As tempting as it is, defaulting follow-ups can lead to further deterioration of your diabetes and diabetic complications, which include kidney disease. The problem is that complications such as diabetic eye and kidney disease are usually silent until in advanced stages. Because of this lack of early physical signs or symptoms, you may not be convinced of the need to see a doctor.

However, your doctor would be able to monitor your condition and help you control the disease. You would also have the opportunity for your kidneys to be checked routinely. To screen for kidney complications, the doctor only needs to check your blood pressure and do some simple urine and blood tests.

Remember - diabetes has the potential to damage many different organs in your body, not just the kidneys. Regular follow-up helps protect your heart and blood vessels, brain and nerves, eyes and skin also.

Medications help, not make you worse

Medications are prescribed to you by your doctor to help in controlling your diabetes, blood pressure and also other conditions.

Many patients worry that taking too many medications may be harmful but they need to understand that the probability of any permanent serious harm from medications is exceedingly low.

It is far more dangerous to allow their diseases to go untreated or uncontrolled. Avoid drugs other than the ones prescribed to you. Do also avoid traditional medications and certain types of pain-killers as these may damage your kidneys further.

Eat healthily

If you are diabetic, you need to watch your diet. You can eat normally but control your carbohydrate and fat intake. If you already have kidney damage due to diabetes, controlling what you eat can avoid excessive accumulation of wastes in your kidneys since your kidneys are not able to function normally.

Control your intake of protein, sodium, potassium and phosphorus according to your doctor or dietitian's dietary plan.

Prevent diabetes

People with pre-diabetes have blood glucose levels higher than normal but not high enough to be classified as type 2 diabetes. The Diabetes Prevention Programme (DPP) was a landmark study conducted in the United States more than five years ago. It showed that about 11 per cent of pre-diabetics may develop type 2 diabetes each year. Therefore, it is important to detect pre-diabetes early.

Like Anna, there are many out there going about their daily lives, not knowing they are suffering from pre-diabetes as the symptoms may develop gradually or not surface at all.

If you are in the high-risk group of getting diabetes, you should go for screening to check whether you have pre-diabetes or diabetes. Those who should go for screening are:

-Those with a family history of diabetes

-Overweight

-Age over 40 years old

-Those with high blood pressure

-Those with high cholesterol

-Women who had diabetes during pregnancy

Embark on a healthy lifestyle

Leading a healthy lifestyle can prevent pre-diabetes from developing into type 2 diabetes. This in turn helps prevent end stage kidney failure. The Diabetes Prevention Program found that people with pre-diabetes can prevent or delay type 2 diabetes by losing just 5 to 10 - of excessive body weight through exercise, and a lower calorie and fat diet. It is recommended that you exercise 30 minutes a day, 5 days a week.

Chronic kidney disease and diabetes are common and harmful. However, most importantly, they are treatable, especially when detected early. It is important for you to work together with your doctor to prevent or manage diabetes appropriately.

The Star/Asia News Network

Dr Sunita Bavanandan is a consultant nephrologist. This article is courtesy of NKF Kidney Care, a community education programme by National Kidney Foundation of Malaysia. For more details, please call NKF at the NKF Hotline: 1-300-88-3110 or log on to www.nkf.org.my.

This story was first published in The Star on Nov 16, 2008.