Introduction
Around one in ten people struggle with diabetes, and over 90 percent have type 2 diabetes. Type 1 diabetes occurs mostly in a phase of childhood, and type 2 diabetes is more commonly seen after 45 years. In type 1 diabetes, the immune system attacks the pancreas and the cells which produce insulin, resulting in the pancreas no longer being able to produce insulin. The symptoms of type 1 diabetes happen suddenly, whereas the symptoms of type 2 diabetes appear very gradually. If left untreated, uncontrolled type 2 diabetes will cause serious complications.
What Is Uncontrolled Diabetes?
Diabetes significantly affects a person's quality of life, and if the blood glucose level remains constantly high, it can be life-threatening to the person. Uncontrolled diabetes is a state of diabetes where the blood sugar level is constantly high, and a person starts experiencing symptoms like being overly thirsty and having an increased urge to urinate.
What Are the Signs of Uncontrolled Diabetes?
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High Blood Glucose Reading - The Center for Disease Control and Prevention (CDC) recommends healthy blood sugar levels of 80 to 130 milligrams per deciliter before food and below 180 mg/dL after 2 hours of eating. To reach the target glucose levels, the doctor will work out a treatment plan with the person and recommend certain medications and lifestyle changes. If the blood sugar level remains high, the person must speak with their doctor and may require adjustments in their treatment plan.
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Frequent Infections - High blood sugar levels always increase a person’s chances of infection. If a person experiences a long time for a wound to heal or frequent infections, they should undergo an evaluation by a doctor. Certain conditions are seen in diabetic patients. They include skin infections like ulcers or cellulitis on the feet, gastrointestinal infections, and respiratory infections like the flu.
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Increase Thirst - Increased blood glucose levels will cause thirst and dehydration and reduce the body’s ability to absorb water.
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Increased Frequency in Urination - Frequent urination is a common sign of uncontrolled diabetes. This is because when blood sugar levels are high, people drink more water resulting in frequent urination.
What Is the Impact of Uncontrolled Diabetes on Deadly Kidney Diseases?
People with diabetes are prone to diabetic nephropathy, renal artery stenosis, renovascular disease, and kidney failure. About 20 to 30 percent of people with diabetes develop kidney diseases; however, not all of them will progress toward kidney failure. Diabetic patients are susceptible to diabetic nephropathy irrespective of their insulin use. This risk depends on the duration of a person who has diabetes.
What Is Diabetic Nephropathy?
Diabetic nephropathy is a part of chronic kidney disease (CKD). High glucose levels cause damage to different parts of the body, including the cardiac system and the kidneys. Kidney damage caused by increased blood sugar levels is called diabetic nephropathy. This is the major cause of long-term kidney conditions, and the final stage of diabetic nephropathy is kidney failure and end-stage renal disease (ESRD). When ESRD occurs, the kidneys will no longer function well to meet the daily requirements, and eventually, it can lead to kidney failure with life-threatening consequences.
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Causes - A persistently high blood sugar level can cause damage to the kidneys, making it difficult for them to filter water and waste products from the body. Other factors that increase the risk of diabetic nephropathy include a family history of kidney disease, being obese or overweight, smoking, being American Indian, African American, or of Hispanic origin, developing type 1 diabetes before the age of 20 years, and having other diabetic complications like nerve damage or eye diseases.
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Symptoms - The early stages of kidney damage are usually asymptomatic. A person starts developing symptoms during the late stages of chronic kidney disease. Symptoms of industrial renal disease include fatigue, headache, loss of appetite, nausea or vomiting, itchy dry skin, an overall unwell feeling, and swelling of the legs and arms.
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Diagnosis - Doctors usually recommend yearly urine and blood tests for diabetic patients to check for early signs of kidney damage since diabetes is a risk factor for kidney problems. A few tests usually done include serum creatinine blood test, microalbuminuria urine test, and BUN (blood urea nitrogen) blood test.
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Treatment - Ideally, there is no cure for diabetic nephropathy. However, the disease progression can be stopped or delayed by treatments. The blood sugar level can be kept at an optimum level by taking medications, using an adequate insulin dosage, and regularly monitoring the blood sugar levels.
What Is the Association Between Diabetes and Kidney Failure?
The most common cause of kidney failure is uncontrolled diabetes mellitus, with increased blood sugar levels. When the sugar levels are constantly high, the tiny filtering units of the kidneys get damaged, eventually leading to kidney failure. Kidney or renal failure occurs when one or both of a person's kidneys can no longer function independently.
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Symptoms of Kidney Failure - Initially patients will be asymptomatic, and the first sign of kidney disease is high protein levels in the urine. However, this will happen many years before the kidneys get severely damaged and show symptoms. The symptoms include fatigue, headaches, nausea, vomiting, difficulty in concentration, confusion, increased urination, muscle spasms, poor appetite, and edema of the face, hands, ankles, or legs due to fluid retention.
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Diagnosis - Common tests to diagnose kidney failure include urine, blood, and imaging tests like a kidney ultrasound, computed tomography (CT) urogram, and magnetic resonance imaging (MRI).
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Treatment - The management of kidney failure depends on the extent and severity of the problem. The two main treatments for kidney failure include dialysis and kidney transplant. Dialysis helps the body in filtering its blood. The two different types of dialysis are hemodialysis and peritoneal dialysis. In hemodialysis, the machine regularly cleans the blood, and people usually require dialysis for around three to four days at a dialysis clinic or hospital. In peritoneal dialysis, the doctor will attach the dialysis bag with a dialysis solution to the catheter in the abdominal lining. In a kidney transplant, the damaged kidney will be replaced by a healthy kidney obtained from a living donor or deceased donor.
Conclusion
Uncontrolled diabetes can cause diabetic kidney disease in about 40 percent of patients, which is the leading cause of chronic kidney disease. The progression of diabetic kidney disease includes glomerular hyperfiltration, albuminuria, a decline in the glomerular filtration rate (GFR), and ultimately end-stage renal disease. The kidney conditions associated with uncontrolled diabetes are mainly diabetic nephropathy and kidney failure. Both conditions are managed by constant monitoring and adequate management by healthcare practitioners.
