Diabetic Nephropathy : An Irreversible Kidney Failure

Diabetes is a disease where the body is unable to produce or use insulin effectively. Insulin is needed for proper storage and use of carbohydrates. Without it, blood sugar levels can become too high or too low, resulting in a diabetic emergency. It affects about 7.8% of the population. The incidence of diabetes is known to increase with age. It’s the leading cause of end-stage renal disease in the US, and is the primary cause of blindness and foot and leg amputation. It is known to cause neuropathy in up to 70% of diabetic patients. Individuals with diabetes are twice as likely to develop cardiovascular disease. There are two types of diabetes: Type 1 and Type 2.

According to Meng, Chunyan, Xiaosheng, Xiangren (2018), diabetes mellitus is a chronic disease caused by inherited and/or acquired deficiency in production of insulin by the pancreas or by the ineffectiveness of the insulin produced. The first WHO Global report on diabetes suggested that the most-to-date number of adults living with diabetes is 422 million, which has almost quadrupled since 1980. This dramatic rise is largely due to the prevalence of type 2 diabetes and the factors driving it include overweight and obesity (para. 1).

Diabetes Overview - While modern lifestyles and medical care have certainly improved the longevity of humans in the developed world, and contributed to a greater quality of life scenario, those same lifestyles have engendered a number of issues that contribute to disease. Lack of proper diet, fast food, high fat and carbohydrate diets without adequate fruits and vegetables, lack of exercise, smoking and alcohol contribute to an epidemic of obesity which, in turn, contributes to a serious metabolic disorder called Diabetes Mellitus Type 2. While not managed by insulin injections, it is nevertheless quite serious and has a number of progressing symptoms that, if not treated properly, can result in cardiovascular, renal and neurological problems, as well as amputation, ocular issues, and even cognitive dysfunction.

The worldwide prevalence of type 2 diabetes is skyrocketing alarmingly to epidemic proportions. According to King, Aubert and Herman (1998), in the year 2000 there were 150 million people with type 2 diabetes worldwide, and this number is expected to double by 2025. This explosive increase in type 2 diabetes prevalence is also associated with a significant increase in morbidity and mortality. (Dankner, Abdul-Ghani, Gerber, Chetit, Wainstein and Raz, 2007). This global increase in diabetes will occur because of population ageing and growth, and because of increasing trends towards obesity, unhealthy diets and sedentary lifestyles. Worldwide, according to the WHO Diabetes Action Now

Diabetes, often referred to as diabetes mellitus, is one of the leading chronic diseases. Diabetes is a group of diseases marked by high levels of blood glucose, also known as hyperglycemia, resulting from problems in the body’s ability to produce insulin, the body’s effective use of insulin, or both (Centers for Disease Control and Prevention, 2014). The food we eat on a daily basis is broken down into glucose and enters the bloodstream. Insulin, a hormone made by the pancreas, is then used to transform glucose into energy by letting them into the cells (Centers for Disease Control and Prevention, 2014). Therefore, insulin is very important because it regulates the blood sugar in our body. High levels of blood glucose increases the risk of heart attacks, strokes, blindness, kidney disease, and limb amputation (Centers for Disease Control and Prevention, 2014). According to International Diabetes Federation, over 387 million people have diabetes worldwide. It is projected that by 2035, this number will rise to 592 million (Atlas, 2013). In 2012, a total of 29.1 million people or 9.3% of the United States population have diabetes (Centers for Disease Control and Prevention, 2014). That’s about 1 out of every 11 people. According to 2010 statistics, diabetes is the seventh leading causes of death in the United States (Centers for Disease Control and Prevention, 2014). The estimated diabetes costs in the United States for 2012 was $245 billion, which

Diabetic neuropathy is the most common factor in almost 90% of diabetic foot ulcers [9, 10]. Nerve damage in diabetes affects the motor, sensory, and autonomic fibers. In patients with peripheral diabetic neuropathy, loss of sensation in the feet can cause further damage such as repetitive minor injuries that are undetected at the time and may subsequently prompt foot ulceration. In addition, structural deformities and abnormalities of the foot further increase the risk of ulceration. Other risk factors include a previous history of foot ulceration or amputation, visual impairment, diabetic nephropathy, poor glycemic control, and cigarette smoking. This may increases the chance of infection to the ulcer. Lack of wound healing, systemic sepsis,

Diabetic renal disease is a comorbidity related to diabetes, according to (citation) Diabetic nephropathy is a syndrome characterized by the presence of low abnormal urine albumin (microalbuminuria), diabetic glomerular lesions, and a loss of glomerular filtration rate (GFR).

