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  • Protecting Kidneys Diabetes

    ACE inhibitors (Angiotensin-Converting Enzyme inhibitors) and ARBs (Angiotensin II Receptor Blockers) are two types of blood pressure medications that have been shown to have a protective effect on the kidneys, especially in individuals with diabetes who have high blood pressure and Diabetic Kidney Disease (DKD).


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    <p><a href="">Endocrinologist</a>, talks about how to protect the kidneys in patients with diabetes.</p>

    Endocrinologist, talks about how to protect the kidneys in patients with diabetes.

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    <p><a href="">Endocrinologist </a>and&nbsp; Registered Dietician, talk about the health benefits of bell peppers in relation to diabetes.</p>

    Endocrinologist and  Registered Dietician, talk about the health benefits of bell peppers in relation to diabetes.

  • Protecting Kidneys in People with Diabetes

    While it is true that metformin, a commonly prescribed medication for diabetes, is generally considered safe for the kidneys, there are certain circumstances in which its use may need to be adjusted.


    Metformin is primarily excreted by the kidneys, and if kidney function is significantly impaired, it can accumulate in the body, leading to a rare but serious condition called lactic acidosis. This condition can be life-threatening, so it is important to exercise caution when prescribing metformin to individuals with kidney problems.

    The current guidelines recommend that metformin be used with caution or avoided altogether in individuals with an estimated glomerular filtration rate (eGFR) below 30-45 mL/min/1.73m², depending on the specific guidelines and patient characteristics. Regular monitoring of kidney function is also recommended for individuals taking metformin.

    Regarding your mention of temporarily discontinuing medications during acute illness, it is true that some medications may need adjustment during periods of illness. This is because illnesses can affect kidney function, blood pressure, and other factors that can influence medication management. However, the specific medications that need adjustment can vary depending on the individual's condition and the advice of their healthcare provider. It's essential to consult with a doctor or pharmacist for personalized guidance on medication management during illness.

    It's always important to rely on accurate and up-to-date medical information, so if you have any concerns or questions about your medications, it's best to consult with a healthcare professional.   Remember to verify the information provided by contacting the healthcare providers directly, as network participation and availability can vary over time. Find local massage therapists and  physiotherapy  treatment options along with strength and exercise options to help with strength and conditioning and massage therapy with tight and sore and you are  experiencing fatigue.                                  

    People with diabetes are unfortunately prone to a wide array of complications. One of the commonest complications is kidney damage, which when progresses can lead to dialysis or even death. Kidneys are like a filter or a sieve in the body. Glucose or sugar is a large molecule, and when present in large quantities can affect the fine mesh of this cell, as can uncontrolled blood pressure. As a result, your kidneys may start leaking protein into the urine, called microalbuminuria, which is an early sign of kidney damage. In the same way, your blood creatinine levels may start rising, which is suggestive of worsening kidney function. If appropriate steps are taken in a timely manner this damage can be halted and the complications prevented. Your doctor may start you on a blood pressure medication to protect your kidneys, even if your blood pressure is not high. In the same way, you might be started on a cholesterol medication too.                

    There is a new class of diabetes medications that help lower blood sugars by dumping the excess sugars in the urine. These have been shown to reduce the rate of progression to dialysis and even the risk of death due to kidney failure by as much as 30%. These agents work by causing reduction on blood pressure in the blood vessels that feed into the kidneys, thereby reducing the strain on the filters. Studies show that when used effectively, these agents can delay kidney failure and might even be effective in those without diabetes. These agents also help reduce the risk of heart failure and cardiovascular disease.  Often seeing a Endocrinologist or  local family physician  in conjunction with a registered dietitian and athletic therapist is a great option to take control of this condition. Smart Food Now and exercise is also optominal for overall health.

    Adequate diabetes management requires not just controlling blood sugars, but also reducing the risk of complications of diabetes. Hence, for people with diabetes, it is important to avoid medications that can damage the kidneys and one should preferably use medications that can help protect the kidneys, especially if one has protein leaking into the urine or rising creatinine levels.

    Both ACE inhibitors and ARBs work by targeting the renin-angiotensin-aldosterone system, which is involved in regulating blood pressure and fluid balance in the body. By blocking or inhibiting certain components of this system, these medications help to relax blood vessels, reduce blood pressure, and decrease the stress on the kidneys. Additionally, they have been found to reduce the amount of protein leaking into the urine, which is a sign of kidney damage.

    In the management of DKD, it is beneficial to consult with healthcare professionals such as an endocrinologist or a local family physician. These specialists can help monitor and adjust the medication regimen, provide guidance on overall diabetes management, and coordinate care with other healthcare providers.

    In addition to medical management, lifestyle factors also play a crucial role in controlling DKD. Working with a registered dietitian can help develop a personalized meal plan that focuses on healthy eating, portion control, and managing blood sugar levels. An athletic therapist or exercise specialist can provide guidance on safe and effective exercise routines, tailored to an individual's needs and abilities.

    Engaging in regular physical activity, following a balanced and nutritious diet, and taking prescribed medications as directed are essential for managing DKD and overall health. However, it's important to consult with healthcare professionals for personalized advice and guidance based on your specific medical condition.

    Medication management during acute illness can indeed vary depending on the individual's condition and the specific medications they are taking. While some medications may need adjustment, others may need to be continued as prescribed. It is crucial to consult with a healthcare provider for personalized guidance on managing medications during illness.

    During acute illness, factors such as changes in kidney function, liver function, fluid balance, and metabolism can affect how medications are absorbed, distributed, metabolized, and eliminated in the body. This can lead to changes in medication effectiveness, side effects, and potential drug interactions. In some cases, temporary adjustments may be necessary to ensure optimal treatment and avoid potential complications.

    The decision to adjust or temporarily discontinue medications during illness should be made on an individual basis, considering factors such as the severity of the illness, the specific medication being taken, the patient's overall health status, and the guidance of the healthcare provider. It is important to communicate with your doctor or pharmacist about any changes in your health status and follow their recommendations regarding medication management during acute illness.

    Remember, the information provided here is general in nature and should not substitute professional medical advice. Always consult with a qualified healthcare professional for personalized guidance on your specific situation.

    The Endocrinologists on this site are in good standing with the College of Physicians and Surgeons of Canada, Dr. Bruce Perkins , Endocrinologist, Toronto    Canadian Diabetes Association and the Canadian Medical Association

    Key Words: Blood Glucose Monitor, Novel Diabetes Medications, Diabetes, Obesity, Protecting Kidneys Diabetes, Type 1 Diabetes, Hypoglycemia, Diabetes Nutrition, Obesity and Diabetes, Lipohypertrophy


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