The Diabetes and Kidney Connection Nobody Talks About Enough

March was National Kidney Month, and if you or someone you love has diabetes, there are some things to keep in mind year-round. Your kidneys do a lot of heavy lifting to keep your body running. They filter 200 quarts of blood every day, manage blood pressure, support red blood cell production, and keep your bones strong. Diabetes can quietly damage them. We want you to know how that happens, and what you can do about it.

The Diabetes Connection

According to the Centers for Disease Control and Prevention (CDC), roughly one in three adults with diabetes also has chronic kidney disease, or CKD. And most of those people don’t even know it because CKD develops slowly, often with no symptoms in its early stages. By the time someone feels sick, the damage may already be serious.

The reason comes down to blood sugar. Each kidney contains millions of tiny filters called nephrons, and when blood sugar stays too high for too long, it damages the blood vessels inside them. Add high blood pressure, which is common in people with diabetes, and the strain on the kidneys compounds over time.

The American Kidney Fund notes that both type 1 and type 2 diabetes raise the risk of kidney disease. As Texas has some of the highest diabetes rates in the country, this hits close to home.

Catching It Early Changes the Outcome

Early detection matters. When kidney disease is found early, there are steps that can slow it down or keep it from getting worse. But when it goes unnoticed too long, it can eventually lead to dialysis or even a kidney transplant.

If you have diabetes, your doctor should be checking your kidney function at least once a year with two simple tests. The first is an eGFR, a blood test that measures how well your kidneys are filtering waste. The second is a urine albumin test, which detects whether a protein called albumin is leaking into your urine. Healthy kidneys keep that protein in your blood, so when it shows up in your urine, it’s one of the earliest signs something is wrong.

You can lose a significant amount of kidney function before any symptoms show up. If you’re not sure whether you’ve been tested recently, bring it up at your next appointment.

What You Can Do Right Now

Managing your diabetes well is one of the best things you can do for your kidneys. That means keeping your blood sugar in the target range your doctor set for you and getting your A1C tested at least twice a year. Blood pressure control matters just as much here, since high blood pressure is one of the biggest drivers of kidney damage.

Where you start depends on your stage. Early on, it’s about finding the cause, whether that’s high blood pressure, diabetes, lifestyle habits, or medications, and getting it under control. As things progress, the goal shifts to protecting existing function and staying off dialysis as long as possible.

Staying active, drinking enough water, and taking your medications the way they’re prescribed are all important. If you smoke, quit. It’s one of the single most protective moves for your kidneys and your heart. The National Kidney Foundation has also noted that certain diabetes medications, including newer drugs like SGLT2 inhibitors, have shown promise in slowing kidney decline. Ask whether your current medication plan includes kidney-protective options.

What You Eat Matters More Than You Think

Diet is a powerful tool too. Sean Michael Barrett, Legacy’s Director of Nutrition and Fitness, says patients rarely connect what they eat to what’s happening in their kidneys, simply because they can’t feel it yet. When you have both diabetes and kidney disease, you need to manage two concerns at once: carbohydrates for blood sugar control — keeping snacks in the 15-30 gram range — and potassium, phosphorus, sodium, and calcium for kidney health, because those are exactly what the kidneys are responsible for filtering.

Eating well with kidney disease means making choices that work for both conditions. Kidney-friendly snack options include things like cottage cheese with blueberries, toast with peanut butter, cheese with unsalted crackers or hummus with vegetables. Some patients may also need to be mindful of protein intake, and a doctor may recommend phosphate binders at mealtimes to help keep phosphorus levels in check.

A dietitian can help you figure out what works for your labs, your stage, and your life.

You Don’t Have to Figure This Out Alone

We get it. Managing diabetes already takes a lot of mental energy. Thinking about your kidneys on top of that can feel like one more thing on a too-long list. At Legacy Community Health, our care teams can help you manage diabetes and keep an eye on your kidney health in the same visit. Small shifts, kept up over time, really do add up.

This spring, schedule a visit and make sure your kidneys are part of the conversation. Ask about your eGFR and urine albumin levels. Talk to your doctor about blood pressure goals. Don’t wait until something feels off, because kidney disease is the kind of thing where waiting means losing your best chance to act.

Sources:

CDC, Diabetes and Chronic Kidney Disease; American Kidney Fund, Diabetes and Kidney Health; National Kidney Foundation, Kidney-Protective Diabetes Medications; NIDDK, Help Patients Understand the Role of Kidneys; Texas HHS, Chronic Kidney Disease; Legacy Community Health, Healthy Holidays and Diabetes