SPILLING THE BEANS ON THE KIDNEYS

The fear in her eyes was palpable. She talked about the "nightmare" of undergoing haemodialysis and being hooked up to a machine thrice a week, week after week. For life.

In a positive way, that fear helped her. She was one of my more motivated patients who did not stop at anything to keep her blood glucose level and high blood pressure under check. Is renal (kidney) dialysis a "life sentence"?

Many patients have taken it in their stride and have coped well. Who is more suited for another form of dialysis, peritoneal dialysis or PD? Figures from the Ministry of Health showed that as of end December 2004, there are 2,700 patients on haemodialysis and 701 patients on peritoneal dialysis. How about renal transplantation? Is transplantation the way to go? Our guest renal specialist, Dr Gordon Ku, touches on these pertinent issues in Medical Conversation.

What can those with diabetes do to reduce the risk of requiring dialysis? For one, good blood pressure control reduces the risk of microalbuminuria (which is the earliest sign of kidney problems from diabetes). Good blood glucose control has the same effects, drastically lowering the risk. One of the biggest problems with managing diabetes is that complications occur many years down the road.

I have come across a number of patients who, at their own peril, embrace the motto, "Live it up today, Tomorrow never comes". But tomorrow does come. And for those with diabetes, it often comes with a vengeance.

Is it possible to live life with diabetes and avoid the many feared complications? In this issue, our experts "spill the beans" on how you can give yourself a fighting chance against diabetes-related kidney disease.

Finally, some good news! Health Minister Mr Khaw Boon Wan announced on 11 April 2006 that plans are afoot to allow the use of Medisave for outpatient bills for chronic conditions such as diabetes and high blood pressure. It is hoped that this will allow those with these conditions to better manage them before complications set in. The maxim that prevention is better than cure cannot be more true.
 

Dr Yeo Kim Teck
Editor, DMLife
Senior Consultant
Singapore National Eye Centre

"Every day, one to two diabetic legs are amputated. What a loss! And it can be avoided or postponed for    many years." - Mr. Khaw Boon Wan, Health Minister, Singapore.