If you have diabetes, good communication with your health care team is key. There are preventative questions you can ask to reduce your risk of CKD and CVD. Talk to your doctor, be curious and, most importantly, make sure you understand his or her answers.
5 Steps to Preventing Kidney Disease Before It Starts
You may have heard that if you have type 2 diabetes, you run an increased risk of chronic kidney disease (CKD). Here, we explain exactly what you need to know about preventing CKD, how your heart and kidneys are connected and the role of regular screenings.
Read on to discover the simple steps you can make to take care of your kidneys and lower the risk for heart disease.
What Causes Kidney Failure?
To understand what causes kidney failure, it’s important to understand how healthy kidneys function and what purpose they serve.
The kidneys are amazing organs that work hard to filter all the blood in our bodies. Made up of thousands of tiny blood vessels, our kidneys act as a full-body filtration system that separates waste products from essential substances like protein and red blood cells in the body.
Kidney failure occurs when this filtration system breaks down and useful bodily substances, like protein, are unintentionally expelled. Protein is necessary for the structure, function and regulation of the body’s tissues and organs—and we need it to survive. When the filtering system is in the early stages of protein loss, it is called microalbuminuria. More extensive breakdown is known as macroalbuminuria.
Thankfully, you can test kidney function to find out about problems early—and make changes to prevent CKD with a simple screening.
How Are the Heart, Kidneys and Diabetes Connected?
Your kidneys are powerful filters that remove toxins from your blood through a complex network of arteries, veins and vessels—which are part of your cardiovascular system.
Type 2 diabetes can put a lot of stress on all these structures—both in your heart and in your kidneys. There’s an overlap between their risks and care. To stay healthy, it’s vital for you and your doctor to keep tabs on both.
What Is a UACR Screening?
Our bodies need protein to build muscle, repair tissue and fight infection. But it should be in the blood, not urine, where protein is lost if you have kidney damage.
People with a high amount of protein (albumin) in their urine have an increased risk of end-stage renal disease. In these cases, dialysis may be needed to survive. The urine albumin-to-creatinine ratio (UACR) is a simple test that shows whether albumin is present in the urine.
A UACR test can be an early indicator of kidney damage and should be part of your annual screenings if you have type 2 diabetes.
What are the Symptoms of CKD?
If you have had diabetes for many years, you could have kidney damage and not even know. High blood sugar (blood glucose), high blood pressure and diabetes-related complications contribute to kidney disease.
Unfortunately, recognizing early-stage kidney disease by checking for symptoms is usually not possible. This is because our kidneys will overwork themselves to make up for the early damage, and you may not have symptoms until nearly all function is gone. Any symptoms you may have wouldn’t make you think it’s kidney disease.
Does Everyone With Diabetes Develop Kidney Disease?
Many people ask if being diagnosed with diabetes automatically means they’ll struggle with kidney disease, and the answer is no. Factors that can influence kidney disease development include genetics, poor blood sugar management and high blood pressure.
It is vital to see your doctor regularly and maintain an ongoing conversation about your health. The better you’re able to keep your diabetes and blood pressure under control, the lower your chance of getting kidney disease.
When you schedule a UACR screening, your doctor will check your blood pressure, your urine protein ratios and talk with you about lifestyle prevention steps.
What can I do for Prevention?
1. Understand risk factors
When you’re living with diabetes, high levels of blood sugar (blood glucose) can cause your kidneys to work harder. Over time, kidney failure is more likely to occur. Not everyone with diabetes will develop kidney disease. Factors include genetics, blood sugar control, and blood pressure.
If you develop kidney disease, you’ll have little to no symptoms until almost all function is gone. Have a discussion with your doctor about how to protect your heart and kidneys. Regular UACR screenings are key to early detection. When kidney disease is diagnosed early, several treatments may keep it from getting worse.
3. Keep blood sugar and blood pressure in your target range
Tight blood sugar management can reduce the risk of early-stage kidney failure by one-third and may reduce the risk of early stages of kidney disease to more severe kidney disease by half. Some studies have shown tight management can even reverse the early stages.
4. Talk to your doctor to see if a low-protein diet is right for you
Another treatment some doctors use with severe kidney disease is a low-protein diet. This can decrease protein loss in the urine and increase protein levels in the blood. Always talk with your health care team before changing your diet.
