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Diabetic Kidney Problems

If you have diabetes, your blood glucose, or blood sugar, levels are too high. Over time, this can damage your kidneys. Your kidneys clean your blood. If they are damaged, waste and fluids build up in your blood instead of leaving your body.

Kidney damage from diabetes is called diabetic nephropathy. It begins long before you have symptoms. People with diabetes should get regular screenings for kidney disease. Tests include a urine test to detect protein in your urine and a blood test to show how well your kidneys are working.

If the damage continues, your kidneys could fail. In fact, diabetes is the most common cause of kidney failure in the United States. People with kidney failure need either dialysis or a kidney transplant.

You can slow down kidney damage or keep it from getting worse. Controlling your blood sugar and blood pressure, taking your medicines and not eating too much protein can help.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Diabetic Nerve Problems

If you have diabetes, your blood glucose, or blood sugar, levels are too high. Over time, this can damage the covering on your nerves or the blood vessels that bring oxygen to your nerves. Damaged nerves may stop sending messages, or may send messages slowly or at the wrong times.

This damage is called diabetic neuropathy. Over half of people with diabetes get it. Symptoms may include:

  • Numbness in your hands, legs, or feet
  • Shooting pains, burning, or tingling
  • Nausea, vomiting, constipation, or diarrhea
  • Problems with sexual function
  • Urinary problems
  • Dizziness when you change positions quickly

Your doctor will diagnose diabetic neuropathy with a physical exam and nerve tests. Controlling your blood sugar can help prevent nerve problems, or keep them from getting worse. Treatment may include pain relief and other medicines.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Hyperglycemia

What is blood glucose?

Blood glucose, or blood sugar, is the main sugar found in your blood. It is your body's primary source of energy. It comes from the food you eat. Your body breaks down most of that food into glucose and releases it into your bloodstream. When your blood glucose goes up, it signals your pancreas to release insulin. Insulin is a hormone that helps the glucose get into your cells to be used for energy.

For people with diabetes, your body doesn't make enough insulin, can't use it as well as it should, or both. Too much glucose stays in your blood and doesn't reach your cells.

What is hyperglycemia?

Hyperglycemia means high blood glucose. It most often affects people who have diabetes. When you have diabetes, your body doesn't make enough insulin or can't use it the right way. Too much glucose stays in your blood and doesn't reach your cells.

What causes hyperglycemia?

A key part of managing diabetes is controlling your blood glucose levels. To do this, you need to follow a diabetes meal plan and get regular physical activity. You might also need to take diabetes medicines. You have to balance all of these to keep your blood glucose at the right levels. But if you eat too much food or the wrong foods, don't take your medicines correctly, or don't get physical activity, you can get hyperglycemia. It can also happen if you are stressed or sick.

Less commonly, people who don't have diabetes can also get hyperglycemia. It can be caused by conditions that can affect insulin or glucose levels in your blood. They include problems with your pancreas or adrenal glands, certain medicines, and severe illnesses.

What are the symptoms of hyperglycemia?

The symptoms of hyperglycemia include:

  • Feeling thirsty
  • Feeling tired or weak
  • Headaches
  • Urinating (peeing) often
  • Blurred vision

If you are diabetic and you often have high blood glucose levels or the symptoms of hyperglycemia, talk with your health care team. You may need a change in your diabetes meal plan, physical activity plan, or diabetes medicines.

If you don't have diabetes and you are having these symptoms, see your provider to find out the cause and how to treat it.

What other problems can hyperglycemia cause?

If hyperglycemia is not treated, it can cause other problems. In people with diabetes, long-term hyperglycemia can lead to serious health problems (diabetes complications).

If your blood glucose levels get very high, you can develop diabetes-related ketoacidosis (DKA). It happens when your body doesn't have enough insulin to allow blood glucose into your cells for use as energy. Instead, your liver breaks down fat for fuel. This process produces acids called ketones. When too many ketones are produced too fast, they can build up to dangerous levels in your body. This can be life-threatening.

The symptoms of DKA may include:

  • Trouble breathing
  • Nausea or vomiting
  • Pain in your abdomen (belly)
  • Confusion
  • Feeling very tired or sleepy

If you have an an at-home test for ketones, check your ketone level every 4 to 6 hours when your blood glucose is very high or when you are having these symptoms. If the test shows that your ketones are moderate or high, or if you don't have a ketones test, contact your health care provider right away or get emergency medical help.

