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Diabetes Mellitus and Chronic Kidney Disease (Stages 1–5)

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Nutrition in Kidney Disease

Part of the book series: Nutrition and Health ((NH))

Abstract

Diabetes mellitus is a disease marked by high levels of blood glucose resulting from defects in insulin production (type 1 diabetes) or insulin sensitivity (type 2 diabetes). Symptoms of diabetes include weight loss, polyuria, polydipsia, and polyphagia. Type 2 diabetes (T2DM) represents approximately 90 % of all patients with diabetes. Risk factors for T2DM include age, genetics, ethnicity, and obesity. T2DM is a progressive condition, which generally begins with insulin resistance and an initial compensatory increase in the production of insulin by the pancreas. Over time, unless there is removal of the precipitating condition (i.e., insulin resistance), the pancreas eventually begins to lose its ability to produce the quantity of insulin required to maintain normoglycemia. The rate of pancreatic decline varies based on many factors but generally takes approximately 5–10 years to develop into diabetes. In the case of T2DM, symptoms of diabetes are usually rare or mild and can often be overlooked. As such, many individuals with T2DM have already developed complications by the time they are diagnosed with the disease. From that point onwards, the production of insulin from the pancreatic beta cells continues to decline over the course of the disease. Although T2DM is a chronic, progressive disease, steps can be taken to control the disease and to lower the risk of associated complications. Today, almost 26 million people (8 % of the population) in the United States have diabetes, and due to the chronic nature and frequently overlooked symptoms listed above, nearly one-third are unaware that they have the disease [1]. An estimated 79 million people have prediabetes [1]; a condition characterized by insulin resistance that results in an above normal blood glucose reading without meeting the cutoffs for the diagnosis of diabetes (Table 8.1).

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Authors and Affiliations

  1. Diabetes Comprehensive Care Program, Diabetes Care Centre, St. Michael’s Hospital, 30 Bond Street, Toronto, ON, Canada, M5B 1W8

    Dana Whitham R.D., M.Sc.

  2. Diabetes Comprehensive Care Program, Hemodialysis Division, St. Michael’s Hospital, Toronto, ON, Canada

    Arti Sharma Parpia R.D., M.Sc.(C)

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  1. Dana Whitham R.D., M.Sc.
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  2. Arti Sharma Parpia R.D., M.Sc.(C)
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Correspondence to Dana Whitham R.D., M.Sc. .

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Editors and Affiliations

  1. Dept. Primary Care, University of Medicine & Dentistry, New Jersey, Stratford, New Jersey, USA

    Laura D. Byham-Gray

  2. Dept. Nutrition, Long Island University C.W. Post Campus, Brookville, New York, USA

    Jerrilynn D. Burrowes

  3. Div. Nephrology, Stanford University School of Medicine, Stanford, California, USA

    Glenn M. Chertow

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Whitham, D., Parpia, A.S. (2014). Diabetes Mellitus and Chronic Kidney Disease (Stages 1–5). In: Byham-Gray, L., Burrowes, J., Chertow, G. (eds) Nutrition in Kidney Disease. Nutrition and Health. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-685-6_8

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