World Diabetes Day Link To Kidney Disease

diabetes52Diabetic Nephropathy is the #1 cause of kidney failure

Almost a third of people with diabetes develop kidney disease.

People with diabetes often have other chronic conditions, such as high cholesterol, high blood pressure and blood vessels disease, as well as nerve damage to their bladder, bladder infections and nerve damage, which means kidney disease is either already present or likely to be on the horizon.

Diabetes comes in two main types and each one requires different treatment.

There are two types of kidney disease in people with diabetes. In type 2 diabetes, the kidney disease may already exist by the time they’re diagnosed with diabetes.

About 90% of people with diabetes have the Type 2 version. In this case their bodies don’t produce enough insulin naturally or work well. Diet and exercise are critical for them.

Symptoms of Diabetes

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Symptoms of diabetes include: always feeling tired and hungry, frequent urination, blurry vision, numbness or tingling in hands or feet, always thirsty, wounds that won’t heal, sudden weight loss, sexual problems, vaginal infections. See your medical provider to get tested if you recognize these symptoms in yourself.

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In type 1 diabetes, diabetic nephropathy develops a decade post diabetes diagnosis.

Type 1 sufferers need to regularly inject themselves with insulin or use an insulin pump. It may develop at any age.diabetes8

Symptoms of Diabetic Nephropathy

Early onset of diabetic nephropathy has no symptoms. As kidney function worsens, symptoms may include:

  • Poor appetite
  • Weakness
  • Trouble concentrating
  • Trouble sleeping
  • Swelling of hands
  • Swelling of feet
  • Swelling of face
  • Nausea
  • Itching (a sign of end-stage kidney disease)
  • Extremely Dry Skin
  • Drowsiness (a sign of end-stage kidney disease)
  • Muscle twitching
  • Irregular heart rhythm (a sign of increased potassium in blood)

It’s a condition known as uremia that’s extremely dangerous as people can become confused and occasionally comatose.

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Diagnosing Diabetic Nephropathy

Specific blood tests and urine tests can diagnose kidney damage. It also can be detected early by finding protein in the urine.

If you have diabetes, make sure to have your urine tested annually.

Treatment for Diabetic Nephropathy

Treatments are available that can help slow the progression of kidney failure.

It’s important to maintain blood sugar control to lower blood pressure. Some medicines called angiotensin converting enzyme (ACE) inhibitors can help slow down the progression of kidney damage.

Although ACE inhibitors — including ramipril (Altace), quinapril (Accupril) , and lisinopril (Prinivil, Zestril) — are usually used to treat high blood pressure and other medical problems, they are often given to people with diabetes to prevent complications, even if their blood pressure is normal.

If a person has side effects from taking ACE inhibitors, another class of drugs called angiotensin receptor blockers (ARBs) can often be given instead.

If not treated, kidneys will continue to fail and larger amounts of proteins can be detected in the urine.

Advanced kidney failure requires treatment with dialysis or a kidney transplant from a cadaver donor. The waiting list for a kidney is currently close to 100,000 people. The other option is finding a living donor that is a match–a family member (they’re not always a match), spouse, friend or a stranger willing to give you the gift of life.

A kidney specialist is called a nephrologist and you need to find one as soon as your kidneys begin to fail so they can help you with diet and treatments.

With medical guidance and dietary changes, symptoms can be eased, and progression of the disease can be slowed.

FLOOD SISTERS KIDNEY FOUNDATION  is an excellent resource if you’re experiencing kidney failure or are in need of finding a living kidney donor.

Jennifer Flood and her sisters founded the foundation after finding a total stranger to be a living donor for her father ten years ago. It began with her tenacious use of social media (on Craigslist) that caught broadcast media attention nationwide.

The awareness not only saved her dad’s life, but left her and her sisters with an abundant supply of willing living kidney donors, which then sparked the idea to start a foundation to help other people.

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“Upon kidney failure, a lot of people end up on dialysis and then enter themselves on the long waiting list without realizing we have resources available to help them understand their best option is to find a living kidney donor.”

“Our foundation helps by actively seeking perfectly healthy strangers who are willing to donate their kidney now.”  

Jennifer Flood, President/CEO, Flood Sisters Kidney Foundation

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Dolly Parton with (left to right) Jennifer Flood’s daughter, Heather Flood and their Mom Roseann Flood

Flood Sisters Kidney Foundation has gained the attention and support from celebrities like Jon Bon Jovi, Barbara Corcoran, Dolly Parton, Geraldo and many more who helped a loved one find a non-related living kidney donor through their foundation.

