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Diabetic nephropathy is kidney disease that develops after years of development of diabetes that is insulin dependent or not. Diabetic nephropathy involves removal of albumin in the urine due to kidney damage, decreased glomerular filtration rate (after an initial increase in type 1 diabetes) and hypertension.
Renal failure due to diabetes when, as is the case of one third of type 2 diabetics with ESRD, also reflects an alteration of the small vessels called microangiopathy.
Mortality of diabetics with ESRD appears to be particularly increased for women or in cases of type 1 diabetes. It is estimated that more than 400,000 diabetics have chronic kidney disease stage 3 and 4 (very severe renal impairment and severe) in France.
Diabetic nephropathy is due to an alteration of normal renal glomeruli that filter blood to produce urine.
Stage 1 begins with the onset of diabetes, is characterized by an increased glomerular filtration rate and renal hypertrophy.
The evolution is more complicated and, in one third of patients, the deterioration of renal function may occur without the appearance of microalbuminuria. After three, the same glomerular disease can be different from the typical glomerulopathy of diabetes. No symptoms are detectable in the early stages of diabetic nephropathy that is why annual reviews are required. All diabetic patients should be regularly tested with a dipstick test (simple test is to dip a dipstick in freshly voided urine and read the result with color calibrations) to detect the onset of microalbuminuria : every year from the 5 th year of diabetes in type 1 diabetes, and every year since its discovery in type 2 diabetes.
It takes at least two positive tests over a period of 3 to 6 months to confirm the diagnosis. It must also have eliminated other causes, especially urinary tract infection or other renal disease.
Proteinuria is confirmed by an assay of a sample of urine or urine collection issued for 24 hours. In conclusion also the dipstick to make each year to detect the onset of microalbuminuria, kidney function is assessed annually by assaying plasma creatinine and research and quantification of proteinuria (flow glomerular filtration medium is estimated according to MDRD formula). However, we can make the test more frequently when proteinuria is important.
The severity is directly related to the stage where the diagnosis is made and treatment options. In type 2 diabetes, the onset of microalbuminuria is an ominous sign since the survival at ten years is estimated at 25% (against 60% in its absence). Protection of the kidneys requires above all a satisfactory control of diabetes, hypertension and hypercholesterolemia when it exists.
Need a good diabetes control (blood sugar) due to diabetic treatment for the chronic imbalance (blood sugar in the blood is too high) promotes the development and progression of nephropathy.
We must also fight against cardiovascular risk factors such as obesity or physical inactivity.
At the stage of ESRD, the treatment of it is based, as for other causes of renal failure on peritoneal dialysis, hemodialysis and transplantation (kidney alone, pancreas-kidney or islet). The proportion of diabetics among patients starting hemodialysis, peritoneal dialysis or transplant patients is higher for women (25% in 2005) than men (21% in 2005).Moreover, women with diabetes on dialysis have a worse prognosis than men. Maintain a regular exercise even moderate achieves a better balance in the rate of blood sugar (glucose) and thus prevent the development of diabetic nephropathy.
The strict carbohydrate balance is essential: first by a low-carbohydrate diet (carbohydrate) and then by antidiabetic drugs (oral or injectable) or insulin. Yes, if it is neglected it leads to dialysis or a kidney transplant. Preventive treatment is essential.
In type 1 diabetes, the frequency increases every year to reach a maximum of 20 to 40% after 20 to 25 years of diabetes. In type 2 diabetes, the frequency is slightly lower, between 10 to 30% after 25 years of evolution.
In type 1 diabetes, men are more affected than women. The risk increases if the diabetes occurs between the ages of 10 and 20 years. No, the diabetes control is essential and requires a diet low in simple sugars (sodas, pastries, …) and providing daily carbohydrates (starches, legumes). Yes, losing a few pounds and weight stabilization may allow better control of diabetes and thus protection of the kidneys. Yes, the treatment of diabetes, high blood pressure contribute to inhibiting the progression of diabetic nephropathy but the best treatment is prevention. Medical specialty that studies the function, diseases and ways to treat the endocrine glands (those that produce hormones) and metabolism (all body functions essential to life as, for example, production and glucose utilization ). The hormonal imbalance are varied: poor growth, weight loss or, conversely, weight gain, obesity, diabetes, abnormal lipid regulation, infertility, problems of rules. Copyright © 2012 Rayur, All trademarks are the property of the respective trademark owners.


Most doctors aren’t as worried about high blood sugar as they are the affects that it will have on your organs. The diagram shows how kidney function reduces and the amount of protein in the urine increases in diabetic nephropathy.
The overall risk of developing diabetic nephropathy varies between about 10% of type II diabetics (diabetes of late onset) to about 30% of type I diabetics (diabetes of early onset).
