How can people with diabetes effectively prevent kidney disease?
Preventing diabetic kidney disease needs a proactive approach with optimal management of lifestyle, medications to control the risk factors, and regular screening.
Lifestyle changes are key in control of the metabolic risk factors for the kidney disease. Portion control of carbohydrates with increasing the vegetables, and lean proteins is important for good glycemic control. Eliminate simple carbs and processed sugars.
Salt restriction is necessary for control of hypertension. A physical activity schedule involving aerobic and resistance training with at least 150 minutes of moderate activity is necessary.
Weight loss of even 5% can improve the insulin sensitivity and reduce the blood pressure.
Adequate hydration is important for renal health. People with diabetes are at a higher risk for urinary infections. It is important to screen and treat the urinary infections promptly as ascending infections often cause renal dysfunction.
Especially people with additional risk factors like urinary stones, phimosis, and urethral strictures etc. need to be extra cautious. Medications such as NSAIDs, antifungals, and antibiotics which can potentially lead to renal injury should be used cautiously under medical supervision.
When choosing the medications in patients with diabetes, the risk for kidney disease needs to be considered. We have medications like SGLT2 inhibitors, and GLP1 receptor agonists which can reduce the progression of kidney damage independent of the glucose control they provide.
For patients with early signs of renal damage like proteinuria, these medications can delay and potentially prevent the onset of kidney disease.
In addition, we need to control the cholesterol levels to optimal targets for reduction of cardiovascular events in addition to renal protection. Medications used for control of blood pressure like ACE inhibitors and ARBs also reduce the proteinuria and help in prevention of progression of the kidney disease.
We have a new class of medications called non-steroidal MR blockers e.g. Finerenone which also reduce the proteinuria and prevent kidney disease progression.
With the help of lifestyle measures and appropriate medications, we should target optimal glucose levels with Hba1c <7% for most adults and to keep the blood pressure < 130/80 mm Hg.
Regular screening for kidney disease helps in early detection. Annual screening for proteinuria (using urine albumin to creatinine ratio) and estimated glomerular filtration rate (calculated based on serum creatinine level) is imperative for people with type 2 diabetes.
Timing of the intervention plays an important role in prevention of kidney damage. Educating the patients about complication screening during clinic visits for diabetes helps a lot.
At a community level educating the public with collaboration of dieticians, primary care physicians, endocrinologists, and nephrologists is imperative in spreading the awareness. Promoting widespread access to screening tests boosts efforts in early diagnosis and prevention.
We need to think of primordial prevention. Identifying the people with metabolic risk factors, and preventing diabetes, and hypertension through lifestyle measures will have a greater impact than interventions at a later stage.
To summarize, prevention diabetic kidney disease revolves around improvement of lifestyle, optimization of the metabolic risk factors through medications, and regular screening to diagnosed the kidney disease in a very early stage. With early diagnosis and optimal management, we can preserve the renal health and improve the quality of life for people with diabetes.
