Kidney disease is an important complication of Type 2 diabetes, probably because the condition damages blood vessels, and blood vessels make up much of the kidney. Diabetic retinopathy is a disease of the eyes in which blood vessels in the back of the eye are damaged. When kidney damage begins, small amounts of protein are spilled into the urine. When the damage becomes severe enough to cause symptoms, more protein is found in the urine. According to a recent study, looking at protein in diabetic patients' urine and examining their eyes might be one way for doctors to predict which Type 2 diabetics might need further treatment to prevent diabetic kidney disease.
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In a study reported on in the journal Diabetes Care in April 2013, researchers at Kitasato University in Kanagawa, Japan, studied Type 2 diabetics with and without damage to their kidneys and eyes, and compared their kidney function after a period of eight years. When the damage becomes severe enough to cause symptoms, more protein is found in the urine. Researchers looked at the amount of retinopathy and protein seen in the urine of 1475 participants with Type 2 diabetes.
They divided the patients into four groups according to their degree of blood vessel damage in their eyes and kidneys:
- normal kidneys without eye damage,
- normal kidneys with eye damage,
- kidney damage with normal eyes, and
- kidney damage with eye damage.
After eight years the group with normal kidneys and no eye damage was compared with the other three. It was found:
- diabetics with healthy kidneys with eye damage were 2.48 times more likely to develop full-blown kidney disease than the diabetics with normal kidneys and eyes.
- those with damaged kidneys and healthy eyes had 10.40 times the risk, and those with damage to both kidneys and eyes had 11.55 times the risk.
From this information it was concluded slight kidney damage as well as eye damage could be useful in predicting which diabetics could be headed for diabetic kidney disease.
Urinalysis and eye examinations are part of the routine examinations for people diagnosed with Type 2 diabetes. Diabetics and their doctors need to heed the warning of small amounts of protein in the urine and diabetic retinopathy. If either one or both is seen, then it is time to look closely at blood sugar control.
If control has not been good, then it is important to plan a program of:
- physical activity, and
- medications if necessary,
and to follow that plan closely. The American Diabetes Association's website, http://www.diabetes.org, has recipes for foods low in carbohydrates and high in flavor. Schedule some time each day to go for a walk. If you are absent-minded, set an alarm clock or have someone remind you when to take your medications.
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Type 2 diabetes is not a condition you must just live with. Take care with your eating program, monitor your blood sugar accurately and keep it in the ideal range. This will help you take control of the disease and prevent many of the diabetic complications.
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