Diabetic Nephropathy or Diabetic Kidney Disease is a syndrome that has been generally defined as disease in which there is increased protein excretion in urine. It is commonly characterized by the presence of pathological quantities of albumin in urine that is excreted from the patient’s body, diabetic glomerular lesions, and loss of glomerular filtration rate (GFR) in diabetics. It can be categorized into stages: microalbuminuria and macroalbuminuria. The early stage is usually characterized by a small increase in urinary albumin excretion (UAE), and it is also called microalbuminuria or incipient Diabetic nephropathy while a more advanced disease that is characterized by the presence of proteinuria is called macroalbuminuria or overt Diabetic

Diabetes is one of the most common chronic diseases and is increasingly becoming a worldwide health issue nowadays. There were about 422 million adults living with diabetes in the world in 2014. The global prevalence of diabetes has nearly doubled since 1980, rising from 4.7% to 8.5% in the adult population (1). It is estimated that between 2010 and 2030, the number of people with diabetes will increase by 69% and 20% respectively in developing countries and developed countries (2). The majority of people with diabetes are affected by type 2 diabetes (1). WHO estimates that by 2025 as many as 200–300 million people worldwide will have developed type 2 diabetes (3).

The symptoms of diabetic nephropathy are normally not present in the early stages but as time goes on and the kidney function worsens, many symptoms can appear.

Diabetic Nephropathy (DN) is a serious and progressive complication of both type 1 DM (Results from the body’s failure to produce insulin) and type 2 DM (Results when the pancreas does not produce enough insulin to control glucose level or

Diabetes kidney disease is normally rare, and diabetes itself is not a direct disease. It is a retrograde functioning of the body which occurs due to low secretion of insulin (type 1) or due to ineffective insulin (type 2) produced by the pancreas. Diabetes and kidney disease are closely related. Insulin is a hormone that helps glucose floating in the blood to enter the blood cells. With the entry of the glucose into the cells, it is converted into energy needed for the body. If there is no insulin secretion, or if it is not working what it should, the glucose keeps on circulating in the blood stream.

One of the diseases is diabetes mellitus which is a major cause of renal failure. This disease can be defined as an increase of fasting blood glucose that is affected by a deficiency in insulin hormone. The normal range for glucose (fasting) in the blood is 2.8-6.0 mmol/L. It is classified into two groups, type 1 (insulin-dependent diabetes mellitus) and type 2 (non insulin-dependent diabetes mellitus). Stein (2008, p.6) points out that kidney failure happens most often when patients have suffered from diabetes mellitus for more than 10 years. According to United States Renal Data System (USRDS) report in 2007, approximately 44% of primary causes of renal failure is diabetes mellitus in the United States in 2005. Also, Stein (2008) indicates that 15% of dialysis patients are influenced by diabetes mellitus in the United Kingdom. Diabetes mellitus has negative affects throughout the kidneys where the increase of the range of blood sugar causes the damages to the cells in the kidneys. This leads to the presence of the glucose in the urine which is known as glycosuric.

Diabetes is highly prevalent condition, affecting 8.2 % of adults globally or 382 million people. Incidence is increasing with a estimated global prevalence of 592 million people by 2035. It further results in Chronic kidney disease & further may lead to ESKD(End-Stage Kidney Disease).

Diabetes is a systemic disease caused by a decrease in the secretion of insulin or reduced sensitivity or responsiveness to insulin by target tissue. (Beale, et al., 2011) The incidence of diabetes is growing rapidly in the United States and worldwide. An estimated 347 million people around the world are afflicted with diabetes. (Whalen, et al., 2012) According to World Health Organization (WHO), Diabetes prevalence among adults over 18 years of age has risen from 4.7% in 1980 to 8.5% in 2014. It is the major cause of blindness, kidney failure, heart attack, stroke and limbic amputation. World Health Organization (WHO) projects that diabetes will be the 7th leading cause of death in 2030. It is a complex and costly disease that can affect nearly every organ in the body and result in devastating consequences. The leading cause of non-traumatic lower extremity amputations, renal failure, and blindness in working-age adults, diabetes is also a major cause of premature mortality, stroke, cardiovascular disease, peripheral vascular disease, congenital malformations, perinatal mortality, and disability. (Cefalu, 2000) Insulin therapy and oral hypoglycemic agents have demonstrated improvement in glycaemic control. However, Insulin therapy has some disadvantages such as ineffectiveness following oral administration, short shelf life, of the need for constant refrigeration, and fatal hypoglycaemia, in the event of excess dosage.