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Tamil Nadu
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Chennai
Once kidney damage sets in, treatment can only slow progression to kidney failure, not reverse it High levels of glucose can damage the tiny filtering units in the kidney that clean the blood CHENNAI: If you are diabetic, there’s a one in three chance that you will develop kidney disease over time if you do not control your sugar and blood pressure levels. Unfortunately, 88 per cent of diabetics in Chennai do not keep either levels in check, according to a 2004 survey. An estimated 50 per cent of people in India do not know that they are diabetic. But only half of those that do know, or 25 per cent of all diabetics, take medication. And just half of those on treatment — that’s only 12 per cent — are keeping themselves healthy enough to avoid complications that could develop out of diabetes in the future, says diabetes expert V. Mohan, whose Specialty Centre conducted the Chennai Urban Rural Epidemiology Study. It’s no good soldiering on until you feel the symptoms — by that stage, doctors say, it’s too late. Once kidney damage has set in, treatment can only slow the progression to kidney failure, not reverse it. Combining regular self monitoring with quarterly visits to the doctor, exercise and good diet patterns minimises this risk. In people with diabetes, high levels of glucose can damage the millions of tiny filtering units in the kidney that clean the blood. This means that waste can build up and other important substances like proteins can leak out into urine. Once the filtering units are gone, regular dialysis (in which the blood is cleaned externally) and, later, kidney transplants, are the only options for survival. At over Rs.15,000 a month for blood dialysis and over Rs.1.5 lakh for a transplant, these options can have a devastating effect on family budgets. Diabetics could instead take preventive measures starting with frequent sugar level monitoring tests. “It is a myth that if you have diabetes you will automatically get eye, kidney or leg problems,” V. Balaji, Chief Diabetologist, Apollo Hospitals, Chennai, told The Hindu. “Just do what the doctor advises, maintain a normal lifestyle and keep a disciplined diet,” he said, adding that the self monitor should not be misused to check sugar levels in advance of taking risks such as eating sweets or going to food and drink-laden parties. Only 15 per cent of patients visit the doctor in the three month intervals that they should, he said. Hospital tests, such as those that detect the protein leak into urine, should be undertaken regularly, he noted. Dr. Mohan said a population-based survey conducted by his Diabetes Centre last year shows that the prevalence of diabetic kidney disease in the city is coming down compared to 20 years ago. While part of this is down to the advent of ACE inhibitors, which lower blood pressure and help protect the kidney’s filtering units, he said improved control and early detection is helping. “As long as the glycated haemoglobin index levels are below 7 per cent and blood pressure is well controlled, the chances of developing complications of the kidney are rare,” he said. But with The International Diabetes Foundation forecasting a rise in the number of diabetics from 40 million to close to 70 million, if just 12 per cent of diabetics are correctly controlling their condition as Dr. Mohan estimates, many still remain at risk of kidney failure.
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