins breaking down fat reserves for energy. However, the breakdown of fat creates acidic by-products called ketones, which accumulate in the blood. If enough ketones accumulate in the blood, they can cause a potentially life-threatening chemical imbalance known as ketoacidosis.
Type 1 diabetes often develops in children, although it can occur at any age. Symptoms include unusual thirst, a need to urinate frequently, unexplained weight loss, blurry vision, and a feeling of being tired constantly. Such symptoms tend to be acute.
Diabetes is diagnosed in one of three ways – a fasting plasma glucose test, an oral glucose tolerance test, or a random plasma glucose test – all of which involve drawing blood to measure the amount of glucose in it.
Type 1 diabetes requires insulin treatment for survival. Treatment may also include taking other drugs to prevent kidney damage or to treat diabetes-related conditions such as high blood pressure.
It’s scary to think of getting kidney disease. But don’t let fear stop you from jumping on the kidney health bandwagon. You can be in the driver’s seat and hopefully prevent it, if you start now. Here’s how:
Health-care folks spend a lot of time reminding you to check your blood sugars and know your A1C levels. Let’s not forget about “kidney numbers,” however. Two tests to make sure you’re getting include a urine microalbumin and a GFR (glomerular filtration rate). The microalbumin test is a simple urine test done in your doctor’s office. It checks for small amounts of protein in your urine, an early sign of kidney disease. The GFR is a blood test that tells your doctor how well your kidneys are filtering. A GFR of more than 60 means your kidneys are working as they should. You may need other blood tests, too; ask your doctor what tests are needed, and always ask about your results.
You no doubt hear this a lot, and it might be annoying to hear it yet again. But the best way to ward of kidney disease (and any type of diabetes complication) is to do your best to keep your blood sugars and your A1C levels in your target range. Find out your target blood sugar ranges, along with your A1C goal (usually less than 7%), as they can be different for different people. A combination of healthful eating, physical activity and medication is usually needed to keep your numbers at goal.
High blood pressure is a leading risk factor for both kidney disease and heart disease. You usually can’t tell if it’s high without getting it checked. For many people with diabetes, the blood pressure goal is less than 140/90; however, if you have high blood pressure, your goal may be lower — less than 130/80. Once again, talk with your doctor about the right goal for you. High blood pressure can be managed with medication, weight loss (if needed), eating right and staying active. Checking your blood pressure at home is a great way to stay on top of your blood pressure levels, too.
Getting the right types of nutrients in your diet can help keep your kidneys healthy. And the same healthy “diet” can help you manage your blood sugars and keep your heart healthy, too. What does a healthy diet look like?
• Fruits and vegetables: Fruits and veggies contain important nutrients needed for overall health (not just kidney health), such as potassium, vitamins, fiber and antioxidants. Go for fresh or frozen produce as much as possible, and shy away from juices and canned vegetables that contain a lot of sodium.
• Protein: Protein is an essential nutrient that helps maintain muscle mass and the immune system. Too much protein, however, can cause your kidneys to work overtime. A low-carb diet tends to be somewhat high in protein; while this may be helpful for your blood sugars, it may not be the best for your kidneys, especially if you are showing early signs of kidney damage (such as a high microalbumin level). Go easy with your portions of meat, poultry or fish. Also, consider replacing some animal protein sources with plant proteins, including beans, lentils and tofu.
• Sodium: Getting too much sodium in your diet can raise your blood pressure, which, in turn, affects your kidneys. The main source of sodium in our foods comes from processed foods, including frozen meals, cheese, snack foods, canned foods, condiments and fast foods. Find out what your daily sodium goal should be from your dietitian or doctor, and start reading food labels for the sodium content. For reference, a low-sodium food has no more than 140 milligrams of sodium per serving. Also, bypass the saltshaker in favor of herbs and spices in cooking and on foods.
• Fat: To lower your risk of heart disease, focus on choosing healthy fats in your diet. Healthy fats don’t raise your cholesterol and can help lower heart disease risk. Plant oils, such as sunflower seed oil, olive oil and peanut oil, are good choices, along with nuts, seeds, olives and avocados. Limit foods that contain partially hydrogenated oils, which means that they contain trans (unhealthy) fat. Go easy on foods that contain saturated fat, as well, such as red meat, poultry skin and high-fat dairy foods.
While a moderate amount of alcohol may be safe for you, too much alcohol can be harmful to the kidneys. Alcohol can interfere with the kidneys’ job of keeping the right amount of water in the body, and it may also raise blood pressure. In addition, too much drinking can cause liver disease, which, in turn, impacts how well your kidneys work. One or two servings of alcohol a day may be OK, but it’s always best to check with your doctor.
Yes, smoking can be harmful to the kidneys, as well as to your heart, lungs, mouth, pancreas and other organs. Smoking slows blood flow to the kidneys, affecting how well they function. And it can interfere with high blood pressure medicine, too. Now’s the time to make a plan to quit.
Medications called ACE inhibitors and ARBs are used to treat high blood pressure. They might also help prevent kidney damage. Ask your doctor about these. Speaking of medication, some medications can be harmful to the kidneys. High doses of prescription and over-the-counter pain meds, some antibiotics and antacids are just a few that you need to be careful about. Always let your doctor know what medications you’re taking at every visit; discuss your doses to make sure they’re safe, and also find out if there are other options that are safer for you.
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