Diabetes is a major risk factor for kidney disease. However, this happens when diabetes is poorly controlled. If well controlled, one can prevent diabetic kidney disease and other complications of diabetes. If one already has diabetic kidney disease, control of blood sugar will help retard the progression of diabetic kidney disease but will not halt progression of kidney disease to kidney failure. Therefore, keeping good blood sugar control from the beginning is very important. Once kidneys fail, renal replacement therapy (dialysis/transplantation) becomes mandatory for survival. Kidney transplant is a better option than dialysis. After kidney transplant, if diabetes remains poorly controlled, diabetic kidney disease can recur in the transplanted kidney. Hence it is very important to keep blood sugars well controlled after transplant. Even if one did not have diabetes before transplant, one can develop it after transplant. This is called new onset diabetes after transplant (NODAT). Our experience shows that it develops in 20% of cases. This is due to side effect of commonly used anti-rejection medicines (Immunosuppressants). Besides medication, other factors also can put one at high risk for NODAT. These include:

• Excess weight gain
• Lack of exercise

Your doctor does help you to keep your diabetes under control. Now with availability of Ambulatory Glucose Profile, it is easier to control blood sugar. However most of your day-to-day care of diabetes is up to you. You can make choices that will have a positive effect on your blood sugar control.

• Make healthy food choices. You can choose what, when, and how much to eat. Healthy meal planning is an important part of your diabetes treatment plan.
• Be physically active. This helps you keep your cholesterol, blood pressure, and blood sugar under control.
• Take your medications / insulin regularly at a specific time instructed by your doctor.
• Keep a sugar monitoring chart. Learn which numbers are important for telling you how well you are doing. Take the chart along to your doctor so you can discuss with your doctor.
• Get your laboratory tests (HbA1C, Lipids, Urine routine, S.Creatinine) & eye check for retinopathy regularly done. Note: If you take good care of diabetes, you can donate your organs after death.

Note: If you take good care of diabetes, you can donate your organs after death.

Written by: Dr. Mita Shah

Consultant Diabetologist, Global Hospitals, Mumbai.

Trustee, Narmada Kidney Foundation