Diabetes is one of the major growing health problems in the Philippines, with over 48,000 recorded deaths in 2021. Data from Philippine Statistics Authority show that it’s the fifth-deadliest illness in the country, after heart diseases, cerebrovascular diseases, COVID-19, and cancer.
Today, diabetes is considered a “silent and persistent” issue to health, as it affects a significant portion of the population in many countries. In fact, one in 14 Filipino adults lives with it, drawing up an astonishing 4 million tally, more or less.
Diabetes, as we know it, poses several health complications if not managed immediately and accordingly. However, you may be unaware that it can cause acute problems to the kidney, such as having an increased risk of diabetic nephropathy.
Read on to learn more about one of the major complications of diabetes, diabetic nephropathy, and how to manage it.
What is Diabetic Nephropathy?1,2
Diabetic nephropathy is a critical complication that can occur in people with type 1 and type 2 diabetes. Also known as diabetic kidney disease, it is deemed the most common cause of kidney failure, wherein 1 in 3 people diagnosed with diabetes develop it.
A chronic disease, diabetic nephropathy is one that progresses slowly. In this condition, the glomeruli, which are the kidney’s filters, become impaired. This may be due to uncontrolled high blood glucose levels due to diabetes, causing immense damage to the kidneys’ delicate filtering system.
Early diagnosis and treatment can prevent a case of diabetic nephropathy from progressing to a much more life-threatening condition, such as kidney failure. However, when left unattended, it may lead to its fifth and final stage, end-stage renal disease (ESRD).
Symptoms of Diabetic Nephropathy2,3
While one might not experience any symptoms during the early stages of diabetic nephropathy, the later stages of the disease may result in the following:
- Uncontrolled blood pressure
- Swelling of arms and legs
- Nausea or vomiting
- Shortness of breath
- Loss of appetite
- Itchy or dry skin
- Easy fatigability
If you find yourself experiencing any of these symptoms, it’s best to visit your doctor immediately for an accurate diagnosis. Professional screening needs to take place in this regard, such as a urine test, blood test, or biopsy.
Risks Factors for Diabetic Nephropathy2,4
The following are some of the several risk factors to account for that might increase one’s chances of developing diabetic nephropathy.
Hypertension, or high blood pressure, is highly connected with diabetes. According to studies, hypertension is twice as likely to occur in patients with diabetes compared with those without it. This is because diabetes hardens and narrows the arteries, ultimately resulting in high blood pressure.
If left untreated, hypertension can result in multiple medical complications, such as heart attack and kidney disease.
Another factor that can cause diabetic nephropathy is hyperglycemia or increased blood sugar. When not managed accordingly, high sugar levels in the blood can damage the many tiny filtering units in each kidney, eventually leading to serious kidney complications in the long run.
Smoking, as you know it, has several long-term consequences. While you often hear about its effects on the respiratory system, it’s also important to note that smoking can easily damage the kidneys and accelerate other issues related to diabetes. It decelerates the blood flow to the important parts of the body, such as the kidney, and can make matters worse.
Scientific studies have shown that adults with type 2 diabetes who have higher body mass index (BMI) are more at risk for diabetic kidney disease. Being overweight or obese increases one’s chances of developing diabetes, as the body has too much sugar circulating in the bloodstream at this state.
Evidence suggests that diabetic nephropathy can be hereditary. This can be attributed to how diabetes itself can be passed from generation to generation. As such, if you have a family member with diabetes, it’s a must to get checked immediately for early diabetes detection and to prevent further development.
Similar to hypertension and hyperglycemia, having high cholesterol increases the risk of coronary heart disease and diabetic nephropathy. This is because cholesterol is a waxy, fat-like substance that can block the arteries if taken too much. A build-up can induce serious medical complications, such as stroke and kidney failure.
Treatment for Diabetic Nephropathy5,6
Even as a serious disease, there are several ways to prevent the onset or delay the progression of diabetic nephropathy. Below are some of the methods worth noting:
For the early stages of diabetic nephropathy, your doctor may prescribe drugs to keep major risk factors at bay. Medications like angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs), sodium-glucose cotransporter 2 (SGLT2) inhibitors or glucagon-like peptide-1 receptor agonists (GLP-1RAs), and statins are recommended to manage triggers of the condition, specifically high blood pressure, high blood sugar, and high cholesterol, respectively.
