Glycemic Control Of End Stage Renal Disease

Why do we treat diabetes? There are a number of downstream events associated with abnormal blood glucose levels. If glucose levels are managed properly, the complications associated diabetes can be controlled, and sometimes completely prevented. The main problem with having more than the normal amount of glucose circulating in the blood stream is the effect that excess glucose can have on both large and small blood vessels (DTC, 2004). Micro-vascular and macro-vascular problems associated with diabetes can be seen in the heart, eyes, kidney, legs and feet. Diabetic patients are twice as likely to suffer from a mycocardial infaraction, twenty-five times more likely to suffer blindness, and seventeen times more likely to suffer kidney failure compared to a non-diabetic (DTC, 2004). Because of great number of risks associated with abnormal blood glucose levels, diabetes is aggressively treated to improve the quality of life and prevent complications in patients.

Diabetes is a disease where the body is unable to produce or use insulin effectively. Insulin is needed for proper storage and use of carbohydrates. Without it, blood sugar levels can become too high or too low, resulting in a diabetic emergency. It affects about 7.8% of the population. The incidence of diabetes is known to increase with age. It’s the leading cause of end-stage renal disease in the US, and is the primary cause of blindness and foot and leg amputation. It is known to cause neuropathy in up to 70% of diabetic patients. Individuals with diabetes are twice as likely to develop cardiovascular disease. There are two types of diabetes: Type 1 and Type 2.

Type 2 Diabetes is a disease that is found in a variety of age groups around the world. This disease is growing at a rapid rate and it is impacting the health of this generation and future generations to come. Diabetes is a disease that impairs the body’s ability to produce or respond to the insulin hormone produced by the pancreas. The insulin allows for the glucose to be effectively used as energy throughout the body. Diabetes causes carbohydrates to be abnormally digested, which can raise blood glucose levels. This means that the glucose is not being taken up by the cells that need it. The cells cannot take up the excess glucose that has accumulated in the blood, so it is excreted through the urine. This can lead to problems with the kidneys, central nervous system, heart, and eyes because high blood glucose can damage the blood vessels of these organs. This diseased is managed by adopting a diet low in fat and high in fiber, increasing physical activity, losing excess weight, and not smoking. If this

Nobel Prize winner Dr. Fredrick Banning once said, “Insulin is not a cure for diabetes; it is a treatment. It enables the diabetic to burn sufficient carbohydrates so that proteins and fats may be added to the diet in sufficient quantities to provide energy for the economic burdens of life”(Banning, 1928). The American Diabetes Association (ADA), states that 9.3% of the population has diabetes, which is why it was the 7th leading cause of death in the Unites States in 2010. The Center for Control Disease (CDC), states individuals younger than 20 years were newly diagnosed with Type 2 Diabetes annually (CDC, 2010). Physicians often instruct patients affected by Type 2 diabetics, to watch their diet and sustain a healthy, more active lifestyle.

Diabetes is an ongoing problem in not only the United States, but also the world. Diabetes is a condition where there is too much glucose in the blood

Chronic kidney disease is that is a decline in the function of the of the renal system due that can be measured by the glomerular filtration rate. Long term complication can lead to end stage renal failure which places patient to be on long-term dialysis. The incidence of chronic kidney is on a constant rise. The main cause of chronic disease is diabetes in combination with hypertension. In the United States, there are an estimated 25 million people who have been diagnosed with chronic kidney disease (CKD), and the prevalence is especially high among the elderly with approximately ten million cases in those over the age of 77. The purpose of this paper is to describe the clinical presentation of chronic kidney disease and describe potential factors that may impact the diagnosis and include treatment options.

Each year, at least 1 million people in the United States are diagnosed with diabetes, which makes this disease one of the nation's most serious health concerns that, if left unchecked, could reach epidemic proportions. And it doesn't stop there. Often, people who suffer from diabetes also have to contend with other complications, which not only increase the risk to the patient's health but also add to the rising cost of health care. This makes it necessary for an effective disease management program for diabetes to be in place.

The number of people who are getting affected by diabetes is increasing alarmingly. Perhaps, only by imparting knowledge and education among people, this trend can be arrested. The problem with diabetes is that it can lead to many other terrible health complications like heart ailments, kidney problems, obesity and so on.

When considered together with the other trials above, there remains a clear benefit of maintaining an HbA1c ≤7.0% for the majority of patients. Tight glycaemic control early in the diabetes disease process is desirable, and is likely to yield the greatest benefit for the prevention of micro- and macrovascular complications, as well as overall mortality. There is no evidence that maintenance of tight glycaemic control (e.g. HbA1c <6.0-6.5%) in a patient with long-standing well-controlled type 2 diabetes increases mortality risk. Attaining tight glycaemic control in advanced disease yields little, if any, benefit for macrovascular disease but this is still effective in retarding the development and progression of microvascular disease (Wright, Cull et al.

Diabetes mellitus has risen to epidemic proportions in the United States, from 1980 through 2011, the number of adults with diabetes has increased immensely from 5.5 million to 19.6 million (Centers for Disease Control and Prevention [CDC], n.d.). Diabetes global prevalence research by Wild, Roglic, Green, Sicree, and King (2004) predicted that, the total number of people with diabetes will rise from 171 million in 2000 to 366 million in 2030. Diabetes has many causative factors that encompass genetic, lifestyle, and environmental categories. Diabetes can vary in different individuals in correlation with their surrounding population and environmental exposures. Individuals who manage their diabetes often need specific plans and counseling.

Diabetic nephropathy, an irreversible kidney failure, continues to be the most common cause of end stage renal disease requiring either a kidney transplant or renal replacement therapies, such as dialysis (Bilous, 2013). Worldwide, approximately fifty percent of cases of end-stage chronic kidney disease are caused by diabetes mellitus, with type II comprising the majority (Vladu, 2014). The prevalence of diabetes has been estimated to increase worldwide with the total number of diabetics rising from 285 million in 2010 to 439 million in 2030 (Mantelo, Oliveira, Ferraz, Lima, & Silva, 2015). This rise in diabetes is a concern to public health, as the effects of diabetes can have life altering consequences.

Chronic Kidney Disease (CKD) is rising in incidence and prevalence placing a significant burden on healthcare resources worldwide. CKD is estimated to affect >10% of the global population, and is currently listed among the leading causes of death in the developed world (ranked ninth by WHO global health) with deaths attributable to CKD is expected to continue to rise. CKD is associated with comorbidities including anaemia, bone disease, diabetes and is recognised as an important risk factor for cardiovascular disease and cancer.

Obesity — A high body mass index (BMI) in patients with diabetes has been associated with an increased risk of chronic kidney disease. In addition, diet and weight loss may

First, a creatinine blood draw was obtained for one patient because of his history of renal failure. The patient was present at the hospital before and his current health care provider believes he needs a CAT scan but the hospitalist on duty did not want to do anything until the patient’s creatinine levels came back. These values “diagnose renal function” because creatinine is eliminated from the body by the kidneys (Pagana & Pagana, 2014, p. 191). Therefore, a high amount of creatinine in the body will indicate the kidneys’ inability to excrete this product. Second, glucose levels were measured in all diabetic patients who came into the ER. Since glucose is a form of sugar, increased levels will leave the patient with a high sugar content in their blood. Some patients cannot withstand glucose levels above a certain number. Therefore, the test results of this blood draw will indicate if the patient needs insulin to decrease their glucose

To examine the efficacy and safety of insulin and other pharmacological interventions for lowering glucose-lowering levels in patients with diabetics and Chronic Kidney Disease (CKD).