5. Get regular screenings
Ask your doctor for a UACR screening once a year if they haven’t scheduled one. This simple urine test is often overlooked but can mean the difference between staying healthy and avoiding dialysis. Your doctor can check your blood pressure, eGFR (estimated glomerular filtration rate), urine protein ratios and talk with you about lifestyle prevention steps.
If you have diabetes, there are simple, preventative steps you can take to reduce your risk of heart disease. Talk to your doctor about how to keep your heart healthy and about getting regular UACR screenings to help you understand the health of your kidneys.
Managing Your Diabetes Starts with Education
Get the latest information and the support you need, all in one easy place.
Managing your diabetes starts with learning about it and having your questions answered, but it can be tough to gain the skills you need — especially if you haven’t been to an education program. Now, you can find the support and information you need to live well with diabetes — and we have everything you need, all in one easy place.
The Easy Way to Manage Your Diabetes
American Diabetes Association® Recognized Education Programs are ready to work with you to find practical solutions that fit your personal needs. Learn how to manage the link between diabetes and heart disease so that you can reduce your risk of heart attack and stroke.
Diabetes Self-Management Education and Support (DSMES) Services
If you have type 2 diabetes, Diabetes Self-Management Education and Support (DSMES) Services will help you navigate your diabetes journey. Here, you’ll find the direction, resources and support you need to succeed.
This program is designed to support you and help you become more confident and empowered as you learn to make your journey easier than ever. Work hand in hand with a diabetes educator during a series of personalized sessions to understand how to manage your diabetes. DSMES is a cost-effective tool, proven to improve health behaviors and health outcomes for people with diabetes. And here’s some good news: If your doctor refers you to a program, most insurance plans will often cover the cost!
Here are three easy steps you can take to empower your diabetes journey:
- Visit our site to find a program near you.
When you visit our site, you’ll be able to answer questions so that you can find practical solutions that fit your individual needs.
- Ask your doctor for a referral.
Wondering when the right time is to request a referral from your doctor?If you’ve never taken part in a diabetes education program or you’re newly diagnosed, requesting a referral from your doctor is a great place to start. Managing diabetes can be extra tough during times of transition, too. If you’ve recently experienced a change in your health or living situation, have started a new medication, received new insurance coverage or have had changes in access to food or money, we recommend asking for a referral.
- Start getting the support you need.
If you have diabetes, there is a lot you can do. Talk to your doctor about your next steps and explore the resources we’ve created just for you.
We know how important it is to have your personal concerns heard and addressed. That’s why we created our monthly Ask the Experts series. Designed to help people with diabetes tackle commonly faced issues, this Q&A series provides a community where individuals can ask questions of our experts and hear from others who share similar experiences — all for free. Get your questions ready; answers are on their way.
Browse tasty recipes, create a shopping list and meal plan all in one place! Check out our healthy eating blog for the latest nutrition knowledge and meal prepping tips and tricks, and create an account for your free, all-access pass to hundreds of recipes and more. ¡Recibas en español Tambien!
Heart Disease and Stroke
Did you know that type 2 diabetes is linked to an increased risk of heart disease and stroke? In fact, adults with diabetes are twice as likely to have a heart attack or stroke than people without diabetes, even if the diabetes is well managed.
And heart disease and stroke may put you at higher risk of complications if you get COVID-19. There are basic steps anyone can take to reduce their risk of getting the virus. Stay vigilant. If you do get COVID-19, you might experience more severe symptoms or serious complications.
Overall, there’s a lot you can do to reduce your risks of heart disease and stroke.
First, talk to your health care provider to better understand your condition and what you can do to stay healthy. With COVID-19, many health care providers are willing to communicate via phone, email or a secure patient portal.
Diabetes is more complicated than most chronic diseases, so it’s important to be proactive and work with your health care team to learn all you can about how to manage it, said Robert Eckel, M.D., professor emeritus at the University of Colorado Anschutz Medical Campus and former president of the American Heart Association.
Reducing your risk starts with making sure your diabetes is well controlled. Work with your health care team to set goals that can get your health on track.
