Listen to your kidneys
Diabetic kidney disease, like diabetes itself, is an insidious and dangerous disease. It can affect both people with type 1 and type 2 diabetes, younger and older, treated with insulin or oral medications. It always develops in secret, for a long time without any symptoms, which is why it is so easy to “miss”.
When diabetic kidney disease is finally detected, much depends on how advanced it is.
– It is often said that the kidneys are silent, because they suffer silently and painlessly. That is why the task of our Association is, among other things, to publicize the fact that excess glucose in the blood damages the delicate structures of the kidneys, that it can lead to their complete destruction, and thus to a situation where the only chance for the patient is dialysis – says Monika Kaczmarek, president of the Polish Diabetes Association.
This was the case of Michał Figurski, a radio journalist and founder of the Najsłodsi Foundation. He learned about diabetic nephropathy when it was already in a very advanced stage. He went through several years of dialysis until he was finally ready for a transplant, after which his health condition improved significantly.
This is a story that, on the one hand, gives hope, but on the other – it is a warning. Diabetes must be treated in a way that does not lead to end-stage renal failure. – Today I know that it is enough to be aware of your disease and the threats it carries. If you are a conscious patient who respects the requirements of treatment, you can live with diabetes without any major limitations. I understood this only after I developed many complications – says Michał Figurski. At the same time, he notes that for many young people, diabetes is a difficult player. They seem to know the risks of neglecting it, but they try not to think about it. They live as if this risk did not exist. – My mission is to speak out loud about the fact that diabetes is a difficult disease, that many times we do not want to deal with it. That perhaps we need to work on our own head, with a psychologist, to finally accept that we are ill and take responsibility for it. That is why I do not want to limit myself to saying that you are at risk of complications. I want to talk about how to cope with the disease on an emotional level. When we come to terms with difficult emotions, our kidneys will also benefit, he adds.
Underrated prevention
– According to PTD guidelines, every patient with diabetes should have their kidney function assessed once a year. In order to reduce the risk of diabetic kidney disease and/or slow it down, it is necessary to ensure that glycemia, blood pressure and lipids are balanced. Diet, physical activity, reducing excess body weight and quitting smoking are also of great importance. Currently, we also have drugs that are helpful in preventing or treating diabetic kidney disease. SGLT2 inhibitors, GLP-1 analogues and non-steroidal mineralocorticoid receptor antagonist (ns-MRA) reduce the risk of progression of chronic kidney disease and cardiovascular complications in people with type 2 diabetes and chronic kidney disease. They are reimbursed for some groups of patients with diabetes, but not yet for all – emphasizes Barbara Soróbka, diabetologist.
– As the Polish Diabetes Association, we will not stop educating people about chronic complications of diabetes, including nephropathy. We do not want to scare patients, we want to make them aware. Three decades ago, a person with diabetes was doomed to complications. Today, this is no longer the case. Our ambition is for new possibilities of treating diabetes to have an impact on statistics. To reduce the percentage of diabetics on dialysis and waiting for a transplant – says Monika Kaczmarek.