Dr. Varun Suryadevara, Endocrinologist, MBBS MD Internal Medicine DM Endocrinology, Apollo Hospitals, Bangalore
One step to a healthier you—join Times Health+ Yoga and feel the change
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
&w=3840&q=100)
Business Standard
7 hours ago
- Business Standard
New guidelines on blood pressure management: What you need to know
High blood pressure has quietly become one of the biggest health burdens worldwide, often going unnoticed until it leads to something serious. The American Heart Association (AHA), along with the American College of Cardiology (ACC), has now updated its blood pressure guidelines, focusing on prevention, early action, and personalised care. For patients and families, these changes are designed to make blood pressure management more relatable and achievable in daily life. Smarter tools for risk detection One of the standout changes is the introduction of a new risk calculator called PREVENT (Predicting Risk of Cardiovascular Disease EVENTs). This tool helps doctors customise treatment by looking beyond the numbers on your BP monitor. It considers factors such as kidney health, whether you're already on statins, and even the challenges of living in a disadvantaged neighbourhood, where hypertension is often more common. Laboratory testing has also been updated to ensure more reliable results, so that treatment is based on clear evidence rather than guesswork. Protecting your brain health The new guidelines draw attention to something often overlooked: the strong link between high blood pressure and memory loss or dementia. Hypertension is known to damage small blood vessels in the brain and is associated with Alzheimer's disease. Research shows that getting blood pressure under control early doesn't just protect your heart – it also helps safeguard brain health over the long term. Tailored medication strategies The days of 'one pill fits all' are over. The refreshed guidelines underline that many people, especially those with type 2 diabetes, obesity, or kidney disease, may need a more customised approach. Doctors are encouraged to consider options ranging from ACE inhibitors and ARBs to calcium-channel blockers, GLP-1 medications, or thiazide diuretics. Special focus on pregnancy Blood pressure management during and after pregnancy gets particular attention. Conditions like pre-eclampsia can pose risks for both mother and baby, making early detection vital. Blood pressure categories during pregnancy are now clearly defined: Non-hypertensive: under 140/90 mm Hg Hypertension in pregnancy: 140/90 mm Hg or higher Severe hypertension: 160/110 mm Hg or higher Here, the first number (systolic) measures pressure when the heart contracts, while the second (diastolic) reflects pressure when the heart rests. Updated categories for all adults For the general population, the AHA and ACC now outline six categories: Normal: under 120/80 mm Hg Elevated: 120–129 systolic and under 80 diastolic Stage 1 Hypertension: 130–139 systolic or 80–89 diastolic Stage 2 Hypertension: 140/90 mm Hg or higher Severe Hypertension: over 180/120 mm Hg without symptoms Hypertensive Emergency: over 180/120 with urgent symptoms such as chest pain, shortness of breath, vision problems, or trouble speaking Severe hypertension without organ damage can often be managed with timely adjustments to oral medicines. However, hypertensive emergencies need immediate hospital care to prevent damage to vital organs. Lifestyle comes first If your readings place you in stage 1 hypertension (systolic 130–139), medication isn't the first step anymore. Doctors will first encourage lifestyle changes that can have a major impact: Reduce daily salt intake to around 2,300 mg, ideally 1,500 mg Follow the DASH diet, rich in vegetables, fruits, whole grains, lean meats, legumes, and healthy oils Avoid alcohol completely, as even small amounts raise hypertension risk Aim for a modest weight loss of 5 per cent if overweight Stay physically active for at least 150 minutes a week, reduce stress, and maintain a regular sleep routine Getting home monitoring right Perhaps one of the most empowering changes is the emphasis on home monitoring. Taking your blood pressure correctly at home can help prevent misdiagnosis. The guidelines suggest: Sit upright with your back supported and feet flat on the floor Keep your arm at heart level and rest for five minutes before measuring Avoid caffeine, smoking, or exercise 30 minutes before the reading Measure at the same time each day and record results carefully These updates reflect a shift towards more personalised, proactive care. By focusing on prevention, lifestyle changes, and accurate monitoring, the guidelines aim to make hypertension management not just a doctor's prescription, but a part of everyday living. If you're concerned about your readings, the best step is to discuss with your healthcare provider which approach suits you best. For more health updates, follow #HealthWithBS