“For us today, it starts with a commitment to provide trusted MDTV compliant education and awareness. Working with MDTV select hospitals to navigate through the clutter and ultimately providing an altruistic living donor for our client in need.”- Jennifer Flood, President/CEO, Flood Sisters Kidney Foundation 

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Rachel Ray, Barbara Corcoran with friend matched with living kidney donor

But Flood sisters are not stopping there because as Jennifer says:

“Almost one-third of people with diabetes develop kidney disease. Kidney failure is not just for the rich and famous. It’s actually even more pervasive in poor communities.”

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Since 1972, poor people who get stuck on dialysis automatically become covered by medicare insurance and the dilemma is they lose all hope or just don’t know about the living kidney donor transplant option.

According to MDTV it costs over $75,000.00 to educate a community and find just one altruistic living kidney donor. It seems such a small price to pay to save a life, especially since the cost of dialysis is $84,000.00 per year (paid for by Medicare).

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Paul Argen
, CEO and Executive Producer of MDTV says, “Flood Sisters broke the code for people who are stuck on dialysis and want the best option to return to some normalcy. I am so impressed with the great work of Flood Sisters Kidney Foundation that we now have formed an exclusive partnership of collaboration to fund this effort with a long-term commitment to penetrate hundreds of these communities nationwide. Our partnership not only will give people renewed hope and save lives, but deliver a unified channel of education for families, hospitals, caregivers, providers, public health and the media to embrace. We are getting ready to move the needle in this disease state –a much-needed Angelic Gift for society. Stay tuned. Coming soon.”

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Jon Bon Jovi with his good friend and attorney Jerry who found a living donor match

Remember, only people with end stage kidney disease can be listed for deceased donor transplantation. But living donor transplants can be “pre-emptive” taking place before the need for dialysis. This has a lot of health advantages.

People who choose pre-emptive transplantation have a lower risk of death and loss of kidney transplant function, compared to those who spent time on dialysis beforehand.

The good news is according to 26 studies involving almost 500 kidney donors, 95% of kidney donors in the United States, rate their experience as good to excellent.

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Chuck Scarborough with 3 sisters (twins Cynthia & Jennifer and Heather on rt) and their dad, Daniel Flood

 

We support the work of Flood Sisters Kidney Foundation as the best resource for matching people with living kidney donors and raising awareness about it.

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You’re not a celebrity, non-celebrity or number to them. You’re family.
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Other complications of diabetes include:

  • dental and gum diseases
  • eye problems and sight loss
  • foot problems, including numbness, leading to ulcers and untreated injuries
  • nerve damage, such as diabetic neuropathy

Fatal complications include heart disease, stroke and kidney disease.

In the case of kidney disease, this complication can lead to kidney failure, water retentionwhen the body does not dispose of water correctly, and a person experiencing difficulties with bladder control.

Regularly monitoring blood glucose levels and moderating glucose intake can help people prevent the more damaging complications of type 2 diabetes.

For those with types 1 diabetes, taking insulin is the only way to moderate and control the effects of the condition.

Meantime, everyone in the world can benefit from paying attention to their nutrition and how it affects them.

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Here Are Nutritional Tips for People With Diabetes and Kidney Disease

Sodium

Sodium can build up when kidneys start to fail, causing fluid to accumulate in tissues. It’s called edema, and will show up as swelling in hands, face and lower extremities.

Most organizations recommend limiting sodium to 1,500-2,300mg/daily.  Besides table salt itself, other high sodium foods you want to avoid are: bacon, ham, canned or instant soups, canned vegetables, cheese, crackers, salted nuts, olives, potato chips, processed foods, soy sauce, barbecue sauces, bottled sauces, pickles, bouillon cubes, dehydrated soups.

Read sodium content on all labels.

Reduce or eliminate processed foods.

Potassium

 

When kidneys can’t filter out potassium, too much can circulate in your blood.

An excess of potassium can be very dangerous because it can cause irregular heart rhythm, which could become severe enough to cause your heart to stop working.

Restricting high potassium foods can help prevent this from happening.

Regular blood tests to monitor your potassium levels can alert your doctor to potential problems. If you must restrict your potassium levels, most people need to limit their intake to ~2000mg/daily.

If you are someone who has diabetes and often experiences low blood sugar, you’ll want to avoid treating with orange juice and will want to use glucose tablets instead.

High-potassium foods include bananas, broccoli, raisins, tomatoes, apricots, baked beans, beets, cantaloupe, collard and other greens, molasses, mushrooms, nuts, oranges, peanut butter, potatoes, dried fruit, salt substitute, and chocolate.

Phosphorus

Hyperphosphatemia (high phosphorus levels in the blood) does not typically become evident until stage 4 chronic kidney disease.

When kidneys start to fail, phosphorus can start to build up in your body. This causes an imbalance with calcium, which forces the body to use calcium from the bones.

