Ok, so over the past couple of weeks, I’ve received several questions relating to the issues diabetics face in relation to kidney problems and how diabetes affects the kidneys, also known as nephropathy.
Diabetic nephropathy is the most common cause of renal failure, accounting for more than half of all cases of end-stage renal disease in the United States. Renal disease will affect between 20-40% of diabetics in their lifetime, so lets take a closer look at what its all about and more importantly, what we can do to avoid it!
Stop me if you’ve heard this one before, but as we’re aware, diabetes can affect many parts of the body, including the kidneys. In healthy kidneys, many tiny blood vessels filter waste products from your body. The blood vessels have holes that are big enough to allow tiny waste products to pass through into the urine but are still small enough to keep useful products (such as protein and red blood cells) in the blood.
High levels of sugar in the blood can damage these vessels over time if diabetes is not controlled. This can cause kidney disease, which is also called nephropathy (say: nef-rah-puh-thee). If your not well controlled and the damage is bad enough, your kidneys could stop working.
Signs And Symptoms Of Nephropathy:
Early signs and symptoms of kidney disease in patients with diabetes are typically unusual. However, signs and symptoms listed below may manifest when kidney disease has progressed:
- Albumin or protein in the urine
- High blood pressure
- Ankle and leg swelling, leg cramps
- Going to the bathroom more often at night
- High levels of blood urea nitrogen (BUN) and serum creatinine
- Less need for insulin or antidiabetic medications
- Morning sickness, nausea, and vomiting
- Weakness, paleness, and anemia
The differential diagnosis of diabetic nephropathy are extensive, but they include the following in a patient with known type 1 and type 2 diabetes:
- Primary or secondary glomerular disease
- Renovascular hypertension
- Renal artery stenosis
- Renal vein thrombosis
- Multiple myeloma
- Cholesterol embolization
- Chronic obstruction
- Interstitial nephritis
So what’s the deal when it comes to metformin? We are all aware of the great job it does when it comes to helping type 2 diabetics better control their blood sugars and studies are even beginning to show that it can actually help you live longer compared to those without the disease, but what about the negative side effects? We were discussing on my Facebook page the other day about the long term side effects, so lets take a closer look!
What Is Metformin?
So what does metformin actually do?
Metformin is used alone or with other medications, including insulin, to treat type 2 diabetes (just to recap, a condition in which the body does not use insulin normally and, therefore, cannot control the amount of sugar in the blood). Metformin is in a class of drugs called biguanides. It helps to control the amount of glucose (sugar) in your blood. It decreases the amount of glucose you absorb from your food and the amount of glucose made by your liver.
Metformin also increases your body’s response to insulin, a natural hormone that controls the amount of glucose in the blood. I’m also beginning to see where metformin is used in addition to insulin to treat type 1 diabetes (again to recap, a condition in which the body does not produce insulin and therefore cannot control the amount of sugar in the blood) and fellow type 1 diabetics are actually gaining better control when introducing metformin to their regular treatment plan.
Metformin has been show to be a great/effective treatment option for helping control ones blood sugar, but what about the associated side effects that some experience? Lets continue reading.
Metformin And Lactic Acidosis:
Although rare, lactic acidosis is potentially the most serious of the side effects. The uptake of lactate by the liver is effected in a negative way. If the kidneys do not process the excess lactate the blood of the patient will acidify which can lead to a whole slew of problems. Most of which are similar to the feeling one gets after an intense workout. For example: anxiety, hyperventilation, irregular heart rate nausea and in some cases vomiting. This is the reason that it is generally only prescribed to people with a healthy kidney function. This side effect is potentially lethal and when you experience any of the symptoms you should immediately contact your doctor or a local hospital.
Metformin And Hypoglycemia:
Since the primary role is to reduce high levels of blood sugar, it has the potential to lower glucose below what is considered the normal levels. With minimal amounts of glucose in the bloodstream weakness, dizziness, shaking and sweating are all signs of low blood sugar. In a situation in which a person feels some or all these symptoms, they must raise the blood sugar immediately to avoid complications such as coma. Therefore, individual need to always have available hard candy or natural juice or glucose tabs to counter this side effect.