a brief introduction to Diabetes

Diabetes is a disease that occurs when your blood glucose, also called blood sugar, is too high. Over time, having too much glucose in your blood can cause health problems, such as heart disease, nerve damage, eye problems, and kidney disease. You can take steps to prevent diabetes or manage it.
As of 2014, 29.1 million people in the United States, or 9.3 percent of the population, have diabetes. One in four people with diabetes don’t know they have the disease. An estimated 86 million Americans aged 20 years or older have prediabetes.
Diabetic kidney disease
What Are Symptoms of Diabetic Kidney Disease
Once your kidneys have been damaged by diabetes, they cannot be fixed. If diabetic kidney disease is not treated early, it can lead to kidney failure.
Diabetic kidney disease does not happen fast. Sometimes it takes many years. This means that you can take steps now to help protect your kidneys. Even if your kidneys are already damaged, you can control your diabetes to help keep them from getting worse.
You will not be able to feel if diabetes has harmed your kidneys. The only way to know is to be tested.

Symptoms
Diabetes symptoms vary depending on how much your blood sugar is elevated. Some people, especially those with prediabetes or type 2 diabetes, may not experience symptoms initially. In type 1 diabetes, symptoms tend to come on quickly and be more severe.
Some of the signs and symptoms of type 1 and type 2 diabetes are:
Increased thirst
Frequent urination
Extreme hunger
Unexplained weight loss
Presence of ketones in the urine (ketones are a byproduct of the breakdown of muscle and fat that happens when there's not enough available insulin)
Fatigue
Irritability
Blurred vision
Slow-healing sores
Frequent infections, such as gums or skin infections and vaginal infections
Although type 1 diabetes can develop at any age, it typically appears during childhood or adolescence. Type 2 diabetes, the more common type, can develop at any age, though it's more common in people older than 40.
When to see a doctor
If you suspect you or your child may have diabetes. If you notice any possible diabetes symptoms, contact your doctor. The earlier the condition is diagnosed, the sooner treatment can begin.
If you've already been diagnosed with diabetes. After you receive your diagnosis, you'll need close medical follow-up until your blood sugar levels stabilize.