It’s important to keep phosphorus levels close to normal to prevent weakening bones.

Reducing high phosphorus foods you eat is one way to keep phosphorus levels down. If you must, most people benefit from restricting phosphorus to 800-1000mg/daily.

Reducing phosphate additives includes eliminating foods that contain ingredients such as, sodium acid pyrophosphate or monocalcium phosphate.

Other foods rich in phosphorus to avoid include beer, bran cereals, peanut butter, caramel, cheese;, cocoa, cola, dried beans, ice cream, liver, milk and milk products, nuts, and sardines.

Carbs

If you have diabetes and kidney disease you still want to include carbohydrate sources, but from vegetables, fruit, and whole grains.

You want to avoid beverages and sugars with sucrose and high fructose corn syrup.  .

If you are someone with advanced kidney disease you may have to discuss reducing intake of high potassium and high phosphorus sources of carbohydrate with your dietitian.

Protein

Too much protein can be bad for your kidneys if you’re living with kidney disease.

When choosing proteins, aim to include lean sources of protein, such as white meat chicken, fish, turkey, and lean beef.

Fats

Focus on incorporating healthy fats into the diet such as oils, and fatty fish and avoid saturated fats and trans fats – processed meats, full-fat cheese, and desserts.

It seems like there’s almost nothing left to eat after you see this list. Fear not.

See “The 20 Best Foods For People With Kidney Problems” by Jillian Kubola, MS, RD at: https://www.healthline.com/nutrition/best-foods-for-kidneys

Discuss your nutrition with your dietitian as it can vary depending on your treatment plan. 

Again, symptoms of kidney damage are:

Urinary issues, anemia, itchy skin, feeling excessively cold, chills, nausea, vomiting, swelling in ankles, legs or face, shortness of breath, metallic taste in mouth or bad breath.

See your physician for a blood and urine test to check the wellness of your kidneys if you’re concerned. They don’t automatically check this. You need to ask.

Stay informed.  Stay healthy.

 

 

 

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New Migraine Prevention Guidelines

According to the journal, Neurology, some over-the-counter meds, such as ibuprofen & naproxen may prevent migraines.

The guidelines also recommend spikey plant petasites, also known as butterbur, beta-blockers and some prescription drugs for migraine prevention.

Dr. Stewart Tepper treats migraine headaches at Cleveland Clinic.

“This is an easy way for a doctor or care provider to look at what is likely to work and on what basis is that drug likely to work.”

Dr. Tepper recommends you seek out a board certified headache medicine specialist if nothing works.

MIGRAINE SYMPTOMS

By Mayo Clinic staff

Migraine headaches often begin in childhood, adolescence or early adulthood. Migraines may progress through four stages — prodrome, aura, attack and postdrome — though you may not experience all the stages.

Prodrome
One or two days before a migraine, you may notice subtle changes that may signify an oncoming migraine, including:

  • Constipation
  • Depression
  • Diarrhea
  • Food cravings
  • Hyperactivity
  • Irritability
  • Neck stiffness

Aura
Most people experience migraine headaches without aura. Auras are usually visual but can also be sensory, motor or verbal disturbances. Each of these symptoms typically begins gradually, builds up over several minutes, then commonly lasts for 10 to 30 minutes. Examples of aura include:

  • Visual phenomena, such as seeing various shapes, bright spots or flashes of light
  • Vision loss
  • Pins and needles sensations in an arm or leg
  • Speech or language problems

Less commonly, an aura may be associated with aphasia or limb weakness (hemiplegic migraine).

Attack
When untreated, a migraine typically lasts from four to 72 hours, but the frequency with which headaches occur varies from person to person. You may have migraines several times a month or much less frequently. During a migraine, you may experience some of the following symptoms:

  • Pain on one side of your head
  • Pain that has a pulsating, throbbing quality
  • Sensitivity to light, sounds and sometimes smells
  • Nausea and vomiting
  • Blurred vision
  • Diarrhea
  • Lightheadedness, sometimes followed by fainting

Postdrome
The final phase — known as postdrome — occurs after a migraine attack, when you may feel drained and washed out, though some people report feeling mildly euphoric.

When to see a doctor
Migraine headaches are often undiagnosed and untreated. If you regularly experience signs and symptoms of migraine attacks, keep a record of your attacks and how you treated them. Then make an appointment with your doctor to discuss your headaches and decide on a treatment plan.

Even if you have a history of headaches, see your doctor if the pattern changes or your headaches suddenly feel different.