How is hyperglycemia diagnosed?

If you have diabetes, you'll most likely need to check your blood glucose every day and make sure that it's not too high. You can do this with a blood glucose meter or continuous glucose monitoring (CGM) system.

There are also blood tests that providers can use to check if your blood glucose is too high.

What are the treatments for hyperglycemia?

If you have diabetes and often have high blood glucose, your health care team may make changes to your diabetes meal plan, physical activity plan, and/or diabetes medicines.

If you have severe hyperglycemia and are having symptoms of DKA, you will need treatment at the hospital. The treatment often includes I.V. (intravenous) fluids and insulin.

Can hyperglycemia be prevented?

If you have diabetes, managing your diabetes can help prevent hyperglycemia. To manage your diabetes, it's important to:

  • Follow your diabetes meal plan
  • Get regular physical activity
  • If you need diabetes medicines, take them correctly
  • Regularly check your blood glucose level
  • Get regular checkups with your health care team

Hypoglycemia

What is blood glucose?

Blood glucose, or blood sugar, is the main sugar found in your blood. It is your body's primary source of energy. It comes from the food you eat. Your body breaks down most of that food into glucose and releases it into your bloodstream. When your blood glucose goes up, it signals your pancreas to release insulin. Insulin is a hormone that helps the glucose get into your cells to be used for energy.

For people with diabetes, your body doesn't make enough insulin, can't use it as well as it should, or both. Too much glucose stays in your blood and doesn't reach your cells.

What is hypoglycemia?

Hypoglycemia means low glucose. It happens when the level of glucose in your blood drops below what is healthy for you:

  • For many people with diabetes, this means a blood glucose level lower than 70 mg/dL. Your number might be different, so check with your health care team to find out what blood glucose level is too low for you.
  • For people who don't have diabetes, hypoglycemia is typically a blood glucose level lower than 55 mg/dL.
What causes hypoglycemia?

Hypoglycemia is common in people who have diabetes type 1 or who have diabetes type 2 and take insulin or other diabetes medicines. It can happen:

  • As a side effect of insulin or some other medicines that help your pancreas release insulin into your blood. These medicines can lower your blood glucose level.
  • If you don't eat or drink enough carbohydrates (carbs). Carbs are the main source of glucose for your body.
  • If you get a lot more physical activity than usual.
  • If you drink too much alcohol without enough food.
  • When you are sick and can't eat enough food or keep food down.

Although it's rare, you can still get low blood glucose without having diabetes. The causes can include conditions such as liver disease, kidney disease, and hormone deficiencies (lack of certain hormones). It can also happen in people who have had certain types of weight loss surgery. Some medicines, such as certain heart medicines and antibiotics, can also cause it. See your health care provider to find out the cause of your low blood glucose and how to treat it.

What are the symptoms of hypoglycemia?

The symptoms of low blood glucose tend to come on quickly. The symptoms can be different for everyone, but they may include:

  • Shaking
  • Sweating
  • Nervousness or anxiety
  • Irritability or confusion
  • Dizziness
  • Hunger
How is hypoglycemia diagnosed?

If you have diabetes, you'll most likely need to check your blood glucose every day and make sure that it's not too low. You can do this with a blood glucose meter or continuous glucose monitoring (CGM) system.

There are also blood tests that providers can use to check if your blood glucose is too low.

If you don't have diabetes and you have hypoglycemia, your provider will likely order other tests to try to figure out the cause.

What are the treatments for hypoglycemia?

If you have mild or moderate hypoglycemia, eating or drinking something with carbohydrates can help. But severe hypoglycemia can cause serious complications, including passing out, coma, or even death. Severe hypoglycemia can be treated with glucagon, a hormone that raises blood glucose levels. It can be given as nasal spray or injection. If you have diabetes, your provider can prescribe you a glucagon kit for use in case of an emergency.

If you have diabetes and you often have mild or moderate low blood glucose, your health care team may make changes to your diabetes meal plan, physical activity plan, and/or diabetes medicines.

