Type 2 Diabetes Treatment Options
Diabetes is a disease that affects the body's ability to produce or process glucose (you may have also heard glucose referred to as "blood sugar"). When blood sugar levels are too high, insulin distributes it to the cells, converting it to energy that keeps you going throughout the day. Diabetes effectively prevents the body from producing insulin, resulting in excess glucose within the blood and leading to very serious health complications over time. An estimated 29 million people in the United States have some form of diabetes -- type 2 accounts for about 90-95% of the diabetic population.
The reason it's so much more common is in large part due to the fact that that type 2 is developed in life, whereas type 1 is a genetic defect. This means that type 2 is usually possible to treat with some lifestyle changes. Every treatment regimen is dependent on the patient's situation, but here are some suggestions you can expect to hear from your doctor.
Ditch the Tobacco
One of the most important and immediately beneficial steps you can take (not just for diabetes, but for your overall health, too!) is to quit smoking. According to the Centers for Disease Control and Prevention (CDC), regular smokers are 30–40% more likely to develop type 2 diabetes than nonsmokers. And people who smoke a pack per day are twice as likely to develop diabetes than nonsmokers.
Smoking can also lead to insulin resistance. This compromises the effectiveness of several treatment options -- many of the medications designed to treat diabetes are centered around producing supplemental insulin. But if your body can't utilize it anyway, those treatments are unviable.
Get the Blood Pumping
Aerobic exercises are your best friends in your fight against type 2 diabetes. The CDC recommends aiming for 150 minutes of aerobics per week. Broken down, that's about 30 minutes a day for 5 days out of the week. It doesn't have to be super rigorous, although the more intense, the better. Weight loss plays a major factor in reversing the effects of diabetes. Combining aerobics, like walking or jogging for 30 minutes, with resistance training, like weight lifting, will help control glucose even more effectively.
Exercise lowers blood sugar levels so it's important to monitor yourself before and after you work out. Eating a snack beforehand may be necessary. Your doctor will discuss your training regimen with you.
Monitor Your Nutrient Intake
Unfortunately there is no "one size fits all" diet for diabetes. Successful diabetes treatment requires constant monitoring of blood sugar, vitamins, fat, fiber, carbs, fat and salt. Generally speaking, diets for diabetics will be low in carbs, fats and calories but high in fiber and nutrients. Be prepared to eat a lot of fruits, vegetables, whole grains and healthy proteins like fish. Portion sizes and a consistent daily meal schedule are also taken into consideration when customizing your diet. Your nephrologist and a dietician will help you plan out a coherent schedule, rich with healthy meals based on your personal tastes.
If diet and exercise aren't enough to control blood sugar, medication will be introduced into the mix. There are a number of possibilities, each with their own ways of working. Some medications train your liver to retain more glucose. Some tell your pancreas to produce more glucose. Some lower insulin resistance so your pancreas doesn't have to work as hard. You may also get insulin supplements by injection, inhaler or an insulin pump for continuous treatment. Your doctor will explain what each drug does and makes recommendations on a case-by-case basis.
Life After A Kidney Transplantation: Now What?
If you've gone through the agony of kidney failure and don't have the capacity to do dialysis, then the only other option is to have a kidney transplant. The process of going through the waiting list, finding a compatible donor, and undergoing a successful surgery can be grueling and take a very long time. But barring those obstacles, if you're one of the lucky 16,000 per year in the US to receive a kidney transplant, there are some things you should know about recovery and your life post-surgery.
Recovery After Kidney Transplantation
Immediately following a kidney transplant, you can expect to be monitored in the hospital for anywhere between 24 hours to a few days, depending on your situation. Doctors will need to ensure that your body doesn't reject the new organ and that you're able to properly produce urine. Beyond that, you can expect to be out of commission during at-home recovery for 5-10 days. Recovery times vary from person-to-person, however it's important to note that your doctor will inform you of all the steps you need to take to make the most efficient recovery -- follow those instructions to a T. You will be able to return to your normal routine after 3-8 weeks.
