Diabetes and kidney disease in Ghana

Diabetes is a very common disease in Ghana. It affects about six out of every 100 people in Ghana. It occurs when you lose the ability to control your blood sugar levels due to malfunction of the organ in the body called the pancreas. The pancreas is responsible for the release of a substance that controls your sugar level (insulin). Diabetes affects both young and old, male and female, black and white. It can also run in families. Your risk of diabetes increases if someone in your family has been diagnosed as being a diabetic.

Diabetes affects virtually every part of the body such as the brain, the eyes, the heart, the blood vessels, the intestines, the nerves and the kidneys. It causes poor healing of wounds and may lead to loss of limbs by amputation in some cases. It also causes numbness and burning sensation in the fingers and toes. Diabetes can also cause men to become impotent and this is a problem with dire psychological consequence to men and may even lead to divorce and suicide in some cases.

Diabetes is a global health problem due to its numerous complications. It should therefore be identified early and managed appropriately. Diabetes is the most common cause of kidney disease worldwide. It is a major cause of kidney diseases in Ghana. Kidney complications from diabetes can be prevented with proper care and regular checkups with your health care provider. The aim is to keep sugar controlled at all times and look out for complications. Sugar control can be achieved with medications taken by mouth or insulin injections.

If you are diagnosed with diabetes, it is very necessary to have your doctor assess your urine at regular intervals for presence of proteins (a nutrient that is NOT supposed to be in your urine) and your blood for the level of creatinine (a substance produced by muscles in the body which helps identify kidney disease).

What alerts you of kidney disease if you have diabetes?

1. When your requirement of your diabetic medications/injection keep reducing
2. When your sugar level drops to very low levels on your regular medication
3. When your feet begins to swell.
4. When you start seeing swelling around your eyes on waking up from bed
5. When you start losing clarity of your vision
6. When you feel tired very easily, experience dizziness and look pale
7. When you start experiencing poor appetite, nausea or even start vomiting especially in the mornings
8. When your urine is very frothy or foamy
9. When the amount of urine you are passing begins to decrease than normal
10. When you develop high blood pressure when you have not been hypertensive previously.

When you have any of the above symptoms, please check your kidney functions.

It is worrying as I see patients on daily basis who have been diagnosed of diabetes but are not screened for kidney diseases regularly and still present very late with kidney disease in the end stage.  At this stage, options for recovery are limited and patients will therefore have to be put on hemodialysis (a machines that remove the toxins from your blood when the kidneys fail) or get a kidney transplant. Management of kidney diseases is very expensive.

How do you prevent diabetic kidney disease?

1. Ensure you have well controlled sugar levels all the time
2. See the dietician regularly for advice on diet that help in sugar control.
3. Ensure your blood pressure is checked and well controlled at all times
4. You should be given medications by your doctor that decreases the protein in your urine and prevent worsening of your kidney function.
5. Avoid painkiller abuse and over-the-counter medications that affects the kidneys
6. Don’t use medications both herbal and non-herbal without knowledge of their effect on your kidneys
7. Maintain a healthy eating habit
8. Keep exercising regularly
9. Ensure you prevent infections and ensure infections are well treated always.
10. Avoid excessive intake of alcohol

By Dr. Elliot Koranteng Tannor (Physician Specialist/Nephrologist)