Type 2 Diabetes and Diabetic Nephropathy


Diabetes or diabetes mellitus is a chronic disease that affects insulin production in the human body. The lack of insulin from diabetes causes instability of glucose regulation in the human blood, which can lead to problems with the functioning of the heart, eyes, and kidneys. The number of people with diabetes is steadily increasing every year, which means that there is a growing number of people exposed to the risks of developing kidney disease. In particular, people with type 2 diabetes face higher risks of experiencing kidney failure, which requires dialysis or a kidney transplant to survive. Despite the high potential for adverse health outcomes, diabetes remains undiagnosed in a large proportion of the population. This medical experience paper will explain how Type 2 diabetes affects the human organs and physiological processes, define the signs and symptoms of kidney failure and discuss available treatment options to explore how the medical problem affects the population.

Medical Problem’s Effect on Normal Anatomy and Physiology

Firstly, there are three types of diabetes disorder which can all be characterized by an increased level of sugar in the blood. Type 1 diabetes is caused by the loss of β-cells responsible for insulin secretion (Petersmann et al., 2019). On the other hand, type 2 diabetes is associated with the development of insulin resistance, a condition where cells become unable to respond to insulin which delivers glucose from the blood into cells. Without being able to get into the cells, glucose accumulates in the blood, leading to high blood sugar levels. Lastly, gestational diabetes refers to high blood sugar levels in pregnant women. Type 2 diabetes is prevalent among adults who experience a lack of physical activities in combination with excessive body weight. Furthermore, type 2 diabetes is sourced from genetics and environmental factors, which means that in addition to many patients affected by diabetes, there is a significant population at risk for developing diabetes (Cloe & Florez, 2020). Thus, type 2 diabetes requires regular monitoring and management through such measures as a healthy diet and physical activity.

The development of insulin resistance in cells negatively affects overall energy homeostasis. Glucose presents one of the most important sources of energy in the human organism. Consumption of food which causes an increase in the proportion of visceral fat, and lack of physical activity contribute to the development of insulin resistance. The energy from glucose becomes unable to reach cells, which causes a misbalance in energy homeostasis.

Diabetic nephropathy is a kidney disease that occurs as a complication in individuals with type 1 and type 2 diabetes. The kidneys are responsible for the important function of filtering waste from the blood. Next, considering the negative effects of type 2 diabetes on the kidneys’ functioning, diabetes can cause damage to blood vessels in the kidneys, which will disrupt the effective operation of the blood filtration system. While the exact mechanics of how high blood sugar levels can damage blood vessels in the kidneys is unknown, it is often associated with high blood pressure common among diabetes patients. Insufficient filtration of blood can also result in increased blood pressure levels. However, the research conducted by Patel et al. (2020) suggests that glucose can enable fibrosis and inflammation in the kidney. The first symptoms of kidney disease may go unnoticed by patients, increasing the chances of further development of the disease. Thus, in combination with the high proportion of undiagnosed cases of diabetes, diabetic nephropathy poses a great danger to the population.

Signs and Symptoms

Next, considering the symptoms of diabetic nephropathy, at the initial stage, the disease is characterized by increased levels of protein in the urine. The sign can be detected by a doctor during regular check-ups with diabetes patients, emphasizing the importance of diabetes monitoring for the disease’s prevention and treatment. However, further development of the disease takes a different time in patients; therefore, depending on the patient’s lifestyle, years may pass before the onset of the following symptoms. Fluid retention, headaches, vomiting, feelings of nausea, and fatigue all present the symptoms of kidney disease. The symptoms mean that the patient’s kidneys received significant damage, and the work of the blood filtration system in the organism is disrupted.

Early diagnosis of type 2 diabetes and kidney disease can facilitate the treatment process. Type 2 diabetes can be detected through general routine screenings with the use of blood tests. Depending on the patient’s blood sugar level data, they can be diagnosed with prediabetes or diabetes. Routine screenings are especially important for patients at risk of developing diabetes. The groups at risk include all overweight adults, women who experienced gestational diabetes during pregnancy, and children whose relatives have diabetes. Furthermore, young adults from ethnic minorities are at higher risk of developing diabetes than their white counterparts (Zamora-Kapoor et el., 2018). In addition to being subjected to higher risks of developing diabetes due to genetic traits, ethnic minorities also face several barriers in access to healthcare. Thus, early diagnosis in populations subjected to higher risks of developing type 2 diabetes can significantly contribute to the solution of the problem.