Adapt and Retain a Healthier Lifestyle
One of the hardest parts of retaining your health after a kidney transplant is avoiding reverting to old habits that may have led to kidney failure in the first place. Changing the way you live is no easy task, but it's necessary if you expect your transplant to increase your lifespan. After all, what good is a brand-new kidney if you're not going to take steps to keep it healthy? Much of maintaining kidney health is connected with maintaining overall health, so you can probably guess what's coming -- that's right, diet and exercise.
Introducing more exercise into your daily routine is an absolute must. Even a 30-minute walk each day goes a long way to your physical and mental health. Refrain from lifting weights until your doctor gives you permission.
Better nutrition will play a larger role in your life from now on, as well. Dialysis carries harsher dietary restrictions than post-transplant life. And since you probably will have experienced dialysis while waiting for a donor, you can easily manage your new dietary requirements. Your diet will also heavily depend on the types of medication prescribed. For instance, while it's important to eat plenty of fruits and veggies each day, your nutritionist may advise you to avoid grapefruit because it can negatively affect certain immunosuppression medications, which are normally prescribed after a kidney transplantation.
Medications for Kidney Disease Transplants
You will need to take medications for the rest of your life, mainly consisting of immunosuppressants. These help the body "accept" the donated organ into the body seamlessly. Every person is different and immunosuppressants help to level the playing field, making the body more receptive to transplanted organs. Now, you may be thinking, "immunosuppressant -- does that mean it suppresses the immune system? Why would I want that?" First off, yes, you're correct. Immunosuppressants are drugs that reduce the strength of your immune system. However, the reason you need them is fascinating: when you receive a transplant, your immune system immediately recognizes the new kidney as a hostile foreign entity and begins to attack it, as it would any other unidentified bacteria or object. Without immunosuppressants, your body's immune system is capable of damaging or destroying the new kidney, bringing you back to square one. This process is called "organ rejection."
Strictly following your medication regimen is crucial to maintaining kidney function, so get to know the names of your meds, the dosage and any other details outlined by your doctor. You will probably have many different meds to take, so don't be shy about calling your doctor to explain the regimen again. Skipping or forgetting a dose should NOT be taken lightly. If you do forget a dose, call your doctor immediately to inform them and ask what steps to take.
What are the Signs of Transplant Rejection?
After the procedure is complete and you're spending time in recovery (and beyond), it's important to keep tabs on your body to ensure proper acceptance of the new kidney. Even if you're properly taking your meds, the body can still reject transplanted organs. Here are the signs of rejection -- if you experience any of these following a transplant, immediately call your doctor:
Don't be alarmed -- organ rejection doesn't mean that you'll lose your kidney. It is often fixed by adjusting the type or dosage of medications. If you do experience rejection, you'll be hospitalized for a few days as doctors try alternative immunosuppressants and monitor your progress.
Despite having its share of potential complications, kidney transplant is the optimal way to cure kidney failure. Patients experience a much higher quality of life than those on dialysis and are able to go on living healthily for the rest of their lives. If you have any questions about kidney failure or feel that you may be at risk, feel free to get in touch with us. We'll be happy to schedule a consultation.
5 Things You Should Know About Kidney Dialysis
Around 30 million Americans have chronic kidney disease and 96% don't even know it, according to the Centers for Disease Control and Prevention (CDC). The most severe stage of kidney disease is called kidney failure -- for which around 660,000 Americans are being treated. About 468,000 of people are treated via kidney dialysis. Besides transplantation, dialysis is the most common and effective treatment for CKD (Chronic Kidney Disease). It is a medical process wherein machines take on the functions and responsibilities of the kidneys, allowing artificial regulation of hydration, hormone production and waste filtration in the blood. If you find that your doctor or nephrologist recommends dialysis, there are some things you should know going in.
