Vinayak Harale

Diabetes is not an isolated disease but a syndrome. It brings with it a host of issues, affecting almost all organs, and that is the reason it is a dreaded issue. Diabetes is the result of chronic inflammation and this inflammation gradually spreads to all other organs. One of the main organs adversely affected is the kidneys. The kidneys are essential filtration agents, and impaired kidney function can have a series of bad effects on the body.

The good news is that not everybody with diabetes will have diabetic nephropathy. However, risk factors for developing diabetic nephropathy are:

1. Severe, uncontrolled diabetes
2. Family history
3. Prior kidney disease, even chronic infection
4. Race or ethnicity (native Americans, African Americans, etc.)
5. Preexisting hypertension or high cholesterol levels
6. Obesity

If you have these risk factors, then all efforts should be aimed at keeping blood sugar at highly optimal level. Once it reaches beyond a certain level, it is very difficult to get it under control.

Symptoms

There would be no symptoms in the initial stages

1. If you suspect that increased sugar levels could be damaging the kidneys, it is imperative to do renal functions annually to test for onset of kidney malfunction
2. There could be swelling of the feet and ankles
3. Urine tests may indicate increased levels of protein in the body (serum albumin in particular)

Management

The idea is to arrest or stop damage to the kidneys.

1. Reduce and maintain blood pressure within the recommended levels. This will depend on the age and overall health status. Using angiotensin converting enzymes or angiotensin receptor blockers is the most effective way to control hypertension and related kidney damage
2. Keeping blood sugar within the recommended levels helps reduce or stop damage to the blood vessels in the kidneys and thereby, prevent progression
3. Maintain optimal levels of cholesterol, as this only adds to hypertension, which further worsens kidney function.
4. Eat a heart-healthy diet and exercise regularly. It is a vicious cycle with components including hypertension, high sugar levels, increased heart disease, which all only continues in a circle nonstop. Breaking this cyclical trend is very important.
5. Diet should not be too rich in protein, as the kidney function is impaired and may not be able to handle too much protein. Talk to a nutritionist as to how much protein is required and follow it strictly.
6. Reduce salt levels in the diet, and strictly do not add extra salt onto your plate
7. If you are a smoker, this is a great reason to quit, as it affects all the above conditions.
8. Maintain weight under optimal levels.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Diabetes is a systemic disease that affects almost every part of your body. Of these, the digestive system is the most badly affected. While gastrointestinal disorders are commonly experienced by everyone, diabetics have a much higher risk of suffering from indigestion, food poisoning, gallstones and ulcers. Some of the most common gastrointestinal problems experienced by diabetics are:

1. Gastroparesis: High blood sugar levels can damage the vagus nerve that controls the emptying of the stomach. As a result fo this damage, the muscles of the stomach and intestines do not work optimally leading to a condition known as Gastroparesis. This is a condition where the stomach is not able to empty itself properly and the digestion process is slowed down. Gastroparesis can cause bloating, nausea, pain in the abdomen, heart burn and a loss of appetite. It can also cause undigested food in the stomach to harden and form lumps that block food from moving into the intestines. This disease cannot be cured but can be managed with medication and a special diet.
2. Ulcers: Stomach ulcers can be described as open sores that develop on the inner lining of the stomach, oesophagus and beginning of the small intestine. These ulcers form as a result of bacterial infections. Diabetes weakens a person’s immune system thus reducing their ability to fight these infections and increasing the risk of developing ulcers. Diabetes also increases the risk of bleeding from these ulcers and secondary infections that may arise from it.
3. Yeast infections: Diabetics are extremely vulnerable to yeast infections. This is aggravated by fluctuation in blood sugar levels and can extend from the mouth to the oesophagus. Common symptoms of this type of yeast infection are pain in the throat and difficulty swallowing. It may also cause heartburn and intestinal bleeding if left untreated.
4. Celiac sprue: This condition creates gluten allergies and causes the inflammation and thinning of the small intestine’s mucosa. In some cases, this condition may interfere with the absorption of food and lead to diarrhoea and weight loss.
5. Diabetic diarrhoea: Patients who have been suffering from diabetes for a few years may experience an increased urge to pass stools frequently. This is usually related to gastric problems in the colon which cause fluids to move at a faster than normal speed through the small bowel and colon. It may also be caused due to the secretion of fluids in the colon and improper absorption of food.

In case you have a concern or query you can always consult an expert & get answers to your questions!