Change in diet
One other key aspect to managing a chronic illness such as diabetic kidney disease is diet.
Upon consultation, your physician may also inquire about your food intake to ensure you’re regularly getting the right nutrients.
In treating a kidney illness like diabetic nephropathy, you need to monitor your saturated fats, sodium, and sugar consumption. Additionally, you would want to incorporate fiber-rich foods in your diet with lots of vegetables and fruits on the side. Skip processed meals and start preparing homecooked dishes for a well-balanced diet. Referral to a Registered Nutritionist Dietitian is advised.
When the kidney stops functioning effectively, one may need to resort to dialysis. Kidney dialysis is the process of using a machine to filter wastes from the blood and remove them from the body.
There are two kinds of dialysis: hemodialysis and peritoneal. Hemodialysis involves a dialysis machine, wherein blood from the body gets drawn out to get filtered in the device and returned via another tube and needle. Normally, these sessions are done in a dialysis clinic for a prescribed number of hours and days per week.
Meanwhile, peritoneal dialysis can be carried out at home. A cleansing fluid flows through a tube (catheter) into the abdomen where the lining of the abdomen (peritoneum) acts as the filter and removes waste products from the blood. After a set period of time, the fluid with the filtered waste products will be released from the abdomen and then discarded.
When diabetic nephropathy reaches its final stage and renders the patient’s kidney useless, a transplant may be another option.
While it’s true that there are a handful of things to consider when taking this route, such as getting a kidney donor, making sure the body doesn’t reject the new organ, and caring for the patient after the operation, a successful transplant can truly be worth it all.
Prevention for Diabetic Nephropathy5,7
The best way to avoid any complex issues is to prevent them from happening in the first place. It requires building good habits and dedication to proper health. Here are some things you can work on to prevent diabetic nephropathy:
Monitor and control blood glucose levels
High sugar levels are one of the key drivers that worsen diabetes and lead to diabetic nephropathy. Therefore, practice the habit of keeping your blood glucose levels in check and regulated. This includes eating regularly, opting for diabetes-friendly dishes, and testing your blood sugar levels as needed.
Maintain a healthy blood pressure range
Since uncontrolled high blood pressure can pose great health risks for people with diabetes, you want to properly maintain its range to ensure it doesn’t result in something as serious of a complication as diabetic kidney disease. You can do this by maintaining a healthy weight, working out, and reducing sodium in your diet.
Go for a healthier lifestyle
Making a switch to a healthier lifestyle can positively impact your efforts to prevent diabetes or other serious illness.
After meeting your dietician, you can change things up a bit in your daily meals and opt for a balanced one consisting of carbohydrates, protein, fruits, and vegetables. Other ways of making healthy habits include creating a workout routine, sticking to it, and practicing how to manage stress accordingly.
Several health hazards come with smoking. If you have diabetes and smoke regularly, try removing cigarettes from your routine since they can trigger or aggravate diabetic nephropathy. Other critical medical conditions like stroke, heart diseases, and chronic bronchitis can also result from smoking, so try eliminating it altogether.
Visit your doctor regularly
A simple yet effective way to prevent diabetic nephropathy is to visit your doctor regularly. Doing so allows your physician to examine your current health status and provide you with the necessary medications and treatments. For circumstances like this, early detection of the disease can make all the difference.
Manage Your Diabetes to Care For Your Kidneys
Diabetic kidney disease is a long-term illness that can lead to other serious medical complications, like heart failure, if left unchecked. Managing your diabetes is the first step to ensuring that it is kept at bay. Maintaining a balanced diet, incorporating exercise, and slowly building good lifestyle habits make a great start to staying on top of your health.
Diabetes and heart failure are known to be related to one another. As such, it’s best to get you and your loved ones checked for any coronary heart disease risks as well. Take this assessment test and seek the advice of a medical professional to learn more!
Disclaimer: The information provided is for information purposes only and is not meant to be substituted for the advice given by a registered medical practitioner. This should not be used for diagnosing health problems or for self-medication. Boehringer Ingelheim shall not be responsible for any damages or losses arising out of access to or use of information provided.