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The Connection Between Diabetes and Kidneys

Diabetes is the leading cause of chronic kidney disease (CKD). 1 in 3 adults with diabetes may have chronic kidney disease*. Diabetes—especially type 2 diabetes—is also the number one cause of kidney failure in the US. If you’re living with diabetic kidney disease, it’s extremely important to stay in control of and care for both your diabetes and kidneys so you can be your healthiest.

What is diabetes?

  • Diabetes is a condition in which the body either doesn’t make enough insulin or isn’t able to use it effectively. This makes it hard to maintain healthy blood sugar (glucose) levels. 
  • People living with diabetes must often make diet modifications. They may need to take medication to keep glucose levels under control.
  • Uncontrolled diabetes can lead to other health problems beyond CKD. These include eye disease, heart disease, high blood pressure, nerve disease, foot health issues, and in rare cases, amputations.

There are two types of diabetes—type 1 and type 2. About 30% of people with type 1 diabetes and 10-40% of those with type 2 diabetes will eventually develop CKD (source).

Type 1 diabetes
Living with type 1 diabetes means your pancreas doesn't make enough or any insulin. People are usually diagnosed with type 1 diabetes as children, teens, and young adults. Still, it can develop at any age.

Type 2 diabetes
Living with type 2 diabetes means your cells don’t respond normally to insulin. This is called insulin resistance. While your pancreas continues to make insulin, your body does not accept it. Type 2 diabetes is most often diagnosed in people over the age of 45, although it can develop at any age.

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Are diabetes and kidney disease related?

Diabetic kidney disease refers to a decrease in kidney function that occurs in some people who have diabetes. Diabetes is a risk factor for kidney disease. Over time, high sugar levels in the blood can cause tiny blood vessels in the kidney to become narrow and clogged. Without enough blood, the kidneys become damaged.

Diabetes can also cause damage to the nerves in your body. If the nerves of the bladder are damaged, you may not be able to feel when your bladder is full. The pressure from a full bladder can damage your kidneys. If urine stays in your bladder for a long time, you may get a urinary tract infection. This is caused by bacteria, which grows rapidly in urine with a high sugar level. These infections can sometimes spread to the kidneys.

People with diabetes may also develop high blood pressure. This is another leading cause of CKD. If you are diagnosed with kidney disease, it's important to know that you can take steps to manage CKD and thrive.

What are the signs and symptoms of diabetes and kidney disease?

Kidney disease and diabetic kidney disease share similar symptoms. You are unlikely to have symptoms with early diabetic kidney disease. Symptoms may begin with feeling tired or having less energy than usual.

As the disease progresses, signs of diabetic kidney disease may include:

  • Poor appetite
  • Nausea
  • Weight loss
  • Dry, itchy skin
  • Muscle cramps
  • Puffiness around the eyes
  • Frequent urge to urinate
  • Fluid retention causing swollen feet and ankles
  • Difficulty thinking clearly

Talk to your doctor about diabetes and CKD
Your doctor is your best source of information on the risks of diabetes and kidney disease. They can assess your overall health and medications to design a care plan that helps you feel your best.

4 ways to manage symptoms of diabetic kidney disease

It’s essential that you follow your doctor’s exact instructions for managing diabetes and kidney disease. In general, there are certain steps that should be part of your daily routine to control blood sugar. 

  1. Test and track blood sugar levels
    You can self-test your blood sugar (blood glucose levels) at home with a portable electronic device. This is called a blood sugar meter and uses a small drop of your blood. You can also use a device called a continuous glucose monitor (CGM).
  2. Manage blood pressure
    More than 80% of people with diabetes and CKD have hypertension (high blood pressure). Talk to your doctor about creating a treatment plan to help you take control of your blood pressure. Steps you can take include eating a healthy, low-sodium diet, exercising regularly, managing stress, and quitting smoking.
  3. Take your medications as prescribed
    Which kidney medications your doctor prescribes may depend on several personal health factors. These include your level of kidney function, which kidney disease stage you're in, and whether you're managing any other health conditions. Your doctor may also prescribe specific medications just for managing diabetes.
  4. Make healthy food choices
    Start by reading nutrition labels to help you select healthier options, such as those with lower sodium and sugar. High-fiber foods, such as whole grains and fresh fruits and vegetables, may help improve blood sugar levels. Talk to your doctor or dietitian to help you learn exactly what to eat and drink to follow a kidney-friendly diet with diabetes.
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Take a free kidney care class
Learn how to look after your kidney health and thrive—in a class that fits your life. Choose an educator-led or self-guided format.
Sign up now