The Types of Dialysis and How They Work
We went in-depth about the two types of dialysis treatment -- hemodialysis and peritoneal dialysis -- in a previous article. They both serve the same function, but in different ways and are prescribed on a case-by-case basis.
Side Effects of Dialysis
Like many medical procedures, dialysis also may come with it's fair share of side effects. These include:
Self-Discipline is Key
If you want to live a longer, more fruitful life that include the activities you love, you need to show up for the dialysis as often as the doctor prescribes. There's no skipping out on treatment -- dialysis is literally taking on a failed organ's duties. Depending on the type of dialysis you receive, you should expect to be in dialysis for as long as 3-4 hours, around 4 times a week. Strictly follow your doctor's and/or nutritionist's health and diet plan that they gave you. Kidney failure leads to a myriad of other health issues including hypertension, diabetes, anemia, bone problems, etc. Dialysis will help to control these, but it's just as crucial for you to take your wellbeing into your own hands to get healthier.
How to Maintain Your Dialysis Equipment
Proper care and maintenance of dialysis is important especially to those that have in-home care. It's not as relevant to those that receive their treatment in hospitals or dialysis centers, although those patients will still need to clean their access site (i.e. where the IV tubes enter/exit the arm or abdomen). Your doctor will recommend the antibacterial soaps that are needed before and after every dialysis session. They will also train you on how to clean your catheters, maintain your hemodialysis fistula or graft. Frequently check all tubes for cracking, wash them with proper soap before and after each session and do not tug on them during treatment.
You Can Still Travel
Dialysis centers are all over the US and in foreign countries. Treatment is globally standardized, so if you plan a business trip or vacation, be sure there is a hospital or dialysis center available with the necessary access and equipment.
If you anticipate going on dialysis, these are some of the basic, universal things to keep in mind. Since treatment is so personalized and based on case-by-case, your nephrologist will explain everything in great detail and make recommendations to ensure that you understand exactly what's happening. If you have any questions about the different dialysis types and what they entail, feel free to contact us or schedule a consultation.
Chronic Kidney Disease Statistics in the US
Chronic kidney disease (CKD) is a very serious condition that affects millions of Americans. In fact, it's the 9th leading cause of death in the United States, yet many people don't even know they have it. Although it's not the most uplifting subject, it is important to know the prevalence of the disease and the statistics surrounding diagnosis, treatment and demographics. One of the best ways to combat diseases is to raise awareness and understand them in order to help curb their presence.
Chronic Kidney Disease by the Numbers
Kidney Disease Treatment Statistics
Demographics: Who is at Risk of Chronic Kidney Disease?
The Cost of Kidney Disease
Per person average annual Medicare expenses attributable to CKD:
Kidney Waiting List Statistics
Renal Hypertension: High Blood Pressure and Kidney Disease
More than 100 million Americans have high blood pressure, also referred to as hypertension. The causes of it can vary greatly, though the largest contributors are weight, diet, age, smoking, high alcohol consumption, a lack of exercise and genetics.
Consistently high blood pressure is the second leading cause of chronic kidney disease (CKD), outranked only by diabetes. Kidney disease is not curable unless the patient undergoes an organ transplant; and if left untreated, CKD will end in fatality in every single case. In order to ensure kidney health, it's important to understand the risk factors involved and how to steer clear of them. The relationship between blood pressure and CKD is sort of a two-way street -- yes, hypertension is a leading cause of CDK, but "renal hypertension" is a term that refers to high blood pressure that is also caused by kidney disease. Here we'll go over what high blood pressure is and how it affects the kidneys.
What is blood pressure and how is it measured?
Blood pressure is the measurement of the force applied to artery walls as blood flows through them. Imagine your arteries are a garden hose. When you turn the water on, the water flows at a consistent pace. But when you put your thumb over half of the nozzle, the water shoots farther because the same amount of water is trying to fit through a smaller space, increasing the pressure. The same principle applies to arteries and blood flow: as the artery gets narrow, the blood flows more quickly (aka higher pressure).
How does blood pressure affect the kidneys?
