Diabetes and the kidney

The kidneys work 24 hours a day to remove toxins the body makes or takes in. They are the body’s filtration units, and poisons from the body enter the kidneys through the walls of tiny blood vessels.

When capillaries cannot filter out impurities, it results in nephropathy where waste products remain in the blood and important products like protein and nutrients are lost in the urine.

Symptoms of kidney damage such as fluid retention,sleeplessness, decreased urination, tiredness, vomiting and weakness are absent in the early stages and appear much after the damage is done. However,not all people with diabetes get nephropathy. 

Hypertension also damages the kidneys. Years of high blood pressure can damage the filtering units and the removal is less efficient. 

Prevention: 

Risk of nephropathy can be reduced by :

—Controlling blood glucose level 

—Testing urine regularly to check for presence of small amounts of protein (microalbumiuria)

—Keeping a healthy weight and consuming low salt diet to control blood pressure

—Having medication to control blood pressure

Diabetes and the nervous system :

The nervous system controls every activity of the body. It is the means of communication between the brain and other parts of the body. Too much glucose can damage nerves by upsetting the chemical balance inside nerves or by getting them pinched by the surrounding tissues; or by slowing down or stopping the flow of blood to them so that they do not get sufficient oxygen. When they are damaged, nerves may be unable to send messages, send them at the wrong times or send them too slowly. This condition is called neuropathy.

Neuropathy is usually seen in people who have had diabetes for many years or have poor blood glucose control. 

Nerve damage can cause a range of effects such as pain in the limbs, loss of sensation, weakness in muscles, loss of bladder or bowel control, trouble with digestion, sexual dysfunction or impotency in males.

Types of neuropathy :

If your arms, hands feet or legs on both sides  -

feel numb, have no sensation to  changes in temperature,  feel shooting or stabbing pains,  feel burning tingling or prickling, or show muscle weakness

                - it could be symptoms of   Distal Symmetric Polyneuropathy.

Wear comfortable shoes and check feet daily as you could injure them without knowing it and it can get infected.

If you have 

Lack of sensitivity to touch or pain, or difficulty moving,  a tingling , burning and numbness of  hands,  and you  keep dropping things without being aware of it,

               - It could be symptoms of Focal Neuropathy 

Nerves are damaged either because blood supply has been cut off or because a nerve is pinched.  

Carpal tunnel syndrome  is one such condition that occurs more often in people with diabetes, especially women,   when the median nerve of the forearm is squeezed by the carpal bones in the wrist. The tingling goes away when arms are relaxed at the sides.

This condition is not permanent and usually goes away within 2 weeks to 18 months with good blood glucose control.

If …

—You have frequent attacksof diarrhoea, constipation, nausea or vomiting,  and stomach and gut muscles do not work properly  

—The bladder cannot be emptied fully and you have  frequent   urinary tract infection 

—Sex life is affected by impotency

—Blood pressure fluctuates between low and high -  (You feel light- headed or dizzy when you stand suddenly, or your blood pressure  goes up  when you exercise)

—You have  too much /too little sweating, or dryness of the skin, or excessive facial sweating while eating

 —Your heart rate does not  speed up or slow down with exercise 

—Early symptoms of low blood glucose levels  are lost and you lose consciousness without warning

You may have Autonomic Neuropathy which affects nerves that control parts of the body not moved voluntarily. 

Neuropathy can start diabetes - related problems:

Charcot’s foot in people with long diabetes- A loss of feeling on weight- bearing joints, such as ankles, and thinning of bones can result in   a painless fracture that goes untreated. Muscle shrinking and joint damage add to the damage and can result in deformed foot. 

 Prevention :

Good blood glucose control, healthy blood vessels  which provide constant blood supply for  good functioning of nerves, exercise, no smoking, healthy meals, foods rich in vitamins and minerals, and  minimum  alcohol consumption.