Research results indicate that Diabetes is the leading cause of chronic kidney disease. Final stage of kidney disease is kidney failure and is known as nephropathy. According to the Centers for disease Control, over 17 million Americans have diabetes. Unfortunately, one third of them do not even realise that they have the disease. Approximately 45% of patients suffering from chronic kidney disease had diabetes as the major reason for this dreadful disease, where once the kidneys are damaged and unable to perform their filtration of impurities from blood, there is no recourse to medicinal cure, and the available options are dialysis (Filtering functions of kidney being substituted by a machine) or kidney transplant, where the donor and recipient have to undergo major surgery.

The only heartening factor is that kidney failure does not happen quickly after onset of the diabetes, but will take at-least 5 to 7 years or longer. There are early and later indications to suggest that kidney is getting progressively deteriorated in functions. There are effective remedial actions to slow down the pace of deterioration and maintain the kidney functions.

Both type 1 and type 2 diabetics are likely to suffer from kidney disease/ failure, but it is more in the case of type 1. The symptoms of type 1 diabetes is diagnosed early and treatment plans could be taken early. Unfortunately, type 2 diabetes goes often undiagnosed for years, because the early symptoms are not pronounced. By the time it is diagnosed, there are irrevocable damages done and the chances for kidney damages increase.

Obesity and overweight conditions are linked to insulin resistance and help in onset of type 2 diabetes. When someone is insulin resistant, he will have high blood sugar persistently which manifest into diabetes.

Link between diabetes and kidney disease: Diabetes damages small blood vessels in the body. When the blood vessels in kidney are injured, kidneys lose their capacity to filter the impurities from blood properly. Body retains more water, salt and this results in increase in weight and swelling in the ankles. Urine contains protein. Waste materials start building up in the blood. Besides, diabetes damage nerves in the body. This causes difficulty in emptying bladder. There is a back-up pressure from the stored urine in the bladder, damaging the kidneys. Moreover, the stored urine in bladder causes infection.

The course of kidney disease: The kidney disease takes a longer time leading to kidney failure. Initially, small amounts of protein / albumin leaks into the urine. The filtration function of kidney remains normal during this period. As time passes, more albumin leaks into urine. This stage is known as 'overt diabetic nephropathy or macroalbuminuria. After this stage, filtration begins to drop. Body retains various wastes as filtration drops. Creatinine is one such waste and blood test for creatinine is used to estimate decline in kidney function. As the damage develops, blood pressure also rises.

There are early and later symptoms of kidney damage which are enumerated below:

Early symptoms:

1. Presence of albumine in urine. ( test on this is recommended each year by diabetics)

2. Weight gain and swelling in the ankles, cramps.

3. Frequent urination, especially during night.

4. Rise in blood pressure

Later symptoms:

1. High level of BUN and creatinine in blood

2. Less need for insulin or anti-diabetic medications due to slow down of kidney in breaking down insulin.

3. Morning sickness, nausea and vomiting.

4. Weakness, paleness and anemia

5. Lower blood count (anemia)

6. Loss of appetite, increasing tiredness, itching, muscle cramps.

What are the possibilities to prevent kidney damage?

1. Good control of diabetes lowers risk of having severe kidney disease.

2. Blood pressure and urine albumin excretion to be checked every year.

3. Ensure enough sleep (at-least 8 hours a day)

4. Regular exercise, followed up with 45 minutes of brisk walk.

5. Avoiding alcohol, smoking.

6. Ensure treatment for urinary tract infections, without delay.

7. Avoid medicines which might damage kidneys (Medicines for anti-inflammation/pain killers)

8. Reduce intake of protein more than the daily recommended allowance.

9. Reduce intake of sodium (Salt and vegetables which are rich in sodium)

10. Use of high blood pressure medicines called angio-tension converting enzyme (ACE) inhibitors is proved to slow down the deterioration of kidney function.

The final stage of renal failure, occurs when kidneys are no longer able to support healthy functions, unable to filter the impurities from blood. Onset of kidney failure is normally about 7 years or longer.

SUGGESTIONS:

1. The best course, therefore, is to check overweight and obesity in the first place to prevent insulin resistance and diabetes type-2.

2. Avoid salt and sugar.

3. Stay off from alcohol and smoking.

4. Eat a healthy diet with good nutrition.

5. Keep the mind peaceful, to the extent possible.

6. Avoid taking fast-food, and food/drink rich in carbohydrate.

7. Regular exercise, with brisk walking ( at-least 45 minutes)

8. If you are a diabetic, then the following might help in reducing blood sugar

a. Change the dietary habits to reduce intake of sugar and carbohydrates and increase intake of fiber and vitamins.

b. Enough physical exercise, which should include fast walking

c. Divide intake of food into smaller portions at regular intervals.

d. Avoid salt which increases blood pressure and aggravates problems of diabetes.

e. Intake of magnesium helping in production of insulin.

f. Juice of bitter melon, taken in empty stomach, helps in a great way to control diabetes and reduces blood sugar.

g. Other nutrients: Zinc, Vitamin B complex and Vitamin C which are good in controlling blood sugar

h. Intake of fenugreek with milk which reduces blood sugar and controls diabetes.

i. Consumption of Jamun fruit and powdered jamun seeds.

j. Consumption of garlick will reduce diabetes.

k. Soak tender neem leaves and tulsi leaves in water for 10 minutes and drink. It controls blood sugar.

l. Spinach and cereal fiber help in controlling diabetes.