One of the most devastating complications of diabetes is diabetic kidney disease. Around 40 % of people with type 2 diabetes can develop kidney disease. By stricter definitions of kidney disease, even up to 60-70 % of people with diabetes can have some impairment in kidney function. Many who develop kidney disease progress to kidney failure, dialysis and transplantation. Is it inevitable? Can we prevent it?
There are many things a person can do to prevent the development and progression of kidney disease.
- Excellent blood glucose control (HbA1c < 6.5 %)
- Good blood pressure management (BP< 130/80 mm Hg)
- Managing LDL to less than 70 mg/dl or 100 mg/dl according to risk
- Reduce weight
- Stop smoking
- Avoiding the use of medicines that can cause kidney damage
- ACE inhibitors/ARB: this includes medicines like Ramipril, Perindopril, Telmisartan, Olmesartan, etc., which can be used in people with diabetes to delay the progression of kidney disease.
- SGLT2 inhibitors include medicines like Empagliflozin, Dapagliflozin, and Canaglifliozin. These can delay the progression of kidney disease to kidney failure.
- GLP-1 receptor agonists like Semaglutide, Dulaglutide and Liraglutide can not only control blood glucose but also delay kidney and heart disease.
- Finerenone: a new drug which can be very effective in people with diabetes to control the worsening of kidney disease.
So, check with your doctor to understand if you are at risk of kidney disease. Understand the medicines and methods to prevent the disease from progressing.
Author
Dr. Mathew John MD, DM