Differential Diagnosis Issues

Next, considering the potential differential diagnosis issues, diabetic nephropathy can be misdiagnosed as a glomerular disorder. In patients with diabetes urinary disorder, symptoms associated with diabetic nephropathy can indicate the presence of cystitis. The study by Yang et al. (2019) suggests that the use of logistic regression in diagnostic models can help define the diagnosis in cases where symptoms point to diabetic nephropathy and non-diabetic renal disease. Furthermore, the additional presence of skin rashes or arthritis may indicate the diagnosis of systemic lupus erythematosus. Lastly, an examination of the patient’s family history can establish the possibility of polycystic kidney disease or other diseases transmitted by genes.

The options for the treatment of diabetic nephropathy include medications, kidney dialysis, and kidney transplant surgery. Treatment with medications is suitable in cases of early stages of diabetic nephropathy. In combination with lifestyle changes, medication treatment can help patients with the management of the disease to prevent its progression. Thus, medications can help patients manage the high sugar level in their blood by stimulating insulin secretion or increasing the glucose excretion from the bloodstream. More advanced medication options can reduce inflammation, resulting in lower risks of kidney failure.

Kidney dialysis is a process where the patient’s blood is diverted to a machine that cleans the blood from waste products. The treatment is recommended for patients with severe kidney damage, preventing them from functioning normally. The kidney dialysis procedure can be performed in two different ways. In hemodialysis, the blood from the patient’s body is diverted through a system of tubes to a cleansing machine or artificial kidney. On the other hand, in peritoneal dialysis, the procedure is performed with the use of the patient’s peritoneum. The cleansing solution, dialysate, is injected into the patient’s peritoneum; after a set time, the fluid with filtered waste products is discarded. Lastly, the more advanced treatment method for diabetic nephropathy is kidney transplantation. The option allows a complete recovery of the patient’s health; however, in order to be approved for a kidney transplant, the patient must pass the requirements for the procedure.


The medical problem impacted me personally because it changed how I approach my health and lifestyle. I found that after getting more information about the state of the medical problem in the country, I started paying more attention to my diet. I also try to raise other people’s awareness about diabetes risks and the importance of regular checks for the early detection of disease. Lastly, I think that it is necessary to provide informational support about the risks of diabetic nephropathy for individuals who have higher risks of developing type 2 diabetes to prevent the rise in cases of kidney failure in the future.

In conclusion, this paper explored how type 2 diabetes affects normal physiology through the development of insulin resistance and increased level of glucose in the blood. The paper also explained how diabetes affects energy homeostasis when glucose is unable to enter cells. Furthermore, the paper listed common symptoms of diabetic nephropathy and differential diagnosis issues that may interfere with the diagnosis process. Next, the paper identified possible treatment options for patients with different stages of diabetic nephropathy. Therefore, the information in the paper explains how diabetes affects the population and defines that early diagnosis of diabetes can reduce the risk of diabetic nephropathy.


Cole, J.B., & Florez, J.C. (2020). Genetics of diabetes mellitus and diabetes complications. Nature Reviews Nephrology, 16, 377–390.

Patel, D. M., Bose, M., & Cooper, M. E. (2020). Glucose and blood pressure-dependent pathways–the progression of diabetic kidney disease. International Journal of Molecular Sciences, 21(6), 1-32.

Petersmann, A., Müller-Wieland, D., Müller, U. A., Landgraf, R., Nauck, M., Freckmann, G., Heinemann, L., & Schleicher, E. (2019). Definition, classification and diagnosis of diabetes mellitus. Experimental and Clinical Endocrinology & Diabetes, 127(1), 1-7.

Yang, Z., Feng, L., Huang, Y., & Xia, N. (2019). A differential diagnosis model for diabetic nephropathy and non-diabetic renal disease in patients with type 2 diabetes complicated with chronic kidney disease. Diabetes, metabolic syndrome and obesity: Targets and therapy, 12, 1963–1972.

Zamora-Kapoor, A., Fyfe-Johnson, A., Omidpanah, A., Buchwald, D., & Sinclair, K. (2018). Risk factors for pre-diabetes and diabetes in adolescence and their variability by race and ethnicity. Preventive Medicine, 115, 47-52.

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