When arteries that deliver blood to the kidneys become narrow or stiff, blood pressure becomes high. When it stays elevated, it stretches the blood cells and weakens them throughout the body. The main role of the kidneys is to filter waste and excess fluids from the blood and expel them as urine -- but as the kidneys' blood vessels become weakened, the kidneys cannot efficiently filter out harmful waste. As they cease to remove fluid in the blood cells over time, the additional fluid will cause blood pressure to increase even more, creating a vicious cycle. High blood pressure damages the kidneys and as the kidneys become damaged it increases blood pressure. This is what renal hypertension is.
How can I avoid renal hypertension?
Since CKD does not show symptoms until it has reached stage 3, it's important to get regular checkups with your doctor. While you're there, inform them that you would like them to do blood tests for CKD just to confirm your kidney health. That being said, there are measures you can take to alleviate high blood pressure without having to visit a doctor:
Dialysis Travel: How to Take a Trip With Kidney Disease
If you or a loved one are a kidney patient, you know that regular dialysis is crucial to staying alive -- especially in the later stages of the disease. Some people need to travel for work, some people want to travel for pleasure. Regardless of the reason, travel might play a major role in one's livelihood and quality of life. That's why it's important for kidney patients to know: yes, you can travel if you have kidney disease. You don't have to let dialysis weigh you down. Most dialysis centers have experience in dealing with patients who require transient dialysis, so most of the time it shouldn't be much of a hassle. Nevertheless, here are some useful tips for traveling with kidney disease.
Plan Ahead With Your Doctor
You probably already know how often you need to receive dialysis treatment, so plan your travels at least 6 to 8 weeks in advance with that in mind. When creating a travel itinerary, ensure that there is an open dialysis center be able to accommodate you in whatever city you're visiting and plan accordingly. Call the dialysis center ahead of time to schedule your treatment and ask them what paperwork you'll need to bring with you. Ask your doctor for recommendations and get approval from them or get help from a social worker.
Become Familiar With Local Cuisine
One crucial aspect of being on dialysis is ensuring you eat a healthy diet that doesn't interfere with treatment. You probably have discussed your nutrition needs with a dietician and already know the types of foods you can and can't eat. But whenever you decide to travel (especially overseas or to places you've never been), do some brief research to get familiarized with local cuisine. Check with your doctor or dietician to make sure you're able to eat local foods, especially while traveling overseas.
Bring Necessary Documentation to Dialysis Centers
When you're planning out your travels and you call to make appointments at your desired dialysis center, be sure to ask what they need from you during and before your first visit. Here are some of the essentials you'll need:
What About Traveling With Peritoneal Dialysis?
We previously explained the difference between peritoneal dialysis and hemodialysis. Those on peritoneal dialysis probably won't need access to a dialysis center because they do home treatment by themselves. However, they should still take extra steps to plan ahead and arrange for backup treatment in the event of equipment failure. Contact the nearest available dialysis center where you'll be traveling to and ensure that they will be able to accommodate you if needed.
What's the Difference Between Type 1 and Type 2 Diabetes?
Diabetes is a common disease in the United States. It disallows the body to process insulin, which it converts into energy. Around 29 million Americans are afflicted with either Type 1 or Type 2 diabetes, and there are an estimated 8 million more undiagnosed.
It's important to recognize the symptoms of diabetes because, while managing it is relatively easy, if it goes untreated it will eventually lead to some serious complications down the road. Diabetes remains the leading cause of kidney failure, which is fatal if not treated quickly. Your kidneys are responsible for filtering out waste from your bloodstream and when a patient is diabetic, it damages the body's small blood vessels. This renders the kidneys ineffective and they slowly stop cleaning the blood, which eventually leads to kidney disease.
What is Type 1 Diabetes?
Type 1 diabetes accounts for 5-10% of all diabetic patients. It's most common in children and although its cause is largely unknown, it is suspected to be due to a genetic defect. In Type 1, the pancreas does not produce enough insulin and the patient will be required to take insulin shots for their entire life. There is no permanent cure and it cannot be prevented, only managed and suppressed.