See your doctor immediately or go to the emergency room if you have any of the following signs and symptoms, which may indicate other, more serious medical problems:

  • An abrupt, severe headache like a thunderclap
  • Headache with fever, stiff neck, rash, mental confusion, seizures, double vision, weakness, numbness or trouble speaking
  • Headache after a head injury, especially if the headache gets worse
  • A chronic headache that is worse after coughing, exertion, straining or a sudden movement
  • New headache pain if you’re older than 50

New Guidelines: Treatments Can Help Prevent Migraine

NEW ORLEANS – Research shows that many treatments can help prevent migraine in certain people, yet few people with migraine who are candidates for these preventive treatments actually use them, according to new guidelines issued by the American Academy of Neurology. The guidelines, which were co-developed with the American Headache Society, were announced at the American Academy of Neurology’s 64th Annual Meeting in New Orleans and published in the April 24, 2012, print issue of Neurology®, the medical journal of the American Academy of Neurology.

“Studies show that migraine is underrecognized and undertreated,” said guideline author Stephen D. Silberstein, MD, FACP, FAHS, of Jefferson Headache Center at Thomas Jefferson University in Philadelphia and a Fellow of the American Academy of Neurology.

“About 38 percent of people who suffer from migraine could benefit from preventive treatments, but only less than a third of these people currently use them.”

Unlike acute treatments, which are used to relieve the pain and associated symptoms of a migraine attack when it occurs, preventive treatments usually are taken every day to prevent attacks from occurring as often and to lessen their severity and duration when they do occur.

“Some studies show that migraine attacks can be reduced by more than half with preventive treatments,” Silberstein said.

The guidelines, which reviewed all available evidence on migraine prevention, found that among prescription drugs, the seizure drugs divalproex sodium, sodium valproate and topiramate, along with the beta-blockers metoprolol, propranolol and timolol, are effective for migraine prevention and should be offered to people with migraine to reduce the frequency and severity of attacks. The seizure drug lamotrigine was found to be ineffective in preventing migraine.

The guidelines also reviewed over-the-counter treatments and complementary treatments. The guideline found that the herbal preparation Petasites, also known as butterbur, is effective in preventing migraine. Other treatments that were found to be probably effective are the nonsteroidal anti-inflammatory drugs fenoprofen, ibuprofen, ketoprofen, naproxen and naproxen sodium, subcutaneous histamine and complementary treatments magnesium, MIG-99 (feverfew) and riboflavin.

Silberstein noted that while people do not need a prescription from a physician for these over-the-counter and complementary treatments, they should still see their doctor regularly for follow-up.

“Migraines can get better or worse over time, and people should discuss these changes in the pattern of attacks with their doctors and see whether they need to adjust their dose or even stop their medication or switch to a different medication,” said Silberstein.

“In addition, people need to keep in mind that all drugs, including over-the-counter drugs and complementary treatments, can have side effects or interact with other medications, which should be monitored.”

-more-Learn more about the guideline’s recommendations at http://www.aan.com/guidelines.

The American Academy of Neurology, an association of more than 25,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as stroke, Alzheimer’s disease, epilepsy, Parkinson’s disease and multiple sclerosis.

The American Headache Society® (AHS) is a professional society of health care providers dedicated to the study and treatment of headache and face pain. The Society’s objectives are to promote the exchange of information and ideas concerning the causes and treatments of headache and related painful disorders. Educating physicians, health professionals and the public and encouraging scientific research are the primary functions of this organization. AHS activities include an annual scientific meeting,

a comprehensive headache symposium, regional symposia for neurologists and family practice physicians, publication of the journal Headache and sponsorship of the AHS Committee for Headache Education (ACHE). http://www.americanheadachesociety.org

For more information about the American Academy of Neurology, visit http://www.aan.com or find us on Facebook, Twitter, Google+ and YouTube.

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SPECIAL ARTICLE

Evidence-based guideline update: Pharmacologic

treatment for episodic migraine prevention

in adults

Report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society

ABSTRACT

Objective: To provide updated evidence-based recommendations for the preventive treatment of migraine headache. The clinical question addressed was: What pharmacologic therapies are proven effective for migraine prevention?

Methods: The authors analyzed published studies from June 1999 to May 2009 using a struc- tured review process to classify the evidence relative to the efficacy of various medications avail- able in the United States for migraine prevention.

Results and Recommendations: The author panel reviewed 284 abstracts, which ultimately yielded 29 Class I or Class II articles that are reviewed herein. Divalproex sodium, sodium val- proate, topiramate, metoprolol, propranolol, and timolol are effective for migraine prevention and should be offered to patients with migraine to reduce migraine attack frequency and severity (Level A). Frovatriptan is effective for prevention of menstrual migraine (Level A). Lamotrigine is ineffective for migraine prevention (Level A). Neurology® 2012;78:1337–1345