Due to the constantly elevated blood sugar levels, small blood vessels are destroyed in the body over time. In the kidneys, the filter apparatus, consisting of small blood vessels, is primarily affected. The first sign of diabetic nephropathy is the excretion of certain protein (albumin) with urine. The loss of albumin develops long before the onset of serious lesions. Patients suffering from diabetes should pass urinalysis to identify albuminuria at least once a year.
After the stabilization of blood pressure and the appointment of the proper treatment for diabetes, the loss of albumin may stop. If the kidney damage continues, the structure of the renal filtration apparatus is disturbed so much that there are holes and blockages in the renal corpuscles. In this case, there is insufficient purification of the blood. Vital substances (including other proteins along with albumin) are excreted in the urine. Decomposition products (e.g. urea) are not completely eliminated from the body. They fall back into the bloodstream. This can lead to urine intoxication (uremia). Ultimately, the kidney cells lose their function. However, it is in the case of diabetes mellitus that it is possible to slow the loss of kidney function through strict monitoring of blood pressure.
Careful treatment of even a slight increase in blood pressure is very important. However, the lack of treatment for limited renal function can lead to chronic impairment of renal function (renal failure). In this case, a permanent replacement renal therapy (dialysis or transplantation) is necessary throughout life.
In Germany, about four million diabetics live; in addition, according to rough estimates, another two million people have diabetes mellitus, which has not yet been diagnosed. In addition, experts expect that the number of diabetics will double over the next ten years.