Medically Verified By: Dr. Rajasekara Chakravarthi Madarasu
Low blood sugar (Image AI Generated)
Chronic kidney disease (CKD) affects millions of people worldwide and can lead to several health complications. Blood sugar level (hypoglycaemia) is one of the not-so-familiar issues faced by individuals suffering from CKD. Low blood sugar isn't most people's concern when discussing diabetes care, but those with kidney disease are at a greater risk to develop it and for a number of reasons.
According to Dr Rajasekara Chakravarthi Madarasu, Senior Consultant Nephrologist, Clinical Director and HOD of Nephrology and Transplant Services at Yashoda Hospitals, Hyderabad, "People with chronic kidney disease and diabetes have a higher risk of developing low blood-sugar and they are especially prone to it."
Kidneys are one of the important organs in regulating normal blood glucose levels. As kidney function decreases, so does blood sugar control.
"This is because the kidneys of most diabetics don't allow these medicine and insulin to be excreted from the blood effectively. Normally, insulin is filtered out of the body through the kidneys. If kidneys are not functioning properly, however, insulin remains in the blood for a longer period of time. This may result in a drop of blood sugar levels deeper than anticipated and make you more susceptible to hypoglycaemia," the doctor added.
In the same way, certain oral diabetes meds could stay in the body for an extended period in individuals with CKD, which will enhance the risk of low blood sugar events.
Another factor that contributes to low blood sugar in kidney disease is the kidneys' ability to create glucose during a fast or during periods of not eating. This process is called "gluconeogenesis" and contributes to keeping your blood sugar level steady from meal to meal.
This function is impaired in persons with CKD. This causes the body to respond less readily to releasing adequate glucose into the blood when it is required, increasing the risk of low blood sugar levels.
People having kidney disease often have a poor appetite, nausea, weakness or other symptoms that lessen their appetite for food. Others may not eat at all since they are not hungry or are being sick.
When you reduce your calorie intake but don't decrease diabetes medications, there is a potential problem with your blood sugar level falling too low. Another very common cause of hypoglycemia in the patient with CKD.
A low blood sugar cannot be ignored. Symptoms can range from headache, sweating, shakiness, confusion, weakness, to loss of consciousness in rare severe cases. Multiple episodes may have a negative impact on a person's quality of life and cause accidents.
Dr Madarasu stresses the need to make careful dose adjustments of diabetes drugs for patients with chronic kidney disease. Frequent self-monitoring of blood glucose also is critical to detect changes early and avoid hypoglycemia.
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