DKD, or diabetic nephropathy: pathophysiology, symptoms, risk factors, diagnosis and management. For patient education. This video is available for instant download licensing here: https://www.alilamedicalmedia.com/-/galleries/narrated-videos-by-topics/diabetes/-/medias/0079bcc6-2a8f-48d6-947d-57b464d2e271-diabetic-kidney-disease-narrated-animation
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Diabetic kidney disease, or diabetic nephropathy, is kidney disease caused by diabetes. It’s a very common diabetic complication, affecting about one third of people with diabetes type 1, and half of those with diabetes type 2. Diabetic kidney disease is responsible for most of the excess mortality associated with diabetes.
Because the kidneys remove metabolic wastes, control blood pH, regulate fluid and electrolyte balance, as well as produce several hormones; loss of kidney function results in accumulation of toxic wastes, electrolyte imbalances, and a number of other health problems.
The disease develops slowly over time, progressing from renal insufficiency to end-stage renal failure. Often, initial loss of renal tissue does not produce any symptoms. Symptoms typically appear when a significant portion of kidney function is already lost. The ability to concentrate urine is usually the first to be impaired, resulting in frequent trips to the bathroom, especially at night. Other early signs include fatigue, loss of appetite, and decreased mental ability.
Chronic high blood glucose levels, together with high blood pressure caused by diabetes, bring damage to tiny blood vessels in the kidneys, affecting their functions. Cellular degeneration in the functional units of the kidneys, the nephrons, in particular the podocytes of renal glomeruli, further contributes to the impairment of renal functions.
Diabetes, especially when poorly managed, is the biggest risk factor for chronic kidney disease. Other risk factors are the same as those for high blood pressure and include smoking, having high cholesterol levels, and being overweight.
Because initial loss of renal tissue does not produce any symptoms, it is important for diabetic patients to test annually for kidney functions. The tests typically include blood and urine analysis.
Prevention and management strategies consist of controlling blood sugar levels, blood pressure, and cholesterol levels; all of which can be achieved with a combination of lifestyle changes and medications.
Lifestyle measures typically include a healthy diet with low salt intake, increased physical activity, weight management, and smoking cessation.
Among all blood pressure lowering medications, ACE inhibitors and angiotensin receptor blockers, which block the renin–angiotensin–aldosterone system, work best to protect kidney functions.
End-stage kidney disease requires dialysis or kidney transplantation.
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Below are very safe supplements shown to improve insulin sensitivity
-Vitamin D
-Magnesium
-Chromium
-Cinnamon
-Apple cider vinegar
-Fish oil
-Tumeric
-Zinc
-Exercise/muscle contraction upregulates Glucose transporters in an insulin-independent fashion lowering blood glucose!

Personally, I believe excessive positive energy balance (obesity+sedentary), coupled with a genetic predisposition towards ectopic fat deposition and beta cell susceptibility for lipotoxicity, are major factors leading to insulin resistance.

VLDL — pancreas fat
Hypertrophic adipose tissue — lpl modification — higher residence time
Hypertrophic adipose tissue — Lipolysis — liver beta oxidation — Gluconeogensis
GWAS — susceptible to pancreas damage — T2D
Subcutaneous hypertrophy — macrophage release Lipolysis THF-alpha & IL-6 — Lipolysis — DAG in liver — PKC epsilon in liver

(PKC theta in muscle)

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Support the Northwest Regional SCI System by donating at https://acceleratemed.org/sci

Presented at the SCI Forum on April 22, 2020

Known as a “silent killer”, cardiometabolic disease (which includes obesity, high blood pressure, high blood sugar, and high cholesterol) affects more than a quarter of adults in the United States. For individuals with spinal cord injuries, maintaining a healthy heart and weight can come with unique challenges. Dr. Nicholas Dabai, DO with the Veterans Association Puget Sound Health Care System provides an overview of how this disease affects people with SCI. Dr. Dabai discusses the current guidelines for diagnosis, and offers recommendations on ideal nutrition, exercise, and medicine. If you want to learn how to spot cardiometabolic disease and keep your heart healthy, this forum is for you!

For resources shared in this presentation (DASH Eating Plan, Mediterranean-Style Diet, Eat Right Tips & Handouts, and Hand-Bike Exercise Study) please visit our website at https://sci.washington.edu/info/forums/video/cmd/.
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Is diabetes a curable disease or is it incurable?
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Professor Eran Segal of the Weizmann Institute speaks with Eric Topol, M.D. founder of the Scripps Research Translational Institute about how the gut microbiome intermediates metabolic diseases such as prediabetes and type 2 diabetes.
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In Peter Attia’s podcast The Drive Episode 194, he interviews Rick Johnson and they spend over two hours explaining how fructose causes metabolic disease: obesity, type 2 diabetes, etc. But it needs to be simplified and explained, and that’s what I do in this video!

