Della Hughes-Carter is an instructor in the MSU College of Nursing and an expert in diabetic kidney disease. November is National Diabetes Month.
Before 1923 if you became ill with diabetes you would die. With the discovery of insulin and oral anti-diabetic medications we are able to survive this challenging disease. Unfortunately, diabetes (type 1 and type 2) continues to cause serious complications such as kidney failure, blindness, amputations, heart disease and stroke. The connection between diabetes and these complications is often overlooked and not managed well until it is too late.
My father developed type 2 diabetes and years later lost his kidney function. He did well with the other complications of diabetes but did not survive kidney failure. His journey has inspired me to help others prevent and manage the complication of diabetic kidney disease.
One of the major problems of DKD is there are no symptoms, until most of the kidney’s nephrons are no longer functioning. Diabetes is the number one reason for kidney failure. Sadly, only 40 percent of those with diabetes receive annual screening for DKD per practice guidelines. That means six out of 10 people with diabetes don’t know how well their kidneys are functioning. One of my goals is to close this gap. I believe that all persons with diabetes should understand the risk to their kidneys and receive proper screening if they choose.
Nearly 10 percent of all Americans, including our children, have this disease and the prevalence rate is increasing. For Americans 65 years and older, the prevalence rate is 25 percent. In fact, diabetes is a global issue with some countries reporting a prevalence rate above 35 percent.
I see this as a crisis and an unsustainable problem. There simply are not enough resources to manage the number of people, who may need kidney dialysis. Our dialysis centers are overwhelmed and the amount of human suffering is devastating. In the United States, 25 percent of the Medicare budget is spent on kidney disease and this cost is expected to rise.
Our work in the College of Nursing is making a difference. Spartan nurses teamed up with a primary care facility to initiate an interprofessional quality-improvement venture and improved the capture of kidney disease in those with diabetes. The results demonstrated a clinical and statistical significance. The results of this research will be published in the next edition of Applied Nursing Research Journal by Elsevier.
Healthcare in America has been focused on treating illness for too long, but the emphasis is changing. As healthcare providers we have a responsibility to lead the country in health promotion and illness prevention.
The Anna Mae (Berg) Spaniolo Endowed Faculty Practice Enrichment Award provided me the resources to create a professionally produced video to disseminate the practice guidelines based on the National Kidney Foundation - Kidney Disease Outcome Quality Initiative. The video is intended for healthcare providers but people with diabetes are benefiting from watching the video as well.
Those with diabetes tell me that they are taking the video to their healthcare provider and asking to be screened yearly for diabetic kidney disease. Certainly a mission, that nurse Anna Mae (Berg) Spaniolo would be proud of, as part of her legacy. I encourage you to pass this video forward. Let’s save our kidneys!