Post Date December, 03 2023
With the rapid development of China's economic level and the continuous improvement of residents' living standards in recent years, diabetes is affecting more and more families. According to the data of the World Health Organization (WHO), 422 million people worldwide had diabetes by 2014. Among Chinese adults, the incidence rate of diabetes was as high as 9.7% about 10 years ago, and now the incidence rate is certainly higher!
As one of the main complications of diabetes, renal disease has always been one of the main reasons that seriously affect the quality of life of diabetes patients. Let's take a look at the following data:
Experts predict that about 30% - 50% of diabetes patients will develop kidney disease, which is what we call diabetes nephropathy.
In Europe and America, nearly 50% of uremic dialysis patients are caused by diabetes nephropathy.
Diabetes nephropathy is terrible, but it is really terrible, because it may eventually develop into uremia; "If it's not scary, it's actually not that scary. Patients only need to do three things:" prevention in advance "," timely detection ", and" scientific treatment. ".
Prevention in advance
If the blood sugar of diabetes patients is not well controlled for a long time and they are in a hyperglycemic state, the blood passing through the glomerulus will increase, which will cause the pressure in the glomerulus to rise. In the long run, kidney disease will occur.
The best way to prevent diabetes nephropathy is to control blood sugar. Through the collaborative management of drugs, diet, exercise and other aspects, blood sugar will be controlled within the target range, which will effectively prevent the occurrence of diabetes nephropathy.
The control objectives are shown in the following table:
*It should be noted that measuring fasting blood glucose alone does not effectively reflect blood glucose control. It is necessary to combine postprandial blood glucose and HbA1c to more accurately reflect blood glucose.
Some studies have shown that strict blood sugar control can reduce the risk of microalbuminuria by 1/3.
Timely discovery
About 30% of diabetes patients will have diabetes nephropathy. Often, patients with diabetes nephropathy have no obvious symptoms at the beginning, but have developed to stage III or even IV of nephropathy when a large amount of proteinuria is found.
In order to find out as soon as possible, it is suggested that type 2 diabetes patients should be routinely screened for diabetes kidney disease every year; Patients with type 1 diabetes should also be screened every year five years after their diagnosis.
Diagnostic indicators for screening include urinary microalbumin, urinary albumin creatinine ratio (ACR), serum creatinine, and estimated glomerular filtration rate (eGFR). There are also some test strips on the market that can be quickly tested at home as one of the means of early screening. Regular screening is helpful to the discovery and diagnosis of early diabetes nephropathy.
Scientific treatment
Once microalbuminuria is diagnosed, special treatment for diabetes nephropathy should be started immediately. Early treatment has a one-third chance to reverse albuminuria and effectively prevent or delay the progress of diabetes nephropathy.
The treatment of diabetes nephropathy mainly includes drug treatment, diet treatment, weight control, lifestyle change, etc. Severe patients may need to cooperate with dialysis, or even kidney transplantation.
Timely and effective treatment can reduce the levels of proteinuria and serum creatinine in patients with diabetes nephropathy, and slow down the decline of glomerular filtration rate. The ideal urinary microalbumin level should be controlled at 0 to 500 mg/d.
Studies have shown that when proteinuria levels decrease by half, the risk of end stage renal disease (ESRD) will decrease by 61%.
In addition to blood sugar, diseases such as hypertension can have an impact on the kidneys, which will be explained one by one in subsequent articles.
