Diabetes and Kidney Health
Please note that the following information is provided as a general guide and is not intended to replace professional medical advice, diagnosis, or treatment. It is important to consult your healthcare team for personalised recommendations and to address any specific health concerns. For medical or health matters, please consult your GP, contact NHS 111, or call 999 in case of a medical emergency. We are unable to provide personalised responses regarding specific health enquiries or comment on individual medical conditions
Diabetes is one of the most common long-term health conditions in the United Kingdom and a leading cause of chronic kidney disease (CKD).
For African and Caribbean communities, understanding the connection between diabetes and kidney disease is especially important. People of African and Caribbean heritage are at increased risk of developing type 2 diabetes and are also disproportionately affected by kidney disease.
This guide explains what diabetes is, how it can affect your kidneys and the steps you can take to protect your kidney health.
What is diabetes?
Diabetes is a serious health condition that causes the level of glucose (sugar) in the blood to become too high.
Glucose comes from the food and drink we consume and is used by the body's cells for energy. A hormone called insulin, which is produced by the pancreas, helps move glucose from the bloodstream into the cells.
When the body cannot produce enough insulin or cannot use insulin properly, glucose builds up in the bloodstream.
Over time, high blood glucose levels can damage many parts of the body, including the eyes, heart, blood vessels, nerves and kidneys.
There are two main types of diabetes:
Type 1 diabetes
Type 1 diabetes can develop at any age but is most commonly diagnosed in children and young people. People with type 1 diabetes do not produce insulin because the body's immune system mistakenly attacks the insulin-producing cells in the pancreas.
Type 2 diabetes
Type 2 diabetes is the most common form of diabetes. It usually develops in adulthood, although increasing numbers of younger people are now being diagnosed. People with type 2 diabetes still produce insulin, but their bodies do not use it effectively. Over time, the body may also produce less insulin. As a result, glucose builds up in the bloodstream instead of being used by the body's cells.
People of African and Caribbean heritage are at a higher risk
of developing type 2 diabetes than the wider UK population
This makes regular health checks and early intervention particularly important
What are the symptoms of diabetes?
Common symptoms of uncontrolled diabetes include:
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Passing urine more frequently than usual
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Feeling unusually thirsty
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Feeling tired or lacking energy
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Losing weight without trying
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Blurred vision
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Recurrent infections, such as thrush
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Cuts and wounds that heal slowly
Some people with type 2 diabetes may have no symptoms at all, which is why regular health checks are important.
How does diabetes affect the kidneys?
Diabetes can damage the kidneys in two main ways.
Diabetic kidney disease (diabetic nephropathy)
The kidneys contain millions of tiny filters that remove waste products and excess fluid from the blood. When blood glucose levels remain high, these filters have to work harder than normal. Over time, this extra strain can damage the filters, causing protein to leak into the urine. As kidney damage progresses, the kidneys become less able to perform their normal functions.
Damage to the kidney blood vessels
Diabetes can also contribute to high blood pressure. High blood pressure damages the blood vessels that supply the kidneys, reducing blood flow and causing scarring. This can further reduce kidney function over time. Kidney damage caused by diabetes usually develops slowly over many years, often without symptoms in the early stages. This is why regular kidney screening is so important.
Why is early detection important?
One of the earliest signs of kidney damage is the presence of small amounts of protein in the urine. Regular urine tests can identify kidney problems before symptoms develop. Finding kidney disease early gives healthcare professionals the best opportunity to slow progression and help protect kidney function. For many people, early treatment can significantly reduce the risk of developing advanced kidney disease.
What other health problems can diabetes and kidney disease cause?
Diabetes and kidney disease both increase the risk of:
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High blood pressure
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Heart disease
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Heart attacks
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Stroke
People living with diabetes are also more likely to develop:
Eye problems - High blood glucose levels can damage the blood vessels in the eyes and affect vision.
