Are You In Control of Your Diabetes?

Written by DaVita dietitian Cheryl Carter, RD

If you are an American with diabetes you should know that not controlling your glucose levels could lead to other health complications including kidney disease. The numbers can be scary — 30% of people with Type 1 diabetes and 10 to 40% of people with Type 2 diabetes will eventually suffer from chronic kidney disease. So how can you avoid being a statistic? One of the best things you can do is get control of your diabetes. 

You can control diabetes

Your lifestyle choices play a big part in how healthy you are and how healthy you stay. By following a healthy diet, exercising regularly, monitoring your blood glucose, taking your medicines as prescribed by your doctor and losing weight if you are over your ideal body weight, you can help delay or prevent the onset of chronic kidney disease, heart disease and other diabetic problems.

Diabetes is a disease that affects your body’s ability to produce insulin (Type 1 diabetes) or to use insulin (Type 2 diabetes). When your body cannot produce insulin or is insulin resistant, this causes too much sugar or glucose to remain in your blood. Over time, high blood glucose levels can damage the small blood vessels in the kidneys as well as cause blindness, heart disease and impotence.

If you have been diagnosed with diabetes, it is important to remember to do the following things that you yourself can control:

1. Eat at about the same times every day to keep blood sugar levels even throughout the day.
2. Eat a meal or snack every 3 to 4 hours to help keep blood sugar levels even throughout the day.
3. Do not skip meals.
4. Keep the amount of carbohydrate in meals and snacks consistent from day to day.
5. Check your blood sugar every day.
6. Take your medicines and/or insulin as directed by your doctor.
7. See your doctors on a regular basis, and inform them of any changes in your blood sugar, or any new symptoms you may notice.

Your goal should be to keep your blood sugar as close to normal as possible. Currently, the recommendation for blood sugar levels is 90 to 130 mg/dl before meals and less than 180 mg/dl within one to two hours after a meal. Your doctor may have different individualized goals for you, so ask where your blood sugar level should be.

Diabetes doesn’t have to lead to kidney disease

While no one really knows what causes diabetes, medical professionals believe genetics, diet, lack of exercise and obesity may play a part in the onset of Type 2 diabetes. If you are overweight, another important goal should be gradual weight loss. Studies show that losing only 10 to 15 pounds can lower your blood sugar and help you gain better control of your diabetes. By eating healthier and getting regular physical activity, you can lose that extra weight. Regular exercise helps to use excess blood sugar for energy and keeps your heart and bones strong, too. Of course, ask your doctor before starting any new exercise program.

If you smoke, stopping smoking can be a great benefit to your heart, lungs and kidneys, as well as the rest of you. While smoking is a tough habit to quit, doing so eliminates one of the risk factors for kidney failure.

Keep an eye on your blood pressure and try to keep it at 125/75 or lower, or where your doctor recommends. High blood pressure can increase the risk of kidney disease for those with diabetes because in addition to the high sugar levels damaging tiny blood vessels in the body, the higher pressure of the blood can also damage blood vessels. Take your blood pressure medicine as prescribed by your doctor. Even if you do not have high blood pressure, your doctor may prescribe blood pressure medicine because it has been shown that some blood pressure medicines protect the kidneys and slow the progression of existing kidney disease.

By following the advice of your doctor and making some of the lifestyle changes discussed above, even though you have diabetes, you may be able to prevent or delay kidney disease.

Get tested for kidney disease

Many people with diabetes may have chronic kidney disease and don’t even know it. Because renal disease usually has few symptoms until kidneys begin to fail, many diabetic with decreasing kidney function have not been diagnosed. Ask your doctor to test your kidney function and to check your urine for protein. If you have the creatinine level from a recent blood test, you can use the DaVita GFR Calculator. Glomerular filtration rate (GFR) is an indicator of a person’s kidney function and can help determine the stage of chronic kidney disease.

If you have already been diagnosed with the beginning stages of kidney disease, you may delay the start of dialysis by following your doctor’s orders for medications and diet. You may be instructed to eat a low-sodium diet to help lower your blood pressure, and a low-protein diet may be recommended to decrease the work of your kidneys.

In any case, a registered dietitian or renal dietitian, who specializes in renal care, can help you figure out the best diet for your diabetes and kidneys. The American Dietetic Association has an easy way to find a dietitian by specialty on the homepage at www.eatright.org. By keeping your blood sugars normal, you can be in control of your diabetes, your kidneys and your life.