Kidney disease and diabetes
Diabetes is a long-term condition that causes a person’s blood glucose level to become too high because of problems with the hormone insulin. Glucose is the main type of sugar that the body uses for energy. If untreated, it can lead to serious health complications – including kidney damage.
Around 40 per cent of people with diabetes could eventually develop diabetic kidney disease, also known as diabetic nephropathy.
Types of diabetes
There are two main types of diabetes:
- Type 1 diabetes – where the body’s immune system attacks and destroys the cells that produce insulin. It often begins in childhood or adolescence and is not caused by dietary or lifestyle factors. Patients need regular insulin injections to stay alive.
- Type 2 diabetes – (the most common) where the body doesn’t produce enough insulin, or the body’s cells become resistant to insulin. The main risk factors include being overweight or obese, having a sedentary lifestyle, having a family history of type 2 diabetes, and being from a minority ethnic group. Type 2 diabetes can usually be controlled with drugs and by diet, but if the condition progresses, insulin treatment often becomes necessary.
How does diabetes affect the kidneys?
High blood glucose levels increase the pressure inside the delicate filtering system in the kidney (the glomeruli), causing increasing damage to the filters. This damage causes high blood pressure, leakage of protein into the urine and, in the long run, can cause progressive kidney damage and eventual kidney failure. It is not inevitable, but it is common.
How to reduce risk of kidney disease worsening if you have diabetes.
Testing kidney function at your yearly diabetic review is essential so action can be taken if there are signs of deterioration. Controlling your diabetes well reduces the risk of kidney damage.
Again, a healthy lifestyle is fundamental in preventing kidney damage: giving up smoking, reducing blood pressure by taking regular exercise, losing weight, keeping alcohol intake down, eating a good healthy diet (especially avoiding processed foods), reducing salt intake and controlling cholesterol. Some people may also need to take tablets to control blood pressure and cholesterol.
Sodium-glucose cotransporter-2 inhibitors, or SGLT-2 inhibitors, (their names end with ‘gliflozin’), are newer medications that prevent the kidneys from reabsorbing glucose back into the blood. This helps lower blood sugar levels in people with type 2 diabetes. They also have kidney protective properties and can slow down the progression of kidney disease in people both with and without diabetes. SGLT-2 inhibitors are also good for people with heart failure. Speak to your GP about accessing these.
One example of our work tackling diabetes and kidney disease
Professor Amy Jayne (AJ) McKnight, from Queen’s University Belfast is studying who is at higher risk of developing new onset (type 2) diabetes after a kidney transplant. This serious complication affects up to half of people who receive a kidney transplant, increasing their risk of transplant failure.
Small studies by AJ and her team suggest there are inherited risk factors for new onset diabetes after transplant which combine with lifestyle factors (medication, diet and exercise) to cause the disease.
With our funding, the team are now collaborating with researchers in the UK, Europe and America to try to predict who is at higher risk. This research could ultimately lead to individually tailored therapy to help prevent new onset diabetes after transplant.
This project is funded through a Stoneygate-Kidney Research UK project grant.
New study to investigate whether changes in gut bacteria can cause kidney disease in people with diabetes
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