- With Mayo Clinic diabetes educators
Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.
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Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.
Nancy Klobassa Davidson and Peggy Moreland
Nancy Klobassa Davidson, R.N., B.S.N, C.D.E
Nancy Klobassa Davidson is a registered nurse who has worked in diabetes education for 17 years. She is a certified diabetes educator (C.D.E.) and is currently in graduate school working on a Master of Science in nursing (M.S.N.) and health care education.Nancy works with adults who have type 1, type 2 and other forms of diabetes. Nancy is coordinator of the Diabetes Unit's intensive insulin therapy program within the Division of Endocrinology, Diabetes, Metabolism, & Nutrition at Mayo Clinic in Rochester, Minn. Nancy has worked extensively with insulin pump therapy and continuous interstitial glucose sensing.
Peggy Moreland, R.N., M.S.N.
Peggy Moreland is a certified diabetes educator (C.D.E.) in the Division of Endocrinology, Diabetes, Metabolism, & Nutrition at Mayo Clinic in Rochester, Minn.Peggy graduated with a Master of Science in Nursing and Health Care Education from the University of Phoenix and is a member of the American Association of Diabetes Educators and the American Diabetes Association. A certified diabetes educator (C.D.E.), Peggy enjoys working with patients to set and achieve diabetes self-management goals.
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Living with diabetes blog
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March 11, 2011
Kidney disease: No early symptoms
By Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.
This blog is in response to a reader question about the symptoms of kidney disease that we received about our blog, "With diabetes, kidney care is crucial."
In some people with diabetes, over time, high blood glucose levels can damage the millions of tiny blood vessels that filter waste from the blood and dispose of it in the urine. Unfortunately, early kidney disease has no symptoms. Generally, not until the damage is extensive do symptoms emerge.
Symptoms of advanced kidney disease include:
- Swelling of ankles, feet and hands
- Shortness of breath
- High blood pressure
- Confusion or difficulty
- Poor appetite
- Nausea and vomiting
- Dry, itchy skin
- Fatigue
To identify kidney problems early, an important part of your yearly diabetes management checkup is getting what's called a urine microalbumin test. This test measures the amount of a protein, albumin, in your urine.
When kidneys are functioning normally, they filter out only waste in your blood, excreted in your urine. Protein and other helpful substances remain in your bloodstream. When your kidneys become damaged, waste products remain in your blood, and albumin leaks into your urine.
When your kidneys are in early distress, only small amounts of albumin escape into the bloodstream. You may lose 30 to 300 milligrams (mg) of albumin a day through the urine. This condition is called microalbuminuria. In advanced stages of kidney disease, you might lose more than 300 mg of albumin a day.
The most reliable test to screen for microscopic protein in the urine is to collect the urine in a container for 24 hours. Another available test, the random microalbuminuria test, requires only a one-time sample of urine.
If your health care provider is aware of early kidney disease through such testing, early treatment measures can help prevent or slow down the progression of diabetes-related kidney disease. Treatment measures include:
- Keeping blood glucose levels in a healthy target range, as determined by your doctor
- Maintaining a healthy blood pressure level, as determined by your doctor
- Starting an ACE inhibitor blood pressure medication, which has protective benefits to the kidneys
- Eating a low-protein diet
Your comments are appreciated.
Have a great week,
Nancy
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