Given the relatively predictable nature of diabetic nephropathy , a kidney biopsy is usually not needed. High blood pressure almost always develops or worsens in diabetic nephropathy, and can be the first abnormality to develop. Blood glucose control Good blood glucose control can prevent the development and slow the progression of diabetic nephropathy, as well as preventing the other complications of diabetes, even if kidney failure has developed. Using ACE inhibitors and AT II antagonists Two classes of drug used to control blood pressure deserve special mention. Diet Above and beyond the diabetic diet, not adding any salt and reducing alcohol intake will have beneficial effects on blood pressure. Controlling blood fat and cholesterol Controlling blood fat and cholesterol levels helps prevent heart disease and possibly strokes, and may slow the progression of diabetic kidney disease.
Smoking You really shouldn't smoke, not only for the sake of your kidneys, but also for the sake of your heart and brain blood vessels. The risk of diabetic nephropathy is greater when the control of blood glucose is poor, as well as in those diabetic patients who have high blood pressure and are smoker. Diabetic nephropathy is a sign of worsening blood vessel disease throughout the body, and is associated with an increased risk of heart attack, stroke and circulatory problems. The risk and effect of diabetic nephropathy can be reduced by controlling blood sugar, blood pressure and cholestrol levels. We examined the restoration of first-phase and total insulin response as well as hepatic and peripheral insulin sensitivity. Suspicion of another kidney disease?) But, in most cases are diagnosed without biopsy. Especially in type 1 diabetes or association of microalbuminuria and retinopathy is suggestive of diabetic nephropathy. And while no two people are alike, there is usually overlap when it comes to warning signs of diabetes. This is usually happens because fat and protein are being used for energy instead of glucose.
High blood sugar causes the lens of the eye to swell, which can cause your vision to become blurry. People with diabetes are at higher risk for opportunistic infections because diabetes damages immune system cell function when it is not controlled. Type 2 diabetes affects both the small blood vessels (microvascular) and large blood vessels (macrovascular) which lead to complications to eyes, kidneys and feet for the small blood vessels. This is one of the main reasons why many doctors ask me of ways to treat diabetes that will improve more than just their blood sugar. It begins with a tiny amount of protein appearing in the urine - this is called microalbuminuria.
With the development of proteinuria, the kidneys' ability to remove poisons from the blood deteriorates such that 5-10 years later the kidneys are almost completely unable to remove these poisons from the blood.
There are many factors, some known and others not, that affect the individual risk of developing diabetic nephropathy. You will be evaluated by history, examination, as well as blood and urine tests and a kidney ultrasound examination.
Diabetic eye disease is usually present by this stage indicating damage to smaller blood vessels. Smokers die earlier than non-smokers, but diabetic smokers die much earlier and often develop serious circulation problems at a young age.
Additionally, to examine the mechanistic basis of observed outcomes, we quantified the change in fat content of the pancreas and liver The data are consistent with the hypothesis that the abnormalities of insulin secretion and insulin resistance that underlie type 2 diabetes have a single, common aetiology, i.e. For the most part, Type 2 diabetes symptoms are usually much less severe than Type 1 symptoms. When you really control blood sugar, it is possible to help your immune system out a lot with this and reduce the chances of infections.


Some people may have frequent urination, while some people may not have any symptoms at all. After many years of diabetes the delicate filtering system in the kidney becomes destroyed, initially becoming leaky to large blood proteins such as albumin which are then lost in urine.
If there are unusual features, then further investigations may be needed to define the kidney condition, and this may well involve a biopsy.
Larger blood vessels (arteries) are almost always affected leading to heart attacks, strokes, and circulatory disease occurring more often and at a younger age than usual. The good news is that we can control diabetes with diet and exercise more than people are aware of. This provides a unified hypothesis to explain a common disease that previously appeared to require separate disease processes affecting the pancreas and insulin-sensitive tissues.
This symptom along with polyuria and polydipsia, tend to be much milder in diabetes type 2 than in type 1. So all of these symptoms really all lead to cardiovascular complications down the line that we want to avoid.
This is one of the main reasons why education is so important and there is no need to fear diabetes. Prior to the onset of spontaneous diabetes in rodents, both total pancreatic fat and islet triacylglycerol content increase sharply.
In vitro, chronic saturated fatty acid exposure of beta cells inhibits the acute insulin response to glucose, and removal of fatty acids allows recovery of this response.
The present data provide clear evidence that decreasing total pancreatic fat is associated with a return of beta cell function.
However, it is probable that the negative effect on beta cell function is exerted by toxic intermediaries such as diacylglycerol and ceramides, which change rapidly in response to acute metabolic changes, rather than by stored triacylglycerol per se, which acts as an index of fatty acid intermediary concentration.
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