Complications > Kidney

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The need for tact, openness and honesty when talking about complications

Discussing the sensitive issue of long-term complications is difficult for people with diabetes and the healthcare providers who work with them. Consequently, this area of diabetes management is often not handled well. In some situations, healthcare providers are reluctant to impose 'unpleasant' information on people who might be struggling to cope with diabetes; in others, the potential risk of developing complications might be used as a threat in an attempt to scare people into following medical advice.

Cardiovascular risk, blood pressure, and kidney damage

People with type 2 diabetes suffer badly from heart disease, strokes, and damage to the blood supply to their feet. Indeed, these cardiovascular conditions are the major causes of ill-health and death in people with the condition. A significant proportion of that ill-health is preventable, including by attention to the levels of fats and sugar in the blood, the clotting tendency of the blood, and blood pressure. Raised blood pressure is also responsible for worsening of eye damage and kidney damage in people with type 2 diabetes, and is therefore particularly well worth treating.

The role of the renal dietitian in diabetes care

Renal dietitians can be especially helpful to people who have diabetes and its kidney complications. However, in a recent survey by the US National Kidney Foundation Patient Services Committee, only two out of 25 respondents received help from a registered dietitian. Yet, when asked to list any queries that related to their diabetes care, two-thirds of these were related to nutrition. Patricia Weber describes the importance of nutritional issues in the prevention of diabetes-related kidney failure and calls for an increased role in diabetes care for renal dietitians.

Worsening the blow: the effects of smoking on diabetes complications

Cigarette smoking is a serious hazard to health. Yet, although as a group people with diabetes are at increased risk of developing cardiovascular disease, this does not appear to influence smoking habits among them. Tobacco use among people with diabetes is strongly associated with a further increase in the risk of developing cardiovascular complications. Furthermore, research has indicated that smoking has negative effects on the metabolism of glucose and lipids (fat), leading

How does smoking affect insulin sensitivity?

It is well known that tobacco smoke is harmful to health and is of particular danger to people with diabetes. All of the chronic complications of diabetes – such as cardiovascular disease, foot problems, kidney disease, and eye damage – are exacerbated by breathing in tobacco smoke. Recently, it was suggested that smoking may increase the risk of developing type 2 diabetes. Although the exact mechanisms are not yet fully understood, it has been suggested that impaired sensitivity to the action of insulin in people who smoke tobacco could be linked to

Cause as well as effect: smoking and diabetes

People who smoke tobacco are at increased risk of cardiovascular disease. Tobacco use contributes to the risk of all the major types of cardiovascular disease, particularly heart attack, stroke and the blockage of blood vessels in the lower limbs. People with diabetes, especially type 2 diabetes, are also at high risk for

Successful islet transplantation has finally arrived: fact or fantasy?

Currently, transplantation of whole pancreases results in insulin independence and normalization of glycosylated haemoglobin values for three years in up to 80 percent of recipients. One group of investigators in Edmonton, Canada, has had initial success with the less invasive procedure of islet transplantation. Should this procedure take precedence?

Diabetes and kidney disease: a report from NephroAsia 2004

The global burden of chronic kidney failure (end stage renal disease) is primarily driven by the current parallel rise in the prevalence of diabetes and high blood pressure (hypertension). Asia, which has more than 60% of the world’s population, is at the forefront of this global epidemic of diabetes and kidney disease. Juliana Chan offers some background on the current status of care for kidney disease and reports on the NephroAsia 2004 meeting in Singapore.

The cost of kidney disease in India: one person's story

India is fast-becoming the diabetes capital of the world. More than 35.5 million people in India now have diabetes. This figure is likely to rise to 57 million by 2025. This increase, principally in people with Type 2 diabetes, is bringing with it a sharp growth in diabetic complications, including eye disease (retinopathy) and kidney disease (nephropathy). In this report, Ambady Ramachandran describes the costs of diabetes and kidney disease to a person in India

The costs of kidney disease

Existing and recent health-care interventions have the potential to reduce the economic impact of diabetes complications, including kidney (renal) disease. In this article, Thomas Songer provides a brief overview of current understanding regarding the costs related to kidney disease.

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