Can both kidneys and liver be affected by type 1 diabetes?

Question

Hello doctor,

My 19-year-old nephew has had type 1 diabetes since he was eight, but his health seems to be getting worse now. Recent blood tests showed high creatinine levels and some protein in his urine, and the doctor said it might be the start of kidney problems. He also complained of swelling in his feet and feels tired even after doing small tasks. His blood sugar levels are usually between 200 to 250 milligrams/deciliters, and his HbA1c (hemoglobin A1c) was 9.8 last month. I am worried because he is been losing his appetite and weight. Could this be diabetic nephropathy? He also had slightly high liver enzymes in the past, but no one told us to monitor it. Is it possible for both the kidneys and liver to be affected at the same time with type 1 diabetes?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

I understand your concern, and it is good that you are seeking help for your nephew.

Elevated serum creatinine levels and protein in the urine are signs of kidney damage. Other indicators, such as a protein-to-creatinine ratio higher than 30 milligrams/milliliters, an albumin-to-creatinine ratio above eight milligrams/deciliters, and a glomerular filtration rate (GFR) below 120, along with symptoms like swelling in the feet and face, suggest that diabetic nephropathy may be developing.

Yes, these could be early signs of diabetic nephropathy, and it is very important to address this as soon as possible with the help of a specialist, such as a diabetologist.

Here is what should be done:

Hospital admission: He may need to be admitted for closer monitoring.
Blood sugar monitoring: Check his blood sugar levels regularly, fasting before and after meals, and at bedtime.
Insulin management: If he is already on insulin, his dosage may need to be adjusted. Insulin therapy might include both regular insulin and NPH (intermediate-acting insulin).
Diet plan: A tailored diet plan should be created to support blood sugar control.
Blood tests: Liver function tests, kidney function tests, and a complete blood count (CBC) should be repeated weekly to monitor his condition.
Additional tests: Arterial blood gases and serum electrolytes should also be checked.

I strongly advise you to take him to an endocrinologist as soon as possible. With proper care and early intervention, this condition can be managed before it progresses to severe kidney failure.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.