If you don't have diabetes and you keep having low blood glucose, the treatment will depend on what is causing it to happen.

Can hypoglycemia be prevented?

If you have diabetes and you take insulin or other medicines that lower blood glucose, you can help prevent hypoglycemia if you:

  • Follow your diabetes meal plan. Eat and drink enough carbs to keep your blood glucose in your target range. Also carry a source of fast-acting carbohydrate, such as glucose tablets or a juice box, with you in case your blood glucose gets too low.
  • Be safe during physical activity. Check your blood glucose before and afterwards. You may need to eat a snack before your physical activity.
  • If you take diabetes medicines, make sure to take them correctly.

Metabolic Syndrome

What is metabolic syndrome?

Metabolic syndrome is the name for a group of risk factors for heart disease, diabetes, and other health problems. You can have just one risk factor, but people often have several of them together. When you have at least three of them, it is called metabolic syndrome. These risk factors include:

  • A large waistline, also called abdominal obesity or "having an apple shape." Too much fat around the stomach is a greater risk factor for heart disease than too much fat in other parts of the body.
  • Having a high triglyceride level. Triglycerides are a type of fat found in the blood.
  • Having a low HDL cholesterol level. HDL is sometimes called the "good" cholesterol because it helps remove cholesterol from your arteries.
  • Having high blood pressure. If your blood pressure stays high over time, it can damage your heart and lead to other health problems.
  • Having a high fasting blood sugar. Mildly high blood sugar may be an early sign of diabetes.

The more factors you have, the higher your risk for heart disease, diabetes, and stroke is.

What causes metabolic syndrome?

Metabolic syndrome has several causes that act together:

  • Overweight and obesity
  • An inactive lifestyle
  • Insulin resistance, a condition in which the body can't use insulin properly. Insulin is a hormone that helps move blood sugar into your cells to give them energy. Insulin resistance can lead to high blood sugar levels.
  • Age - your risk goes up as get older
  • Genetics - ethnicity and family history

People who have metabolic syndrome often also have excessive blood clotting and inflammation throughout the body. Researchers don't know whether these conditions cause metabolic syndrome or worsen it.

Who is at risk for metabolic syndrome?

The most important risk factors for metabolic syndrome are:

  • Abdominal obesity (a large waistline)
  • An inactive lifestyle
  • Insulin resistance

There are certain groups of people who have an increased risk of metabolic syndrome:

  • Some racial and ethnic groups. Mexican Americans have the highest rate of metabolic syndrome, followed by whites and blacks.
  • People who have diabetes
  • People who have a sibling or parent who has diabetes
  • Women with polycystic ovary syndrome (PCOS)
  • People who take medicines that cause weight gain or changes in blood pressure, blood cholesterol, and blood sugar levels
What are the symptoms of metabolic syndrome?

Most of the metabolic risk factors have no obvious signs or symptoms, except for a large waistline.

How is metabolic syndrome diagnosed?

Your health care provider will diagnose metabolic syndrome based on the results of a physical exam and blood tests. You must have at least three of the risk factors to be diagnosed with metabolic syndrome:

  • A large waistline, which means a waist measurement of
    • 35 inches or more for women
    • 40 inches or more for men
  • A high triglyceride level, which is 150 mg/dL or higher
  • A low HDL cholesterol level, which is
    • Less than 50 mg/dL for women
    • Less than 40 mg/dL for men
  • High blood pressure, which is a reading of 130/85 mmHg or higher.
  • A high fasting blood sugar, which is 100 mg/dL or higher
What are the treatments for metabolic syndrome?

The most important treatment for metabolic syndrome is a heart-healthy lifestyle, which includes:

  • A heart-healthy eating plan, which limits the amount of saturated and trans fats that you eat. It encourages you to choose a variety of nutritious foods, including fruits, vegetables, whole grains, and lean meats.
  • Aiming for a healthy weight
  • Managing stress
  • Getting regular physical activity
  • Quitting smoking (or not starting if you don't already smoke)

If making lifestyle changes is not enough, you may need to take medicines. For example, you may need medicines to lower cholesterol or blood pressure.

Can metabolic syndrome be prevented?

The best way to prevent metabolic syndrome is through the heart-healthy lifestyle changes.

NIH: National Heart, Lung, and Blood Institute