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Technology & Medications for Kidney Care in Diabetes | Journey Biosciences

Written by Admin | Mar 25, 2024 12:00:00 PM
As we wrap up our #KidneyMonth series on diabetes and kidney health, we've explored the essential role of the kidneys, why regular screenings matter, and how lifestyle choices can impact kidney health. In this final article, In this final piece of our #KidneyMonth series, we're breaking down the latest tools and treatments available for those at risk or diagnosed with diabetes-related kidney disease. There are many options available that can help slow down or even prevent kidney disease from getting worse. For those with diabetes, protecting kidney health begins with early detection through regular screenings, followed by informed changes to treatments, lifestyle, and education with their care team.
 

Diabetes Devices

Diabetes devices like blood glucose meters, CGM systems, and insulin pumps have improved significantly over the years, becoming more user-friendly and less invasive. In addition to their wide capabilities in monitoring and managing diabetes, these devices can also have positive effects on kidney health! Let’s explore them and how they contribute to diabetes management and kidney health.

  • What is a CGM? A wearable device that constantly measures blood sugar levels, providing instant readings anytime.
  • Benefit for Diabetes: Provides real-time insights into blood sugar levels, helping with day-to-day adjustment of food intake, exercise, and medication.
  • Benefit for Kidney Health: Helps maintain optimal blood sugar levels, reducing the risk of diabetes-related kidney damage.
  • Suitable for: Both Type 1 and Type 2 diabetes patients. No specific restrictions; useful for anyone requiring detailed glucose monitoring. Selection might depend on insurance coverage and personal preference. 
  • Brand Examples: Dexcom (with models like the G6 and G7), Freestyle Libre (by Abbott), Guardian Connect (by Medtronic)
  • Further Reading: NIDDK | Continuous Glucose Monitoring
  • What is an insulin pump? A small device that delivers insulin through a small tube underneath the skin, replacing the need for multiple daily injections.
  • Benefit for Diabetes: Allows for precise insulin dosing and flexible meal times, improving blood glucose management.
  • Benefit for Kidney Health: Consistent insulin delivery helps avoid blood glucose spikes that can harm kidney function over time.
  • Suitable for: Primarily used by Type 1 diabetes patients but increasingly adopted by Type 2 patients who require insulin. Recommended for patients who seek flexibility and precise control over insulin delivery. Suitable across various age groups.
  • Brand Examples: Medtronic, Tandem Diabetes Care, Insulet (Omnipod).
  • Further Reading: ADA | Insulin Pumps
  • What is a smart pen? An insulin injection device that, when used with a smartphone app, helps track doses and provide helpful reminders and alerts.
  • Benefit for Diabetes: Improves overall diabetes management by helping to provide the right amount of insulin and keep track of doses.
  • Benefit for Kidney Health: Accurate insulin dosing contributes to stable blood sugar levels, which helps protect the kidneys.
  • Suitable for: Both Type 1 and Type 2 diabetes patients who use insulin. Ideal for patients looking for a more convenient and accurate way to manage insulin dosing. Compatibility with insulin types and brands may vary.
  • Brand Examples: InPen (by Medtronic), NovoPen (by Novo Nordisk).
  • Further Reading: ADA | Smart Insulin Pens

  • What is an AID? Also known as an artificial pancreas, this system combines a CGM and an insulin pump with a control algorithm to automatically adjust insulin delivery based on glucose readings.
  • Benefit for Diabetes: Provides almost constant management of blood sugar, reducing the need for frequent checks and changes.
  • Benefit for Kidney Health: Keeps blood sugar levels more consistent, which may reduce the risk of serious kidney problems.
  • Suitable for: Mainly Type 1 diabetes patients, but research is expanding into Type 2 diabetes. Best suited for patients who require constant glucose monitoring and insulin therapy, willing to wear a device continuously.
  • Brand Examples: Medtronic (MiniMed systems), Tandem Diabetes Care (t:slim X2 with Control-IQ).
  • Further Reading: NIDDK | Artificial Pancreas
All of these tech options not only help to simplify diabetes management but also serve as important tools in protecting kidney health and preventing progression of disease by maintaining healthy blood sugar levels.
 

Medications

When it comes to keeping diabetes and kidney health in check, certain medicines can do a lot of good. They not only help manage blood sugar levels but can also protect your kidneys and heart from damage. Let's take a closer look at some key medications that might be part of your health plan if you're dealing with diabetes, especially if you're also trying to take care of your kidneys.

