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Diabetes and kidney disease

Staying on top of type 2 diabetes may help prevent a common–and potentially serious–secondary problem

Head photo, one man, afro, smiling

Around the time of his 40th birthday, Mike Brown* mentioned to his doctor that, for the first time in his life, he was needing to go to the bathroom during the night. Tests confirmed that Brown’s blood sugar levels were abnormally high. Like his father years before him, Brown was diagnosed with type 2 diabetes. “I knew a little bit about it and I had some concerns,” says Brown. But once he was feeling better, he adds, he basically put it out of his mind.

Looking back now, Brown admits that having diabetes was the least of his concerns at the time. He and his wife were busy working and raising three sons, and he admits he wasn’t rigorous about checking his blood sugar level or taking his medication. “Back in those days, it was an inconvenience,” he says. Today, 19 years later, he adds, “it’s my whole life.”

Diabetes is a chronic disease that develops when the body either cannot produce or properly use insulin, a hormone that is created in the pancreas and that is responsible for regulating the amount of glucose, or sugar, in the blood.1 Some people, like Brown, may be genetically susceptible to developing diabetes; other factors include ethnicity, obesity and environment.2

Eleven million Canadians are prediabetic or are living with diabetes.3 About 10 per cent of them have type 1, or insulin-dependent, diabetes; whereas the majority, like Brown, are living with type 2 diabetes.4 While they may develop in different ways, both types can damage small blood vessels in the kidneys and the bladder, decreasing both organs’ function and potentially leading to kidney failure.5 In fact, up to a half of people living with diabetes will have signs of kidney damage in their lifetime,6 which also increases the risk of stroke and heart problems.7

Because there are rarely symptoms in the early stages of kidney disease–and by the time there are symptoms, the disease is often advanced–annual (at least) kidney screening through blood and urine tests is important for anyone living with diabetes.8

In his early years with the disease, Brown admits he didn’t always take the best care of himself. “I wish I’d paid more and better attention to my doctors back then, who were saying, ‘You really better get on top of this,’” he says. “And I just kept saying, ‘Oh yeah, don’t worry, I’ll do better,’ and I wouldn’t do better.”

By 2013, Brown had been diagnosed with congestive heart failure and diabetic kidney disease (DKD). Doctors warned him that if he didn’t take the proper measures to improve kidney function, he was facing the possibility of a transplant or dialysis. “Again, it was one of those things that at some point might happen,” Brown says. “They tell you what the possible consequences are, but you don’t have as deep an understanding of them as you should have when you’re diagnosed as a diabetic.”

Two years ago, Brown’s kidneys failed, and he now spends 10 hours every day on dialysis.

Because kidney disease often goes unnoticed until it’s advanced, the sooner you take action, the better. And taking care of your kidneys may also help protect you from heart disease.9

While diabetes is the leading cause of kidney disease in Canada,10 DKD is not an inevitable outcome. Keeping blood pressure, cholesterol and blood sugar levels controlled through diet and lifestyle changes are essential.11 And regular blood and urine screenings will help you maintain healthy kidneys and catch any problems before they start.

BE KIDNEY CONSCIOUS

If you’ve been diagnosed with type 2 diabetes, talk to your doctor about whether you are at risk of developing DKD. Some things to discuss include:

  • What dietary or lifestyle changes could help keep my kidneys healthy?
  • Would changing my medications be beneficial?
  • How often should my kidney function be tested?
  • What is a good result of a kidney function test?

Visit www.mykidneyscount.ca to learn more.

*Name has been changed

REFERENCES:
1Diabetes Canada. What is Diabetes. Accessed Sept. 27, 2020 https://www.diabetes.ca/about-diabetes/what-is-diabetes
2Diabetes Canada. Causes of Diabetes. Accessed Sept. 27, 2020 https://www.diabetes.ca/about-diabetes/causes-of-diabetes
3Diabetes Canada. What is Diabetes. Accessed Sept 27, 2020 https://www.diabetes.ca/about-diabetes/what-is-diabetes
4Diabetes Canada. What is Diabetes. Accessed Sept. 27, 2020 https://www.diabetes.ca/about-diabetes/what-is-diabetes
5Kidney Foundation. Diabetes and Kidney Disease. Accessed Sept. 27, 2020 https://kidney.ca/Kidney-Health/Newly-Diagnosed/Risk-Factors/Diabetes-Kidney-Disease
6Diabetes Canada. Canadian Journal of Diabetes. Chronic Kidney Disease in Diabetes. Accessed Sept. 27, 2020 https://diabetes.ca/DiabetesCanadaWebsite/media/Health-care-providers/2018%20Clinical%20Practice%20Guidelines/Ch29-Chronic-Kidney-Disease-in-Diabetes.pdf
7Diabetes Canada. Canadian Journal of Diabetes. Chronic Kidney Disease in Diabetes. Accessed Sept. 27, 2020 https://diabetes.ca/DiabetesCanadaWebsite/media/Health-care-providers/2018%20Clinical%20Practice%20Guidelines/Ch29-Chronic-Kidney-Disease-in-Diabetes.pdf
8My Kidneys Count. Screening for Kidney Disease in T2D. Accessed Sept. 27, 2020 https://mykidneyscount.ca/living-with-ckd.html
9https://mykidneyscount.ca/type-2-diabetes.html
10Diabetes Canada. Canadian Journal of Diabetes. Chronic Kidney Disease in Diabetes. Accessed Sept. 27, 2020 https://diabetes.ca/DiabetesCanadaWebsite/media/Health-care-providers/2018%20Clinical%20Practice%20Guidelines/Ch29-Chronic-Kidney-Disease-in-Diabetes.pdf
11Diabetes Canada. Canadian Journal of Diabetes. Chronic Kidney Disease in Diabetes. Accessed Sept. 27, 2020 https://diabetes.ca/DiabetesCanadaWebsite/media/Health-care-providers/2018%20Clinical%20Practice%20Guidelines/Ch29-Chronic-Kidney-Disease-in-Diabetes.pdf

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