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What is the relationship between diabetes and creatinine level?

Tuesday, 28 September 2004
Answered by: Dr. Dinesh Dhanwal
Senior Consultant Endocrinologist,
Maulana Azad Medical College,
New Delhi
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Q. What is the relation between diabetes and creatinine? My mother was diagnosed with kidney problem and infection in her urine/blood. A nephrologist cleared out the infection she had but by that time her creatinine level had gone up to 8. The doctor prescribed Endoxin and Wysolone medication. After that her haemoglobin and white cells went beyond the range. In 2 subsequent visits doctor checked her creatinine which was found to be 4.9 & 5. Her sugar was found to be 536 and the doctor said that this was because of Wysolone hence he reduced the dose from 25 to 15 mg. After that her sugar levels came down to 430. Recently the doctor advised her to take insulin with 4,4,4 units daily (3 times) to maintain her sugar levels & asked her to go on a strict diet. When we measured it after 3 days after stating insulin, her sugar level came down to 230. We consulted our doctor so he increased the insulin dose as 6,4,4. Her creatinine level still varies between 4.5 to 4.9. I need your opinion about the same. Can her creatinine & glucose levels come down to normal in future with the current medication & diet? Will she face any other problem/complications in future and what precautions should we take to avoid further complications? My mother is 56 years old and weighs 66kgs. She has high blood pressure since 10 years and is taking ATANOL-50.

A.  Issues to be addressed in query are 1) Wysolone (steroid) induced Diabetes mellitus and 2) DM and raised creatinine levels (kidney failure). There is a relationship which exists between Diabetes Mellitus and raised creatinine levels. Usually this situation arises when DM is there for a long time and not controlled and this situation is called as diabetic nephropathy meaning kidney disease due to DM. Initially this presents as protein in urine but as the disease progresses creatinine level goes up. This type of kidney failure is irreversible and these patients need dialysis and renal transplant. In your mothers case high creatinine levels are not due to DM but seems to be due to glomerulonephritis which can be treated. Best person for this is a nephrologist. In this case the blood sugars are high because of wysolone and hopefully blood sugars should come down when wysolone is tapered off. But with such a high levels of sugar your mother needs higher doses of insulin i.e., at least 10 units of Actrapid/Huminsulin R 30 minutes before meals three times a day and Insulatard/ Lente 10 units at bed time. Home monitoring of blood glucose is also needed. For control of blood sugars please get in touch with an endocrinologist or daibetologist or provide us more details so that we can advise you accordingly.

A.  Issues to be addressed in query are 1) Wysolone (steroid) induced Diabetes mellitus and 2) DM and raised creatinine levels (kidney failure). There is a relationship which exists between Diabetes Mellitus and raised creatinine levels. Usually this situation arises when DM is there for a long time and not controlled and this situation is called as diabetic nephropathy meaning kidney disease due to DM. Initially this presents as protein in urine but as the disease progresses creatinine level goes up. This type of kidney failure is irreversible and these patients need dialysis and renal transplant. In your mothers case high creatinine levels are not due to DM but seems to be due to glomerulonephritis which can be treated. Best person for this is a nephrologist. In this case the blood sugars are high because of wysolone and hopefully blood sugars should come down when wysolone is tapered off. But with such a high levels of sugar your mother needs higher doses of insulin i.e., at least 10 units of Actrapid/Huminsulin R 30 minutes before meals three times a day and Insulatard/ Lente 10 units at bed time. Home monitoring of blood glucose is also needed. For control of blood sugars please get in touch with an endocrinologist or daibetologist or provide us more details so that we can advise you accordingly.

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