What is Type 2 Diabetes?
This is the more common form of diabetes, accounting for 90-95% of the diabetic population. It occurs in people over 40 years old and is commonly referred to as "adult onset diabetes". This is because the pancreas DOES produce insulin, but the body doesn't know how to efficiently process it. This is normally controlled by diet or medication, but in some extreme cases, patients take insulin. With proper care, exercise, diet and possibly medication, Type 2 diabetes can be reversed.
Symptoms of Diabetes
Type 2 diabetes symptoms often don't show until some damage to the body has been done. Type 1 symptoms develop fairly quickly and are much more severe, although the two types share many of the same symptoms:
Image source: Medical News Today
The Difference Between Hemodialysis and Peritoneal Dialysis
Kidney disease is a very serious ailment that affects 30 million adults in the US, with millions more at risk. It inevitably becomes fatal if left untreated. The most effective way to treat kidney failure is through dialysis, of which there are two types -- hemodialysis and peritoneal dialysis. In order to understand these two processes better, it's important to first thoroughly understand what the kidneys do and why they are significant.
So, What DO Kidneys Do?
Your kidneys are crucial to filtering waste and harmful substances out of the bloodstream. They absorb essential vitamins and nutrients, expelling everything else out of the body in the form of urine. Kidneys also regulate your body's hydration levels and assist in hormone production. If your kidneys fail, they allow harmful elements into the bloodstream, leading to various complications with the central nervous system, diabetes, heart problems and more. You can read further on the subject here.
Kidney dialysis is the most effective way to treat kidney disease. It's a process that allows artificial regulation of hydration, hormone production and waste filtration. Essentially the process conducts the kidneys' duties. Treatment is administered on average for about 4 hours, 3 times per week. Frequency depends on the severity of the disease and the patient. There are two types of kidney dialysis: hemodialysis and peritoneal dialysis.
What is Hemodialysis?
Hemodialysis is a process that cleans the blood via an external artificial kidney -- a machine called a dialyzer. The doctor will create an exit and entry point for the blood, normally done by arm surgery. The blood is drawn out of the body, through IV tubes that send it into the dialyzer, which filters out the waste and retains essential nutrients. It then begins pumping the newly cleaned blood back into the body.
This process is done either in a hospital, dialysis center or, depending on the severity of the disease and the patient's personal situation, at home. Treatment normally takes place for around 4 hours for 3 times a week, sometimes more frequently if done at home. If the kidney disease is caught early enough, hemodialysis may not be needed for the long-term. As long as the patient maintains a strict and healthy diet, as instructed by the doctor, the kidneys may heal over time and the patient will see restored functionality. However, if the disease is progressed to severe levels, which is often the case, hemodialysis will be administered for the rest of the patient's life unless they receive a kidney transplant.
Peritoneal dialysis shares the same basic principles as hemodialysis -- to do the jobs that the kidneys no longer can -- albeit in a different manner. The first type of peritoneal dialysis is called Continuous Ambulatory Peritoneal Dialysis (CAPD). It's machineless, so there's no need to visit a dialysis center or hospital 3 times a week. Instead, the filtration system is within the body. A special cleansing fluid is administered via IV into the abdomen, left for several hours to clean the blood, and then later drained. The administration and draining process take around 30 minutes each and is done around 3-5 times a day. During this time, the patient can carry on about their normal day.
A second type of peritoneal dialysis, called Automated Peritoneal Dialysis (APD), is the same as CAPD, though rather than manually administering and draining the cleansing fluid from the body, a machine does it (hence the term "automated"). It is often done at night while the patient sleeps.
While there are different types of dialysis, there are many factors that play a role in which will be administered. These factors often include the patient's lifestyle, line of work, disease severity, and personal preferences. Your kidney specialist will explain more in-depth the pros and cons of each type of dialysis to find what's best for you. That being said, catching the kidney disease early enough and avoiding treatment altogether is much more convenient. So if you or a loved one suffer from, or are at risk for kidney disease, please contact us for an examination.