Time of India
10 hours ago
- Time of India
Common painkillers can increase the risk of repeated heart attacks: Study
Many people reach for over-the-counter painkillers like Advil, Motrin, or Aleve without a second thought, assuming they are completely safe for everyday use. However, a 2012 study suggests that heart attack survivors may need to exercise caution when using these common medications. Published in the Journal Circulation , the research examined the effects of nonsteroidal anti-inflammatory drugs (NSAIDs) and found that they can significantly increase the risk of repeated heart attacks and even death among individuals with a history of cardiovascular disease. While NSAIDs are generally considered safe for occasional use at low to moderate doses, the study emphasizes that people who have experienced a heart attack should consult their doctors before taking these drugs. Understanding the risks and exploring safer alternatives can be crucial for long-term heart health What the study revealed about painkillers and repeated heart attack risk The research, conducted in Denmark, followed nearly 100,000 people who had survived a first heart attack, monitoring their health outcomes over five years. During that time, almost half were prescribed NSAIDs for pain relief. The results showed a striking pattern: those who took NSAIDs were about 60% more likely to die within the first year compared to people who avoided them. The study also highlighted that the use of these drugs increased the risk of experiencing another heart attack or serious cardiovascular complication. These findings underline the importance of long-term monitoring for heart patients who continue to use such medications after their initial recovery. by Taboola by Taboola Sponsored Links Sponsored Links Promoted Links Promoted Links You May Like Buy Resmed AirSense 11 with flat 20% off ResMed Buy Now Undo Which painkillers pose the greatest risk Not all NSAIDs carry the same level of danger. The study found that diclofenac (sold under brand names like Voltaren and Cataflam) was linked to the highest rates of death and recurrent heart attacks, making it particularly concerning for people with cardiovascular conditions. Ibuprofen, one of the most widely used NSAIDs, also showed an elevated risk when taken regularly. In contrast, naproxen (found in Naprosyn and Aleve) appeared relatively safer and was associated with the lowest risk among NSAIDs. However, researchers stressed that 'lower risk' does not mean 'no risk.' Even naproxen should be used cautiously, and only under a doctor's guidance, especially in patients who already have heart problems. Why NSAIDs may be dangerous The biological reasons behind these risks are not fully understood, but researchers have put forward several explanations. One possibility is that patients taking NSAIDs may stop their daily low-dose aspirin, which is often prescribed after a heart attack to prevent clotting. Without aspirin's protective effects, the likelihood of another heart attack rises. Another theory is that NSAIDs themselves interfere with aspirin's ability to thin the blood, reducing its effectiveness against clot formation. Additionally, NSAIDs can increase blood pressure, cause fluid retention, and affect kidney function – all of which add stress to the cardiovascular system. This combination of factors likely contributes to the higher rates of recurrence and mortality seen in heart attack survivors who take these drugs. Safer alternatives for pain relief Given these risks, experts recommend that heart patients avoid NSAIDs unless absolutely necessary. The American Heart Association advises acetaminophen (Tylenol) as a safer alternative for mild to moderate pain because it does not carry the same cardiovascular risks. In cases where an NSAID must be used, doctors urge patients to take the lowest possible dose for the shortest amount of time. Timing also matters – if a patient is on both aspirin and an NSAID like ibuprofen, aspirin should be taken at least an hour beforehand to maintain its protective effect. Beyond medications, non-drug strategies such as physiotherapy, exercise, hot and cold therapy, or lifestyle adjustments may also help manage chronic pain without raising cardiovascular risk.
