Diabetic nephropathy (kidney damage)

Diabetic nephropathy is a serious complication of diabetes. Many diabetics develop this complication after a duration 15-20 years.

How to suspect diabetic nephropathy

1. Appearance of albumin in urine which is detected by " Urine albumin test".

2. Rise in blood urea & serum creatinine levels.

Control of sugar is very important & a Nephrologist ( Kidney specialist) should be consulted. If neglected, it may lead to renal (kidney) failure & may need "dialysis". Dialysis may be needed on multiple occasions. This helps in maintaining electrolyte balance of body. Thus it prevents acidosis.

Diet & Anti-Diabetic Drugs

Diet

1. Diabetic patient should have small frequent meals throughout the day rather than eating more at a time. Always remember - Hypoglycemia is more dangerous than hyperglycemia.

2. Have whole grains and pulses food dishes

3. Avoid refined food items & junk food.

4. Add dietary fibers like fruits, leafy vegetables, millets in your daily diet. can Have a teaspoon of flaxseed powder, fenugreek powder which help in regulating blood sugar. Synchronize your meals with medications, physical activity and insulin dosage.

5. Bananas consist mainly of sugars (glucose, fructose and sucrose). So diabetics should avoid eating bananas in excess.

6. Dairy products – sweets made from milk, butter.

Oral hypoglycemic drugs

1) Sulfonyl urea

2) Biguanides- metformin

Phenformin –not used due to lactic acidosis
Newer drugs like glitazones –rosiglitazone,pioglitazone are used.

Diabetic Foot & Care

Diabetic Foot

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In diabetic patients, wound healing occurs slowly. Tight sugar control, wound dressing is needed. This can lead to infections. If neglected, it may lead to gangrene & amputation ( cutting of the part of foot ) may be required to save the patient from risk of septicemia.
Diabetic patients are advised to use special type of footwears which will not cause any injury to foot

Anti-VEGF Drugs

VEGF

VEGF is ne of the factors responsible for pathogenesis of diabetic retinopathy.

Which Drug Is Most Commonly Used ?.

Bevacizumab - It is available as- trade name " Avastin".

When this drug is given

1. In cases of nonresolving vitreous hemorrhage ( Blood in eye which is not clearing) where laser is not possible

2. Before vitrectomy surgery