Common Myths About Chronic Kidney Disease
The gradual degradation of the kidneys, known as chronic kidney disease (CKD) is a more serious issue than most people realize. The kidneys are responsible for a host of bodily procedures that keep your blood clean, your body hydrated, and various hormones regulated (among other crucial responsibilities.) Yet, there are many myths surrounding CKD, its prevalence and severity.
Myth: Chronic kidney disease is curable
Fact: Chronic kidney disease is NOT curable. Those afflicted with CKD will undergo one (or even both) of two options: dialysis and organ transplantation. Dialysis is extremely effective at slowing the progression of kidney disease, but ultimately is NOT a cure. Since CKD will always lead to death if untreated, it's important to know that transplantation is the closest thing to a cure. However, if a patient does not commit to improving their health habits after the transplantation, the same lifestyle factors that led to CKD in the first place could persist. Additionally, the waiting list for a suitable donor could take anywhere from 3-10 years (if one is ever found at all), so it's quite common for patients to undergo dialysis until they find their new kidney.
Myth: I haven't shown symptoms, so I don't have to worry
Fact: Patients don't actually exhibit symptoms of kidney disease until it has already significantly progressed. There are 5 distinguishable stages of chronic kidney disease, each measuring the progressive level of deterioration. Stage 5 is called end-stage renal disease, meaning the kidneys have lost all function and emergency surgery is needed if the patient intends to live. Symptoms for kidney disease don't surface until stage 3.
Myth: Everybody is at equal risk for developing kidney disease
Fact: There are many factors that play into who is at risk of CKD. Adults with diabetes, high blood pressure, heart disease, obesity, and a family history of it are at higher risk. Additionally, CKD affects a disproportionate amount of African Americans and Hispanics. The Centers for Disease Control (CDC) estimates that African Americans are 3 times more likely to develop CKD than Caucasians, while Hispanics are 35% more likely than Caucasians to develop it.
Myth: Kidney disease isn't very common
Fact: An estimated 15% of the American population has kidney disease, but around 96% are unaware of it, since symptoms take a while to show. That's more than 30 million Americans.
Myth: It's difficult to test for CKD
Fact: All it takes to test for CKD is a simple blood or urine test from your doctor. If you feel that you or a loved one are at risk of developing kidney disease, it would be best to schedule an appointment sooner rather than later. To find out more about how doctors test for CKD, check out our extensive article on the subject.
What To Expect When Getting Tested for Kidney Disease
The vast majority of people that suffer from chronic kidney disease (CKD) are unaware of it. In fact, an estimated 90% of stage 3 CKD patients do not know they have it and that it's getting worse with each passing day. This is largely due to the fact that kidney disease does not exhibit symptoms until the disease has progressed significantly -- stage 3 is when the first signs surface. Because of this, it's important to know if you're at risk so you can get tested regularly, earlier.
However, when you finally do make the decision to get tested for kidney disease, it's important to be prepared and know what to expect. There are a couple methods, but how do doctors test for kidney disease?
Doctors will typically utilize two main methods of testing for chronic kidney disease, the first being a urine test. Depending on the situation, there are a few signs doctors look for:
Blood Test | Glomerular Filtration Rate (GFR)
Glomeruli are the tiny filters in the kidneys that ensure waste does not enter the bloodstream. Your glomerular filtration rate measures the rate (in milliliters per minute) at which blood passes through the glomeruli. A lower rate indicates that smaller amounts of blood are being cleaned.
Doctors may also utilize scanning technologies in determining the severity of kidney disease. They may use ultrasounds and CT scans to check for tumors or abnormal growths on the kidneys.
In some rare cases, kidney biopsies may be conducted. These are usually only reserved for patients that are experiencing transplant rejection, or when doctors need to figure out the severity of physical damage done to the kidneys.