Diabetes Care in Dialysis Patients

A lot of dialysis patients have diabetes. If you do not have diabetes then you can skip this letter. Diabetic kidney disease is often the reason that a person needs dialysis. Once you are on dialysis, the diabetes can still damage other parts of your body. You need to keep your diabetes well controlled to protect against heart attacks, strokes, blindness and amputations of your legs. You need to check your finger stick blood sugars as your doctor advises. Please note that the A1c test that you have used to monitor your diabetes over the years is not as accurate in dialysis patients. A1c tells your doctor how good your blood sugar has been. In dialysis patients, A1c tends to make your doctor think your sugars have been lower than they really have been. If the number is much higher than 7.0, then your diabetes is not well enough controlled just like it was before you started dialysis. However, some patients with A1c below 7.0 may have too high blood sugars. Checking your finger sticks will help your doctor see if that is the case.
You should see your Primary Care Doctor or your Endocrinologist routinely to help with your diabetes. You also should see your eye doctor and podiatrist (foot doctor) regularly. They can find eye or foot problems before they get too bad. There are treatments that can really help you.

The dialysis unit staff should check your feet each month. This is not being done in place of your podiatrist. Rather, it is an additional evaluation that can be done more often than you see your podiatrist.

Your Doctors are available at answer any questions you may have about this.

Posted in Dialysis Blog.