Dr. Johnson’s hypothesis is that fructose is prime cause of metabolic syndrome and the rapid uptick of modern diseases. He writes about it in his new book “Nature Wants Us to Be Fat”. It explains a lot:

Why it’s harder to stay lean when we get older.
Why athletes seem like they can eat anything they want.
Why most traditional calorie restrictions diets are so hard to maintain
Why keto, low-carb, and paleo diets have had so much success

And importantly, his theory of fructose metabolism is still totally consistent with thermodynamics, and the equation “Calories in minus calories out equals weight gained” is still true.

Link to Podcast episode: https://youtu.be/V02z9mqTWzg
Amazon Affiliate link to Dr. Johnsons most recent book “Nature Wants Us to Be Fat”: https://amzn.to/3BmISvM
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Presented by Dr Dorit Samocha-Bonet From Garvan’s Type 1 and Type 2 Diabetes Seminar: http://www.garvan.org.au/get-involved/events. Dr Samocha-Bonet discusses the changes in dietary recommendations over the years, the alkalising diet and gives her tips on healthy eating.
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#DiabetesMellitus,#Diabetes,#HighlevelSugar,#diabetes,#diabetesmellitus,#diabetestreatment,

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Diabetes mellitus, or diabetes,
is a metabolic disease that causes
high blood sugar levels.

Insulin transports sugar from the
blood into your cells, where it is
stored or used for energy. Diabetes
occurs when your body either does
not produce enough insulin or does
not use the insulin that it does
produce effectively.

Diabetes-related high blood sugar
can harm your nerves, eyes, kidneys,
and other organs if left untreated.

Diabetes is classified into several
types:Diabetes type 1 is an autoimmune
disorder.

The immune system attacks
and destroys cells in the
pancreas, which manufactures
insulin.

It is unknown what is causing
this attack.
This type affects
approximately 10% of diabetics.

Type 2 diabetes develops
when your body becomes
resistant to insulin,
causing sugar to accumulate
in your blood.

Prediabetes is defined
as having blood sugar
levels that are higher
than normal but not high
enough to warrant a
diagnosis of type
2 diabetes.

Gestational diabetes is
defined as high blood sugar
levels during pregnancy.
Insulin-blocking hormones
produced by the placenta
cause this type of diabetes.

A rare condition called
diabetes insipidus is not
related to diabetes mellitus,
although it has a similar name.

It’s a different condition
in which your kidneys remove
too much fluid from your body.

Symptoms of diabetes
Diabetes symptoms are
caused by rising blood
sugar.

General symptoms
The general symptoms
of diabetes include:

*Increased hunger
*Increased thirst
*Weight loss

*Frequent urination

*Blurry vision

*Extreme fatigue

*Sores that don’t heal

Symptoms in men

In addition to the general
symptoms of diabetes, men
with diabetes may have a
decreased sex drive,
erectile dysfunction
(ED), and poor muscle
strength.

Symptoms in women

Women with diabetes can also
have symptoms such as urinary
tract infections, yeast
infections, and dry,
itchy skin.

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The epidemic of obesity, and Type 2 diabetes have contributed to the increase in fatty liver disease in the United States. James Hanje, MD, Director of Hepatology and Program Director of Transplant Hepatology at Ohio State, discusses the important lifestyle changes needed to treat these conditions, including healthy diet, aerobic exercise, review of food labeling, and less salt. To learn more or to schedule an appointment, visit https://internalmedicine.osu.edu/digestivediseases/ or call (614) 293-6255.
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The first step in the treatment of gestational diabetes is to modify your diet and lifestyle changes. When I say diet changes, it means reduce your carbohydrate intake because gestational diabetes is a condition where the blood sugar levels are high. We would like to keep it in the normal range where it is below 140 mg/dl even after two hours of diet. So by way of diet change, you have to minimize your intake of carbohydrates and at the same time, maintain a balanced nutrition for the growing fetus. So instead of cutting down on carbohydrates totally, I would advice you to take small, frequent meals or you can distribute the meal intake. In between three meals, you can take some fruits and still maintain the blood sugar in the same level.. nnBest advice will be to take more of proteins and vegetables and fruits. To minimize sugars, sweets, candies and pastries. Do not skip meals and go on diet during pregnancy.. nnA little bit of exercise and an active life is mandatory. If there is a contraindication to exercise, maybe you should go for some medication from your doctor. Exercise will be moderate walking for at least half an hour everyday in the morning or evening. Not too brisk walking or not stressful working at office.. nnYou may require frequent visits to the hospital as the doctor would like to monitor your blood sugar. Ideal would be to monitor your blood sugar at home. If you ever feel its more than 140 or 160, then visit the hospital. Maybe ultrasonography every month specially in the second trimester to make sure the baby is doing well. Other tests like NSTs, blood sugar and blood and urine tests will also be checked during your visit.
If there are still complications, the doctor would like to put you on medication. With good diet and exercise, oral medication is sufficient. Insulin shots will be given otherwise. If things are not settling down, hospitalization is advised. Pre term delivery might happen if there are more complications..
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