  • What is insulin therapy? A way to control blood sugar using injections or a pump, essential for managing diabetes.
  • Benefit for Diabetes: Helps to keep blood sugar levels stable, helping to prevent diabetes-related complications.
  • Benefit for Kidney Health: By maintaining stable blood sugar levels, insulin therapy helps protect the kidneys from damage caused by high blood sugar.
  • Suitable for: Necessary for all with Type 1 diabetes and some with Type 2 diabetes who need extra help beyond diet, exercise, and medications.
  • Common Names: A few well-known options for injections include NovoLog, Lantus, and Humalog; Omnipod and Medtronic for pumps; and Afrezza for inhaled insulin.
  • Further Reading: Mayo Clinic | Using Insulin to Manage Blood Sugar

  • What are SGLT-2 inhibitors? Medications that stop sugar from re-entering the blood through the kidneys, instead passing it out in urine.
  • Benefit for Diabetes: Lowers blood sugar levels, aids in weight loss, and has been shown to benefit the heart.
  • Benefit for Kidney Health: They have shown to have protective effects against the progression of kidney disease in diabetes patients.
  • Suitable for: Primarily Type 2 diabetes patients. Research is exploring benefits in Type 1 diabetes under careful supervision. Not recommended for patients with significant kidney damage (effectiveness decreases as kidney function declines). 
  • Common Names: Canagliflozin (Invokana), Dapagliflozin (Farxiga), Empagliflozin (Jardiance).
  • Further Reading: National Kidney Foundation | SGLT2 Inhibitors

  • What are GLP-1s? Shots that boost insulin production and lower sugar levels when eating.
  • Benefit for Diabetes: Improves blood glucose control and promotes weight loss, with a low risk of hypoglycemia (low blood sugar).
  • Benefit for Kidney Health: They have been observed to benefit both the heart and kidneys, and can lower the amount of protein in urine (albuminuria) among other advantages.
  • Suitable for: Type 2 diabetes patients. Not suitable for individuals with a personal or family history of medullary thyroid carcinoma or patients with Multiple Endocrine Neoplasia syndrome type 2.
  • Common Names: Liraglutide (Victoza), Semaglutide (Ozempic), Dulaglutide (Trulicity).
  • Further Reading: Cleveland Clinic | GLP-1 Agnonists

  • What are ACE Inhibitors and ARBs? Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are medicines that ease blood vessel tension and lower high blood pressure. 
  • Benefit for Diabetes: Helps control blood pressure, an important factor in diabetes management.
  • Benefit for Kidney Health: Helps to slow the progression of kidney disease by reducing pressure in the glomeruli (kidney filters).
  • Suitable for: Both Type 1 and Type 2 diabetes patients, particularly those with high blood pressure and/or excess protein in the urine. Careful monitoring is required for high potassium (hyperkalemia) and kidney function, especially during the initial stages of therapy.
  • Common ACE Inhibitors: Generic names end in "-pril". Some familiar names include Lisinopril and Enalapril. 
  • Common ARBs: Generic names end in "-sartan". Some familiar names include Losartan and Valsartan.
  • Further Reading: National Kidney Foundation | ACEs and ARBs

  • What are MRAs? MRAs block a hormone, aldosterone, which makes kidneys retain salt and lose potassium.
  • Benefit for Diabetes: Particularly helpful for people with Type 2 diabetes who also have chronic kidney disease (CKD), as they help guard against heart issues.
  • Benefit for Kidney Health: MRAs can slow down the progression of kidney disease and lower the chance of heart problems, especially in those at higher risk of their kidney disease worsening.
  • Suitable for: Type 2 diabetes patients with CKD and a high risk of heart disease. Beneficial for those with proteinuria (excess protein in urine) despite receiving the standard of care. Monitoring for potassium levels and renal function is essential to avoid high potassium levels (hyperkalemia) and worsening kidney function.
  • Common Names: Finerenone (Kerendia).
  • Further Reading: National Kidney Foundation | Game-Changing Medications for Kidney Disease and Type 2 Diabetes


Combining Technology and Medication for Optimal Outcomes

Combining tech tools and medicines forms a comprehensive plan for managing diabetes and improving kidney health. Identifying risk of kidney disease early allows doctors to implement personalized, proactive care plans for their patients. This approach can slow down or stop kidney disease as a complication of diabetes, leading to a better quality of life.

Transforming the Approach to DKD

NaviDKD® transforms the early detection of kidney disease in individuals with diabetes through a simple blood test. The screening measures blood biomarkers to predict the risk of developing diabetes-related kidney disease before any signs or symptoms appear. The results categorize risk as low, elevated, or high and provide personalized clinical recommendations, guiding care decisions involving technology, medication, and lifestyle considerations. Suitable for adults over 18 with diabetes and an eGFR of 80 or greater, NaviDKD provides the earliest insight into kidney health, enabling early action and protection against kidney complications.

If you're a person living with diabetes or a healthcare provider looking to leverage NaviDKD for early kidney health insights, we invite you to contact us today!


Conclusion

Our #KidneyMonth series has shown the importance of early and regular screenings, as well as taking prompt action against kidney disease for people with diabetes. By adopting the latest technologies and medications, individuals facing diabetes-related kidney disease can manage their health with better accuracy and support. As we learn more about these conditions and continue to see innovative solutions, the outlook for improving the management of diabetes complications is bright.

DISCLAIMER: The information provided in this article is for educational and informational purposes only. It is intended to promote understanding and knowledge of various health topics but not to substitute for professional medical advice, diagnosis, or treatment. The information presented is generalized and may not apply to everyone's individual health situation. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before making any health-related decisions. 
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