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Kidney Disease and Diabetes: Care Instructions


When you have diabetes, your body cannot make enough insulin or use it the way it should.

Your body needs insulin to help sugar move from the blood to the cells. Without it, your blood sugar gets too high.

High blood sugar damages your kidneys and makes it hard for them to filter blood. This causes fluid and waste to build up in your blood.

If you have diabetes, it is very important to keep your blood sugar in your target range. There are many steps you can take to do this. If you can control your blood sugar, you will have the best chance to slow or stop damage to your kidneys.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

To manage your diabetes and slow or stop damage to your kidneys

  • Keep your blood sugar in your target range. Diabetes Canada recommends a hemoglobin A1c (HbA1c) target level of 7% or less. Talk to your doctor about your target. The lower your A1c, the better your chance of stopping kidney damage.
  • Lower your blood pressure. Keep your blood pressure below 130/80. Doctors recommend specific types of blood pressure medicines for all people who have diabetes and kidney disease. This is even true for some people who do not have high blood pressure. Examples of these medicines are ACE inhibitors and angiotensin II receptor blockers (ARBs).
  • Take your medicines. You may need to take several medicines. For instance, you may need a medicine for your diabetes, another to lower cholesterol, and others to lower your blood pressure. It is very important to take all your medicines just as your doctor tells you to and to keep taking them.
  • Make good food choices. Follow an eating plan that is best for your diabetes and your kidneys. You may want to work with a dietitian to make a plan. This will help you know how much carbohydrate to have for meals and snacks. It will also make sure that you get the right amount of salt (sodium), fluids, and protein.
  • Stay at a healthy weight. If you need help to lose weight, talk to your doctor or dietitian. Even small changes can make a difference. Try to be aware of your portion sizes, eat more fruits and vegetables, and add some activity to your daily routine.
  • Exercise. Get at least at least 2½ hours of moderate to vigorous activity each week. Walking is a great exercise that most people can do. Being more active can help you manage your blood sugar and stay at a healthy weight. It also can help you lower cholesterol and blood pressure.

To improve your kidney health

  • Follow your treatment plan. Check your blood sugar as many times a day as your doctor recommends. Go to all of your follow-up appointments, and have all the tests your doctor orders. Call your doctor or nurse advice line if you think you are having a problem with your medicines.
  • Avoid certain medicines. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, can damage your kidneys. It is important to talk to your doctor about all medicine that you take.
  • Avoid tobacco. Do not smoke or use other tobacco products. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).

Call your doctor or nurse advice line now or seek immediate medical care if:

  • You have new or worse nausea and vomiting.
  • You have much less urine than normal, or you have no urine.
  • You are feeling confused or cannot think clearly.
  • You have new or more blood in your urine.
  • You have new swelling.
  • You are dizzy or light-headed, or you feel like you may faint.

Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if:

  • You do not get better as expected.

Where can you learn more?

Go to

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Care instructions adapted under license by your healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.