Diabetes

[TonyAlmeida]

In Type 1 diabetes, about 60 percent of those individuals develop kidney disease.  I was just wondering - of all the Diabetics on this forum .... how many have had endocrinologists put you on medication to *prevent* kidney failure soon after your were first diagnosed?  My endo is really pushing to put me on medication in case (and I stress the words "in case") I may get Kidney Disease.  I have no signs of it or have it now.  My Kidneys are healthy.  I keep my blood glucose in the upper 80s to mid 90s.  I watch the protein intake (okay - I have my 4 oz. of meat for dinner and a slice of cheese every now and then).  But I'm worried that A. I may be taking unnecessary medication that may end up causing the problem I want to prevent and B. I know my endo does get some sort of *compensation* (like most doctors do) by the drug companies he prescribes medication from (I used to work volunteer at a clinic, so I know first hand doctors *do* get perks by the drug reps - and not just postit notepads or pens either).  Has anyone else been prescribed "preventative" medications for Kidney Disease - even though they show no signs of it or don't have it?  And what medication?  Taking medication "just because it may or may never happen" kind of scares me.  To me - it's like taking chemotherapy without any signs of cancer because "you may get cancer someday" .....

[Knees]

Hi Tony-
I have been a diabetic for almost 31 years.  I developed kidney disease 14 years ago.  I too have a low protein diet and now I have a low phosphorus diet as well.  Believe me, the low protein is a piece of cake compared to the phosphorus.  As for the meds, I am sure that the meds taken just in case do work, you and your doctor have to find the right ones for you.  I have had some horrible reactions to many blood pressure meds which were not only to lower my pressure but also to protect my kidneys.  I am sure without the meds I would be waiting for a kidney.  The nephrologist told me that I only had 1-2 years before I would need a transplant.  But, with a few diet changes, especially with lowering the phosphorus, my numbers actually got better. Listen to your dr. If you are not sure go for a second opinion.  Anything they can do to put off or lessen the complications is well worth it.  Good Luck and Take care.

[JDRF-Team-dm]

Dear Tony,

You bring up a very good question. We never want to take unnecessary medications, but as LRS stated many type 1's are taking preventative meds due to the higher risks associated with diabetes. I would also recommend speaking to your endo or get a second opinion. You might also look at the NIH or FDA websites for possible side effects from the particular meds your doctor is recommending. You can then feel more comfortable when you make your decision.

Good Luck,
dm

[JDRF-Team-LRS]

Hi Tony,
It is now recommended practice that diabetics be on ACE/ARB meds for their ability to prevent kidney disease.  Many of the Type 1s and Type 2s that I know use this type of med for prevention.

I've been on one or the other for a long time (hmmm, maybe 6-7 years).  At the time I started, my bp was about normal, but borderline.  We diabetics are also at significantly greater risk for high bp and heart disease and so I didn't mind starting the meds.  The most recent issue of JDRF's Diabetes Countdown has an article on our risk for heart disease.  

I do udnerstand not wanting to take unnecessary meds, and yet preventative medicine is good medicine.  In my opinion, meds to delay/prevent kidney disease are worth it.  I also started a statin med recently -- normally given to lower cholesterol -- even tho' my cholesterol numbers have always been very good.  This class of drugs have also been shown to offer heart protection for folks, like us, who have significant other risk factors.

I'm not a physician and before starting on the ACE and more recently on the statin drug, I did discuss *my particular situation* with my endo & another physician before I decided to start the meds.  I'd encourage you to talk with your doc about your reservations/skepticism (which is quite reasonable) and/or to get a second opinion.