Foot problems - Diabetes can affect circulation and nerve function, increasing the risk of foot ulcers and infections.
Regular health checks with your GP, diabetes team, optician and podiatrist can help identify problems early when they are often easier to treat.
How will my kidneys be monitored if I have diabetes?
Diabetes is a lifelong condition that requires regular monitoring. As part of your diabetes care, your healthcare team should regularly check:
Your urine - A urine test can detect protein leaking from the kidneys and is often the earliest sign of kidney damage.
Your blood pressure - High blood pressure can worsen kidney damage and increase cardiovascular risk.
Your kidney function - Blood tests are used to assess how well your kidneys are working.
If kidney disease progresses, your GP may refer you to a kidney specialist, known as a nephrologist, for further assessment and treatment.
How is type 1 diabetes treated?
Type 1 diabetes is treated with insulin. This may be delivered through:
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Multiple daily insulin injections
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An insulin pump
People with type 1 diabetes require lifelong insulin treatment because their bodies cannot produce insulin naturally. Healthcare professionals will provide education and support to help people manage their condition safely and effectively.
How is type 2 diabetes treated?
Treatment for type 2 diabetes often starts with lifestyle changes, including:
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Eating a healthy, balanced diet
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Increasing physical activity
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Maintaining a healthy weight
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Reducing excess body weight where appropriate
Many people will also need medication to help manage blood glucose levels.
SGLT2 inhibitors
SGLT2 inhibitors are a group of medicines used to treat type 2 diabetes. They help the kidneys remove excess glucose through urine, lowering blood glucose levels. Research has shown that some SGLT2 inhibitors can also help slow the progression of chronic kidney disease.
Finerenone
Some people with chronic kidney disease linked to type 2 diabetes may be prescribed finerenone. This medication can help slow the decline in kidney function and reduce the risk of kidney-related complications. Your healthcare professional can advise whether these treatments may be suitable for you.
Protect your kidneys with ACKEE
Protecting your kidneys starts with small, consistent actions that support your overall health.
A | Attend your health checks
Diabetes can damage the kidneys slowly and often without symptoms in the early stages.
Attend your diabetes reviews, annual kidney checks, eye screenings and other healthcare appointments. Regular urine, blood pressure and blood tests can help identify problems early, when treatment is often most effective.
C | Control your blood glucose and cholesterol
Keeping your blood glucose levels within your target range can help reduce damage to your kidneys, blood vessels, eyes and nerves.
It is also important to keep your cholesterol levels within the range recommended by your healthcare team, as high cholesterol increases the risk of heart and blood vessel disease.
K | Know your numbers
Understanding your health numbers can help you take greater control of your health.
Ask your healthcare team about:
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Your blood glucose targets
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Your HbA1c result
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Your blood pressure reading
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Your kidney function results
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Whether there is protein in your urine
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Your cholesterol levels
Knowing your numbers helps you recognise changes and have informed conversations about your care.
E | Exercise and eat well
A healthy balanced diet and regular physical activity can help manage diabetes, blood pressure and weight.
Aim to stay active throughout the week and choose activities that fit your lifestyle and ability. If you need support with your diet, ask your healthcare team whether a referral to a dietitian would be beneficial.
E | Eliminate harmful habits and review your medicines
Smoking can worsen kidney disease and increase the risk of heart attacks and strokes. If you smoke, seek support to stop.
It is also important to review all medicines, supplements and herbal remedies with your healthcare team. Some products may not be suitable for people living with kidney disease.
If you drink alcohol, aim to stay within current NHS guidelines.
Key message
Diabetes does not automatically lead to kidney disease. However, diabetes remains one of the leading causes of chronic kidney disease and kidney failure in the United Kingdom. The good news is that by protecting your kidneys with ACKEE - Attend your health checks, Control your blood glucose and cholesterol, Know your numbers, Exercise and eat well, and Eliminate harmful habits - you can take practical steps to protect your kidneys and support your long-term health.