Causes
To understand diabetes, first you must understand how glucose is normally processed in the body.
How insulin works
Insulin is a hormone that comes from a gland situated behind and below the stomach (pancreas).
The pancreas secretes insulin into the bloodstream.
The insulin circulates, enabling sugar to enter your cells.
Insulin lowers the amount of sugar in your bloodstream.
As your blood sugar level drops, so does the secretion of insulin from your pancreas.
The role of glucose
Glucose — a sugar — is a source of energy for the cells that make up muscles and other tissues.
Glucose comes from two major sources: food and your liver.
Sugar is absorbed into the bloodstream, where it enters cells with the help of insulin.
Your liver stores and makes glucose.
When your glucose levels are low, such as when you haven't eaten in a while, the liver breaks down stored glycogen into glucose to keep your glucose level within a normal range.
Causes of type 1 diabetes
The exact cause of type 1 diabetes is unknown. What is known is that your immune system — which normally fights harmful bacteria or viruses — attacks and destroys your insulin-producing cells in the pancreas. This leaves you with little or no insulin. Instead of being transported into your cells, sugar builds up in your bloodstream.
Type 1 is thought to be caused by a combination of genetic susceptibility and environmental factors, though exactly what many of those factors are is still unclear.
Causes of prediabetes and type 2 diabetes
In prediabetes — which can lead to type 2 diabetes — and in type 2 diabetes, your cells become resistant to the action of insulin, and your pancreas is unable to make enough insulin to overcome this resistance. Instead of moving into your cells where it's needed for energy, sugar builds up in your bloodstream.
Exactly why this happens is uncertain, although it's believed that genetic and environmental factors play a role in the development of type 2 diabetes. Being overweight is strongly linked to the development of type 2 diabetes, but not everyone with type 2 is overweight.
Causes of gestational diabetes
During pregnancy, the placenta produces hormones to sustain your pregnancy. These hormones make your cells more resistant to insulin.
Normally, your pancreas responds by producing enough extra insulin to overcome this resistance. But sometimes your pancreas can't keep up. When this happens, too little glucose gets into your cells and too much stays in your blood, resulting in gestational diabetes.
How can I prevent diabetic kidney disease or keep it from getting worse?
The steps to prevent diabetic kidney disease are the same as the steps to keep it from getting worse. You will need to:
Control your blood sugar
Control your blood pressure
Control your cholesterol
Follow a diabetic diet
Do not smoke or use tobacco
Exercise most days of the week
Keep a healthy weight
Controlling your blood sugar
Foods to Eat and Avoid for PKD Patients with High Blood Sugar
Keeping your blood sugar in a healthy range can help protect your kidneys. A special diabetic diet, exercise and medicines can help you keep a healthy blood sugar level. You will need to check your blood sugar often to know how you’re doing.
When you have doctor appointments, you will probably have a blood test to check your hemoglobin A1C. This is a blood test that tells your doctor how your blood sugar has been doing over the last 2 or 3 months. Ask your doctor what your A1C result should be. Most people with diabetes should have an A1C less than 7 percent.
To check your blood sugar at home, you will use a blood glucose meter (also called a glucometer). You can get a meter at your local drug store, hospital, clinic or online. Your doctor can help you find a meter that is right for you. Most insurance policies will help pay for your testing supplies.
Your doctor can show you how to use your meter. Ask your doctor how often to check your blood sugar and what your blood sugar level should be.
In most cases, your blood sugar level should be:
Between 70 and 130 BEFORE eating;
Less than 183 about 2 hours AFTER eating;
Between 90 and 150 at bedtime.
Print this chart to track your blood sugar levels.
Tell your doctor if your blood sugar is often too high or too low. If your blood sugar is low, eat a glucose tablet, raisins, hard candy or honey. You can also drink fruit juice, milk or a sugary drink. Check your blood sugar again after 15 minutes to make sure it is getting higher.
Tell your doctor if this happens more than once.
Control your blood pressure
High blood pressure is the #2 cause of kidney failure. Having both diabetes and high blood pressure makes it more likely that you will have kidney disease and heart disease.
A healthy blood pressure is less than 120/80 (or 120 over 80). Ask your doctor how often you should have your blood pressure checked.
Click here for more information about blood pressure and kidney disease.
Control your cholesterol
Cholesterol is a waxy, fat-like substance in your blood. Having high cholesterol and diabetes makes it more likely that you will have kidney disease, heart disease or a stroke. High cholesterol can also make your diabetic kidney disease get worse faster.
There are two types of cholesterol you should pay attention to: HDL (“good” cholesterol) and LDL (“bad” cholesterol). For most people, normal cholesterol levels are:
Total cholesterol: less than 200
HDL (“good” cholesterol): more than 40
LDL (“bad” cholesterol): less than 100.
Your triglycerides are also important. Triglycerides are a type of fat in your blood. For most people, a healthy triglyceride level is less than 150.
Talk with your doctor about what your cholesterol and triglycerides levels should be and how you can control them.
Follow a diabetic diet
What you eat and drink affects your blood sugar. Ask your doctor, dietitian or diabetes educator about:
What to eat
How much to eat
How often to eat.
Picking healthy foods, eating smaller meals and eating more often can help you control your diabetes and prevent problems. Medicare and many private insurance policies will help pay for appointments with a dietitian or diabetes educator. Check with your insurance provider to find out if your policy covers medical nutrition therapy (MNT).
Do not smoke or use tobacco
Using tobacco (smoking or chewing) can make kidney problems worse. If you use tobacco, quitting can help lower your chance of getting kidney disease or help prevent your kidney disease from getting worse if you already have it.
Exercise most days of the week
Exercise can help your body use insulin better. This makes it easier to keep a healthy blood sugar level. Exercise also helps control your blood pressure and cholesterol.
To get the most benefit, exercise for at least 30 minutes, five days a week. If that seems like too much, start slowly and work your way up. Look for fun activities that you enjoy. Try walking with a friend, dancing, swimming or playing a sport. Adding just a little more activity to your routine can help.
Be sure to talk to your doctor before starting any exercise program.
Keep a healthy weight

Keeping a healthy weight can help you control your blood sugar and lower your chances of getting kidney disease. Talk to your doctor about how much you should weigh. If you are overweight, losing just a few pounds can make a big difference.

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