What do you need to know?
Diabetes is the leading cause of kidney failure and dialysis in Canada. Diabetes is a lifelong condition which is caused by not having enough insulin in the body or by the body not being able to use the insulin properly. Insulin is a hormone made by the pancreas (a gland in your body). This hormone is needed to allow sugar (glucose) from foods that we eat to provide energy (fuel) for your body. Diabetes will cause the sugar to stay trapped in the bloodstream leading to high blood sugar levels.
WHAT ARE THE DIFFERENT TYPES OF DIABETES?
There are several types of diabetes. The most common ones are Type 1 and Type 2:
Type 1 Diabetes:

• The body does not make insulin
• Insulin injections are taken daily
• Most often, but not always, develops in young people

Type 2 Diabetes:

• The body is not able to respond to insulin
• The body is not able to make insulin properly
• Diabetes medications and/or insulin injections may be needed to control blood sugar levels

WHO IS AT RISK?

• Family history of diabetes
• Being overweight
• Members of a high risk group
• High cholesterol levels
• Diabetes during pregnancy (gestational diabetes)
• High blood pressure
• Heart disease

HOW IS DIABETIC KIDNEY DISEASE (DIABETIC NEPHROPATHY) DIAGNOSED?

• Urine test
• Blood test

WHAT EFFECT DOES DIABETES HAVE ON THE KIDNEYS?

• High blood sugar levels damage the filters and blood vessels
• Damaged filters spill protein and sugar into the urine
• On-going damage to the filters cause wastes to build up in your blood

WHAT ARE THE SYMPTOMS OF DIABETIC KIDNEY DISEASE?

• Many or repeated kidney infections
• Cloudy, foamy or frothy urine (proteinuria)
• High blood pressure
• Swelling around the eyes, hands or feet
• Shortness of breath
• Voiding (peeing) more often (mainly at night)
• No symptoms

HOW DO I CARE FOR MY KIDNEY DISEASE WITH DIABETES?

• Maintain good blood sugar control
• Measure and record your blood sugar levels in a log book
• Fasting Blood Glucose (FBG) should be between 4 – 7 mmol/L and 2 hours after eating (postprandial) between 5 – 10 mmol/L
• Have your A1C checked every 3 months (Goal: less than 7.0, less than 6.0 is ideal)
• Eat healthy
• Know your blood pressure (target less than 130/80)
• Keep cholesterol levels in a healthy range (Ask your doctor what your target range should be)
• Stop smoking
• Become physically active
• Minimize the amount of alcohol
• Maintain a healthy weight
• Control your stress level
• Watch for symptoms of infection such as urinary tract infections or wounds that won’t heal after two days
• Take your medication as prescribed

REFERENCES
Kidney Foundation of Canada
Canadian Diabetes Association