A longstanding effect of diabetes is target organ damage, in which the kidneys and eyes are among the most affected organs (Wynne & Hanavan, 2012).
Diabetic nephropathy is the terminology used to describe lesions that develop in the diabetic kidney (Grossman & Porth, 2014). The leading cause of chronic kidney disease is diabetic nephropathy (Grossman & Porth, 2014). The most common kidney lesion affects the glomeruli causing thickening of the basement membrane, glomerular sclerosis, and nodular glomerulosclerosis (Grossman & Porth, 2014). Glomerulosclerosis causes plasma protein to seep into the urine, causing proteinuria, hypoproteinemia, edema, and other signs of impaired kidney function (Grossman & Porth, 2014). Increased albumin in the urine (microalbuminuria) is one of the first signs of diabetic kidney nephropathy (Grossman & Porth, 2014).
All diabetic patients should have an annual spot urine test to check for microalbuminuria (urine protein loss of 30-300 mg/day). Two tests over a period of 3 to 6 months would be used to confirm the diagnosis of diabetic nephropathy (Wynne & Hanavan, 2012). The glomerular filtration rate (GFR) would be used to determine what stage of diabetic nephropathy the patient is in (Grossman & Porth, 2014). The patient should be referred to a nephrologist when the GFR falls below a certain level (80 mL...
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...tocoagulation treatment can be used to reduce chronic leakage and destroy scarring of lesions (Grossman & Porth, 2014). This treatment has an established effectiveness in preventing vision loss (Wynne & Hanavan, 2012).
Prevention of diabetic retinopathy is accomplished by improving glucose control; the protective effects of glucose control reduces retinopathy (Wynne & Hanavan, 2012). Insulin and oral antidiabetics are used to maintain HbA1c s Pathophysiology: Concepts of Altered Health States (9 ed.). Lippincott Williams &Wilkins. Retrieved from http://digitalbookshelf.southuniversity.edu/#/books
Type 2 Diabetes. (n.d.). Retrieved from PubMedHealth: http://www.ncbi.nih.gov/pubmedhealth
Wynne, A., & Hanavan, K. (2012). Diabetes Mellitus. In T. Woo, & A. Wynne, Pharmacotherapeutics for nurse practitioner prescribers (Third ed.). Philadelphia: F.A. Davis Company.
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