BACKGROUND

Diabetes mellitus type 1 and type 2 national and global level has become the leading cause of end stage renal disease, that is due to:

1. The increase in the prevalence (number of patients) in type 2 diabetes especially.
2. Patients with diabetes are living longer.
3. Patients with chronic renal failure due to diabetes mellitus are being accepted into dialysis programs / hemodialysis and kidney transplantation of which were previously excluded.

In patients with diabetes mellitus type 1 with 20 years of evolution, 50% of them develop diabetic nephropathy, and patients with type 2 diabetes mellitus only 10 to 20%. However, the great difference in prevalence (most common type 2) causes the majority of patients with diabetic nephropathy is secondary to type 2 diabetes mellitus.

NATURAL HISTORY

The earliest clinical sign of diabetic nephropathy is the appearance of low but abnormal albumin in the urine (more than 30 milligrams a day), which is called microalbuminuria, and microalbuminuria in patients with incipient nephropathy have, simultaneously with these patients develop hypertension (increased pressure in the blood). Without specific treatment of patients with incipient diabetic nephropathy reach the state of overt diabetic nephropathy, and once you get to frank diabetic nephropathy and there is no specific treatment renal function and decreases gradually over several years developing the ESRD.

Diagnosis

It must perform a screening test for microalbuminuria at the time of diagnosis of type 2 diabetes mellitus. Microalbuminuria is common in type 1 diabetes mellitus of short duration, which is why testing in patients with type 1 diabetes mellitus should be started at 5 years of onset. After the initial screening test, and absence of microalbuminuria, the evidence should be repeated once a year.

Albuminuria (albumin excretion in urine) also may be temporarily increased by hyperglycemia (elevated blood glucose) of short duration, exercise, urinary tract infection, hypertension pronounced, heart failure and febrile illness.

Albumin excretion varies significantly from day to day, so before determining that a patient has microalbuminuria should be found high levels in at least 2 of 3 collections made over a period of 3 to 6 months.

Treatment

Control of glucose (sugar) blood. Intensive treatment of diabetes mellitus can significantly decrease your risk of developing microalbuminuria and overt nephropathy in patients with diabetes mellitus.

Blood Pressure Control

To reduce the risk and delay progression of nephropathy, we must optimize blood pressure control. At the onset of overt diabetic nephropathy, decrease the nutritional value.

In an emergency or accident is important that the people around you know you live with diabetes and which type of diabetes you have.

Very importantly, we have no habit of using, is a medical ID, this means that you must always wear a bracelet, insert, or something that says you live with diabetes and that type.

It is also important that you remember to take with you all your medications and what they need to be well.

a) glycated hemoglobin is the average of 3 months you should do it every 4 months minimum. This is a blood analysis and you must try this very about 6 or less.

b) Lipid Profile to check that the body fat are normal (once or twice a year).

c) Profile thyroid is recommended once a year.

d) Albumin in urine once a year. To see that your kidneys are excellent as ever.

e) Ophthalmologist to review the fundus (twice a year).

f) cleaning dentist every 6 months.

“Ideally, before pregnancy do a routine Czech your eyes (the eye), blood pressure and kidneys. It’s very important to maintain glucose levels within normal range every day. Before each meal than 100mg/dl two hours after each meal between 140 and 150mg/dl .. It means you have to measure yourself many times in one day!

You must keep your glycosylated hemoglobin than 6%, we know that sometimes this is hard, but remember that if you really want.

Do a little exercise will help you a lot, I highly recommend swimming and water if they’re not very good walk also suit you.

As always a balanced diet is very important, remember to make 5 meals a day in small portions is very good, consult your nutritionist.

The generalization of overweight, obesity and diabetes among the population has already reached in many developed countries the size of a real pandemic, which in 2025 may affect worldwide to 300 million people, with a high risk of suffering severe vascular disorders.

The problem is much greater in countries like the U.S., where smoking also threatens to collapse the health system unless we take drastic measures to narrow, but the so-called “diabesity” ‘-clever contraction of the words diabetes and obesity-is reached worrying proportions in other developed countries.

The relationship between excess weight and diabetes was one of the main issues discussed during the last congress of the uropean Association for the Study of Diabetes (EASD) held in the city of Jerusalem. The participants have agreed on linking diabetes with the current sedentary lifestyle and poor diet which encourages overweight, and warned that there will be an escalation in the incidence of both diseases if urgent measures are taken so that society change their behavior.

Excess fat, excess sugar behaves like a true gland attached to the body and dangerous to your health. This is because fat cells secrete molecules that promote insulin resistance, a process that causes blood sugar to rise, along with promoting inflammation, alter immune response and damage the inner lining or endothelium of the blood vessels.

Diabesity sufferers are born with a pancreas that produce insulin in adequate quantity and works well. But due to obesity that insulin than before did its role in the body is now produced in exorbitant amounts, the muscles have to
carry the glucose to fly resistant to this hormone and an increased glucose level blood, in what is called diabetes II.

The continuous action of this explosive cocktail poses serious health consequences in the medium term as it adversely affects cardiovascular function, kidney and eye. The growing number of people who have this double disorder to endocrinologists concerned because diabetes type II only appeared among middle-aged or older, but now an increasing number of cases in all ages and is increasingly being diagnosed in patients younger, especially in children and adolescents overweight and very overweight.

Any person with excessive weight can end up developing diabetes,although there is a type of fat that predisposes them to suffermore type II diabetes: the “central obesity, where fataccumulates more easily around the abdomen and waist andconcentrates around the internal organs.

For many experts the solution to this problem, it can mean for the developed world a similar threat to that posed the infectiousdiseases for the poorest nations, is not dependent on drugs, but to avoid diets loaded with unhealthy fats and sugars and to make physical exercise a duty almost daily.

The Mediterranean diet, with olive oil or nuts, which lowers LDL or “harmful” and raises HDL, or “beneficial”, remains, accordingto experts, the best medicine to prevent obesity-binomialdiabetes.

By contrast, excess fast food or “junk”, and less consumption of fruits and vegetables, favor this disorder.

Diabetes often goes unnoticed because their symptoms appear to be harmless. New studies indicate that the early detection of diabetes symptoms and treatment can decrease the likelihood of developing complications of diabetes.

Symptoms of diabetes include:

* Frequent urination
* Constant thirst
* Excessive hunger
* Unexplained weight loss
* Increased fatigue and weakness
* Irritability
* Blurred vision

If you have one or more of these diabetes symptoms, see your doctor immediately. You can also take our risk test, test to identify risk factors for diabetes and