One of the most serious complications of diabetes is the emergence of non-healing wounds on the feet. Unfortunately, even today the most common result of the non-healing foot wounds is amputation. This can be prevented in many cases by a foot screening and treatment. The main cause of diabetic foot syndrome is damage to the small nerves in the feet caused by high blood sugar levels. This leads to a faulty load, since the various groups of muscles in the foot are no longer coordinating. Typically this goes unnoticed by patients, as there is no pain unless it develops into an open wound (which can expand quickly). These pressure lesions can almost always be avoided by wearing appropriate footwear and maintaining careful foot care. It is for this reason that we highly encourage patients to have regular foot checks. We specialize in the early detection and treatment of diabetic foot ulcers in all stages of the disease.
Diabetic kidney disease (diabetic nephropathy) is one of the most common causes of renal insufficiency requiring dialysis in industrialized countries. Approximately 30 percent of diabetics (type 1 and 2) develop diabetic nephropathy during their lifetime. The risk of deteriorating kidney function in diabetic patients is determined by both genetics and factors beyond people’s control. The deterioration of renal function in diabetic nephropathy is very dangerous. It is crucial to treat hypertension and control glucose and lipid metabolism. It’s also extremely important to carefully select medicine for treatment of high blood pressure.
The earliest sign of diabetic nephropathy is the development of a microalbuminuria, the elimination of a small protein body (albumin) in the urine. We examine our patients regularly for this, as microalbuminuria indicates a high risk for the development of diabetic kidney disease and vascular disease.
If you’re nearing the need for dialysis and would like to explore getting a transplant, start the discussion with your nephrologist. Your doctor will discuss the transplant process with you, which generally starts with being referred to a transplant center for further evaluation. While transplant requirements vary between centers, you’ll most likely undergo comprehensive medical tests to determine if you’re a viable candidate. If you are, then the search for a donor can begin.
There are two types of organ donors: a living donor and a non-living, or cadaver, donor. Compatibility between a patient and the donor reduces the chances of organ rejection and can contribute to a more successful transplant. Additionally, because medication to help prevent organ rejection is so effective, donors don’t always have to be genetically similar to the recipient. If you don’t have a potential living donor, you will be placed on the waiting list for a cadaver organ. The wait for a transplant can vary greatly depending on the type of donation you receive and current health.
You’ll be scheduled for surgery as soon as an appropriate organ match has been identified. In most cases, your surgeon will leave your kidneys in place and simply place the new, healthy kidney in a different location in your abdomen. You will remain in the hospital for several days after the surgery and be monitored for any complications.
Common transplant concerns: While your age and health conditions prior to the transplant surgery can affect the risk of complications, there are two common post-transplant concerns.
Rejection: Medication will be prescribed to help ensure your body accepts the new kidney.
Functionality: In some cases, the newly transplanted kidney begins working right away, while in others it may require dialysis for a few days before it starts functioning normally.
Maintaining healthy habits and following your doctors’ recommendations is vital to help your new kidney function properly so you can have a better quality of life for years to come.
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