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October 25, 2003

Complications

Question from Bellingham, Washington, USA:

I am 59 years old, developed neuropathy in my feet a year and a half ago, was diagnosed with type 2 diabetes two months ago, and it has taken this long for doctors to find out what I had. I have protein in my urine, and I am wondering if my kidney condition can be improved/cured over time by my current weight reduction/exercise program. My readings average 98-135 mg/dl [5.4-7.5 mmol/L] at the present time.

Answer:

The most important interventions for treatment of diabetes involvement of the kidneys are good blood pressure control and good blood sugar control. Diet and exercise can help with blood sugars, but they are not effective once protein in the urine is persistent.

In this case, it is important for patients to be treated with a drug from either the ACE inhibitor class or the angiotensin II receptor blocker class. These medications have been shown to have protective effects on the kidney that help to prevent progressive kidney function loss over time.

You need to speak with your physician about these issues and individualize your medical therapy. This is not to say that diet and exercise have a role in treating hypertension. They can be effective, but their potency is not as great as the medications spoken of above.

JTL

[Editor’s comment: Also, see How to Protect your Kidneys at the Diabetes Monitor.

WWQ]