Time of India
5 days ago
- Time of India
American Heart Association releases new guidelines for blood pressure management
If you've ever been puzzled by blood pressure numbers or wondered what's really changed in the guidelines, you're in the right place. On August 14, 2025, the American Heart Association (AHA) and the American College of Cardiology (ACC), along with a slew of trusted partners, dropped their 2025 guideline for preventing, detecting, evaluating, and managing high blood pressure in adults. In the US, nearly half of adults (46.7%) have high blood pressure, and it's still the single most modifiable risk for death worldwide. This new guideline doesn't just outline targets, it puts you at the center, blending lifestyle, science, and real-world tools. Whether you're looking after your own health or supporting a loved one, it's about feeling empowered, not overwhelmed. Prevention first, but be ready to act fast Still the star of the show: lifestyle. Think heart-healthy diet, less salt, exercise, stress management, you know the drill. But the new guidance encourages early treatment, when needed, to help ward off not just heart attacks and strokes, but also kidney issues, type-2 diabetes, and even memory decline and dementia. Yes, your brain, too, is in the game. A smarter risk calculator: PREVENT Meet PREVENT, the brand new risk calculator debuting in 2023, now officially part of the guideline lineup. It estimates your 10- and 30-year risk of heart trouble by weighing age, blood pressure, cholesterol, and even zip code, as a nod to social determinants of health Sharper lab tests Kidneys and hormones get a closer look: the urine albumin-to-creatinine ratio test is now routine for all hypertensive patients, not optional anymore. . On top of that, the aldosterone-to-renin ratio test, used to detect a specific hormone-driven type of high blood pressure (primary aldosteronism), now applies to more people, especially if you also have sleep apnea or stage 2 hypertension. Brain health gets a spotlight Turns out, your blood pressure isn't just a heart and kidney issue, it's a brain issue, too. Even slight increases can chip away at memory and cognition. That's why the guideline now targets a systolic (upper number) goal of under 130 mm Hg, especially to protect your brain. Medication gets personalized For many adults, especially those juggling type-2 diabetes, obesity, or kidney disease, one pill might not do it. The updates encourage starting with drug classes like ACE inhibitors, ARBs, calcium-channel blockers, or thiazide diuretics. If stage 2 hypertension (140/90 mm Hg or up), a combo pill, two drugs in one, is often the way to go. And for some individuals struggling with obesity, adding newer options like GLP-1 medications (yes, the ones often in the headlines) may make sense. Pregnancy gets a careful tune-up Hypertension during pregnancy is no joke, with risks like preeclampsia or even preterm delivery. The guideline steps up: recommending low-dose aspirin (81 mg/day) for some, tighter blood pressure control during pregnancy (140/90 mm Hg threshold), and continued monitoring postpartum, because high blood pressure can hang around after childbirth. The lifestyle hot sheet: Real, doable, effective Here's your personal game plan: Salt: Keep it under 2,300 mg/day, ideally closer to 1,500 mg. Hint: packaged and restaurant foods are the main culprits, not the salt shaker. Alcohol: Skip it if you can. If not, aim for no more than two drinks/day for men, one for women. Stress: Not evict it, just manage it. Exercise, meditation, breathing checks, yoga, pick your calm. Weight: A modest 5% reduction can go a long way. Diet: Go for DASH, the Dietary Approaches to Stop Hypertension. Think fruits, veggies, whole grains, nuts, seeds, lean protein, low-fat dairy, and healthy oils. Exercise: At least 75–150 minutes per week of cardio and/or strength training. You got this. Home Monitoring: Don't just trust clinic readings—track your numbers at home too. It helps you, and it helps your doctor personalize treatment. 'High blood pressure is the most common and most modifiable risk factor for heart disease,' said Chair of the guideline writing committee Daniel W. Jones, M.D., FAHA, dean and professor emeritus of the University of Mississippi School of Medicine in Jackson, Mississippi, and was a member of the writing committee for the 2017 high blood pressure guideline. 'By addressing individual risks earlier and offering more tailored strategies across the lifespan, the 2025 guideline aims to aid clinicians in helping more people manage their blood pressure and reduce the toll of heart disease, kidney disease, Type 2 diabetes and dementia,' he told Eurekalert. The guideline, led by the American Heart Association and American College of Cardiology Joint Committee on Clinical Practice Guidelines, has been developed in collaboration with other health care organizations: the American Academy of Physician Associates; the American Association of Nurse Practitioners; the American College of Clinical Pharmacy; the American College of Preventive Medicine; the American Geriatrics Society; the American Medical Association; the American Society of Preventive Cardiology; the Association of Black Cardiologists; the National Medical Association; the Preventive Cardiovascular Nurses Association; and the Society of General Internal Medicine. Get the latest lifestyle updates on Times of India, along with Happy Independence Day wishes, messages , and quotes !