When unmanaged, diabetes damages blood vessels over time. Excess blood sugar (also called blood glucose) makes the vessels stiff and the vessels can also fill with a fatty substance called plaque that can cause blockages.
Many patients with diabetes also have other conditions—including extra weight, high blood pressure, high cholesterol and high triglycerides— that increase the risk for heart disease. Work with your health care team to manage those factors. You may need a combination of medication and lifestyle changes.
Stay in contact with your health care team about your progress, and make sure you don’t miss any appointments. Be prepared with questions. Talk about steps you can take before your next appointment and how to track your progress.
Many patients with diabetes may need to take one or more medications to manage their diabetes. Make sure you take all your medications as prescribed. If you are running into challenges or if the side effects are difficult to manage, talk with your doctor about alternatives.
If you use tobacco, stop. Stick to a heart-healthy diet that limits sodium and sugar and focuses on vegetables, fruits, whole grains, lean protein, low-fat dairy and healthy fats.
Get your heart rate up. Aim for at least 150 minutes each week of moderate aerobic activity like a brisk walk.
With an increased risk for stroke, it’s important that you and those around you recognize the common symptoms of a stroke. F.A.S.T. is an easy way to remember that if your face is drooping or you experience arm weakness or speech difficulty, it’s time to call 911 and get immediate medical attention.
Most of all, stay positive. There are millions of people with diabetes leading healthy lives and you can be one of them.
Types of Diabetes
Did you know there’s more than one type of diabetes? Most people have heard of type 2, type 1 and gestational diabetes; however, there are additional forms of the disease, such as latent autoimmune diabetes (LADA), and maturity-onset diabetes of the young (MODY).
Here, we’ll discuss the most common types of diabetes and the best practices to treat each one.
This is the most common form of the disease and accounts for nearly 90-95% of cases. In this instance, your body still produces insulin, but does not make enough or use it efficiently. The best treatment options are eating a balanced diet; starting or increasing physical activity; regularly monitoring your blood glucose and taking medication prescribed by your doctor, if needed. Most often found in middle-aged and older adults, younger people can also be diagnosed with type 2 diabetes.
Accounting for about 5% of diabetes cases, type 1 diabetes often begins in childhood, but can occur at any age. In type 1 diabetes, the body produces little or no insulin. Unlike type 2 diabetes where taking insulin may or may not be part of a treatment plan, people living with type 1 diabetes must use insulin to survive.
People with type 1 diabetes manage their diabetes with healthy eating and physical activity, along with using insulin and carefully monitoring blood glucose levels.
Pregnancy is beautiful and can also be taxing on the body. Sometimes, when women aren’t able to produce enough or properly use insulin, they’re diagnosed with diabetes during their pregnancy; this is known as gestational diabetes. The onset of this type of diabetes usually happens around the 24-week period, and the treatment plan generally includes a special meal plan, scheduled light physical activity, regular blood sugar monitoring, and may also require insulin.
Who is most likely at risk?
Now that we’ve discussed the various types of diabetes, let’s take a closer look at the populations, personal habits and family history of those most likely to encounter the disease.
You’re more likely to develop type 2 diabetes if you’re:
- Hispanic or Latino
- Black or African American
- American Indian
- Asian (especially South Asian)
- Pacific Islander
Additional factors for type 2 diabetes:
A family with a history of diabetes
Having been diagnosed with gestational diabetes
Not getting enough exercise
It’s a lot of information, but there’s a lot you can do.
Did you know adults with diabetes are two times more likely to experience a stroke or develop heart disease? That’s why keeping your heart healthy and your blood pressure in check (plus other numbers) are such important priorities.
And, if you are someone living with diabetes or serving as a caregiver for someone else, it may feel overwhelming— but you’re not alone. The first course of action is to establish a treatment plan with your doctor’s help. And while you’re there, don’t forget to discuss how a medication plan can help reduce the risk of developing cardiovascular disease.
We’re here to help by providing the most up-to-date information and resources available to combat all types of the disease. Yes, diabetes is a lot … but there is so much you can do to manage the disease and live a happier, healthier life.
