Mild T2, but CKD

[HarryM1byt]

I'm 73, diagnosed with CKD over a year ago. One completely failed kidney, they fitted a stent to the working one. My T2 is diet controlled. I had regular renal appointments with the renal consultant since then, but over the phone recently due to Covid.

I had my phone call from a different consultant yesterday, having been passed onto a different renal consultant further up the chain. During a long chat on the phone, he advised me I would likely need to begin dialysis within the next 18 to 24 months time. All a bit of a shock and my head is still spinning from the announcement and the implications. He briefly mentioned home dialysis and hospital, I asked if there were anything useful I could do to delay that day, but he just suggested avoiding salt, not that I have ever used much, if any.

I asked about what symptoms to expect, he just said I would know - I would feel absolutely terrible. I was told I had no chance of a transplant, due to age and other health issues - high blood pressure, very minor stroke many years ago and choked arteries.

 

[trophywench]

Hi Harry - sorry to hear about your CKD. I have to disagree with your use of the word 'mild' regarding your diabetes - has nobody ever told you that diabetes is like pregnancy - impossible to have 'mildly' - you either are diabetic/pregnant - or you aren't.

So how are your day to day BG readings going and what's your current HbA1c?

 

[HarryM1byt]

HbA1c was 55 a couple weeks ago.
I don't know what BG stands for?

[EDIT} BG = Blood Glucose - I don't recall them ever mentioning a figure for that, or recording it in my patient record. When I have had the finger prick test (if that is the BG?), they have suggested it was normal or just a little high.

 

[AJLang]

Hi Harry
The BG is the blood glucose obtained from the finger prick test. Many Type 2 diabetics on this forum regularly check their BG at home and I’m sure some will come along with advice as to how and why they do this. We cannot give medical advice on this forum but the better your HBA1C the more chance there is of reducing complications - although as with all things in life this is not guaranteed.
NICE (National Institute of Clinical Health and Excellence) guidelines say
1.6.7 For adults with type 2 diabetes managed either by lifestyle and diet, or by lifestyle and diet combined with a single drug not associated with hypoglycaemia, support the person to aim for an HbA1c level of 48 mmol/mol (6.5%). For adults on a drug associated with hypoglycaemia, support the person to aim for an HbA1c level of 53 mmol/mol (7.0%). [new 2015]

 

[HarryM1byt]

The doctors have said I'm not at a stage where I would need to check it regularly, just control it with diet, but thanks anyway.

 

[ianf0ster]

The doctors have said I'm not at a stage where I would need to check it regularly, just control it with diet, but thanks anyway.

Hi Harry, Yes, nearly all GPs and Diabetes Nurses say that but the reason the say it is because unless you are on a drug capable of giving dangerous hypos, they don't want the cost of prescribing BG meters and Test Strips. So its purely a cost cutting measure.

Most T2's who are well controlled/in remission self fund a BG Meter (one with cheaper test strips such as the Spirit TEE2+ or the SD CodeFree or more recent SD Gluconavii ) if they rely on lifestyle (Way OF Eating) with the possible addition of Metformin.
Why do we do this when the test strips cost around £8 for 50 and you use a lot at first? - Because it enables us to work out which food we can eat (we all have differences in our Carb intolerance) as well as how much we can eat and what times of day are best for us to eat.

How can you control it with diet if you only based on HbA1C reading showing the average over the last 3 month? Its like steering a car by looking in the rear view mirror.
Obviously not everybody can afford to self-fund, but if you can (even for a couple of months) I would strongly recommend it.

 

[trophywench]

The nearer to normal (ie under 42 HbA1c test level) the better chance you have of getting more chance of the treatment for the kidney trouble being effective for you, since your body will have better healing capacity.

 

[everydayupsanddowns]

Welcome to the forum @HarryM1byt

Sorry to hear about your kidneys and need for dialysis.

It sounds like this has come on quite suddenly. Did you have any inkling of earlier stages of kidney disease before? Eg raised protein/albuminuria?