Future Medicine

DISEASE SPECIAL Diabetes & Kidney How can we prevent damage to kidney?

Once the person is detected to have micro albuminuria, it is very necessary to control diabetes and blood pressure to the best extent possible and also reduce the salt intake by 50 percent.There is also a class of medicine called ACE inhibitors which can reduce the albumin leakage and prevent further kidney damage.

Do patients with kidney damage need insulin injections?

In the early stage of kidney disease, one can continue with the tablets for diabetes, but when the kidney damage becomes more pronounced and the creatinine levels increase, insulin treatment should alone be given for the patient.

Are all diabetics likely to develop kidney disease?

Diabetes kidney disease runs in families. The patients who belong to such families should be more careful.Apart from this,high salt intake, high blood pressure and cigarette smoking can cause kidney disease.

What is diabetic neuropathy?

Diabetic neuropathy is a condition where the nerves in the feet are affected and the person has no sensation in the legs and feet. This condition affects people who have uncontrolled diabetes and high cholesterol levels, and those who smoke cigarettes.

What is the danger of diabetic neuropathy?

Diabetic neuropathy can lead to serious problems in the feet like foot infection because patients tend to ignore injuries since they have no sensation.People who undergo massage of their legs and feet can develop severe infection.Diabetic neuropathy can lead to amputation if the person develops foot infection.

What are the latest methods available to treat diabetic foot infection?

A number of modern wound dressings are available with companies like Convatec who manufactures dressings using hydrofibre technology.With the negative pressure wound therapy from KCI, it is now possible to heal the wounds much faster.Stem cell injections from the bone marrow areavailable in India for the people who have reduced blood circulation in the wounds.

What about the diabetic footwear?

MV Hospital for Diabetes, Royapuram Chennai, has developed a number of diabetic footwear in collaboration with CLRI. Thefootwear is meant for the people who have diabetic neuropathy. Special footwear using customised footwear insole is also prepared for the people who have neuropathy and deformities in the feet.The ordinary footwear costs about Rs750while the customised footwear insoles cost about Rs 2000.

Any message for the people with diabetes?

• Control diabetes • Stop smoking • Control blood pressure • Reduce salt intake • Do regular exercise • Have a balanced and proper diet control • Check blood sugar level regularly and report to the diabetologist 44 FUTURE MEDICINE I April 2013