Your KDBH Guide to Federal Aid During COVID-19
We’ve put together an overview of resources to help you find information about health care coverage, food assistance and financial relief during the current Coronavirus pandemic. Some laws that may affect your family include:
- Families First Coronavirus Response Act
- Coronavirus Aid, Relief and Economic Security Act
- Paycheck Protection Program and Health Care Enhancement Act
Below, we’ll help you understand how to use these new benefits.
HEALTH CARE COVERAGE
COVID-19 Testing (Health Insurance)
Health plans, including private insurers and Medicare, are required to cover diagnostic testing for COVID-19, at no cost to patients, when deemed medically necessary by an attending health care provider. Tests must be approved for use by the Food and Drug Administration or individual states, provided by labs on an emergency basis or deemed appropriate by the U.S. Department of Health and Human Services.
COVID-19 Testing (NO Health Insurance)
Some states have opened special enrollment periods that allow people who aren’t eligible for health insurance through their workplace or governmental program (such as Medicare or Medicaid) to sign up for health insurance under the ACA.
Medicare Part D plans are required to fill or refill prescriptions for up to a 90-day supply if a patient requests it. If you have private insurance, check to see whether refill limitations have been eased.
You may be eligible to enroll in a health plan with standardized benefits under the Affordable Care Act. Those who become uninsured due to a loss of job or other factors may be eligible to enroll in an ACA plan outside of the usual enrollment period in the fall. Income changes or a death in the family are also considered Qualifying Life Events that can open additional enrollment.
Some states have opened special enrollment periods that allow people without health insurance through a job or a government program such as Medicare or Medicaid to sign up for health insurance under the ACA.
The American Heart Association and American Diabetes Association, and our public health partners, are urging federal policymakers to create a special enrollment period for all states.
Visit healthcare.gov to learn about enrollment opportunities in your state.
Telehealth and Remote Care
In general, telehealth services are more readily available, and high-deductible health plans may waive the deductible for telehealth and other remote care services — even if not related to COVID-19.
Medicare beneficiaries aren’t required to have a preexisting relationship with a provider to use their telehealth services during the COVID-19 emergency period. Also, patients on home dialysis aren’t required to have a nephrologist conduct some required evaluations face-to-face. Learn more about telehealth options by watching this video.
If you’re struggling with the high cost of your insulin or we’ve consolidated a list of insulin manufacturers that can offer immediate assistance and long-term resources for individuals in need. Visit insulinhelp.org today.
Public school systems are continuing to offer Free and Reduced-Price lunches for all eligible enrolled students. See if your child is eligible for this program and sign up online.
The Supplemental Nutrition Assistance Program, commonly known as food stamps, helps ensure that low-income Americans receive the food they need. To apply, contact your state SNAP office — use the online directory to find contact information.
The Special Supplemental Nutrition Program for Women, Infants and Children, commonly known as W.I.C., provides food assistance to low-income pregnant women and mothers. You can check online to see whether you may be eligible or to apply.
To find food assistance near you, call the USDA’s National Hunger Hotline at 1-866-3-HUNGRY or 1-877-8-HAMBRE.
Under the CARES Act all eligible U.S. residents who met the guidelines, should have already received their economic stimulus checks. Requirements for this one-time $1,200 payment ($2,400 for joint filers), plus an additional $500 per child, are:
– An adjusted gross income up to $75,000 ($150,000 for joint filers)
– Not be a dependent of another taxpayer
– Have a work-eligible Social Security number
The executive order to ban evictions has ended. Check with your state government for the latest updates on protection against eviction or and late-payment fees. If your home mortgage is backed by a federal loan, your lender may offer to hold or reduce your payments for six months.
You may qualify for the Low-Income Home Energy Assistance Program, which helps low-income households pay their energy bills, and also funds various federal housing and homeless assistance programs. Check the criteria on this website.
Congress passed emergency paid leave provisions that help protect families’ financial security. The bill expires December 31, 2020.
Federal law now provides broad relief including an administrative forbearance that allows student borrowers to stop making payments through Sept. 30, 2020. And, for some loans, interest will temporarily be reduced to 0%.
Additionally, employers can provide a tax-free student loan repayment benefit this year of up to $5,250 through December 31, 2020 — the payment isn’t counted in the employee’s income and is not subject to federal tax.
You can now deduct up to $300 in charitable contributions, whether you itemize or not on your 2020 taxes.