In diabetics, surgery is a little more complicated than that in healthy individuals as they are more prone to cardiac problems and infections.
Gestational diabetes & kidney stones: Diabetes is a fairly common condition, especially in India, which is almost the diabetes capital of the world. Patients with diabetes have problems in regulating their blood sugar and this freely roaming sugar forms, toxins called advanced glycosylation end products which cause damage to many parts of the body such as the retina, the kidneys and nerves, to name a few. Patients who have diabetes need to take special care for stones because of higher incidence, different nature of stone that forms, already existing risks to the kidney, more top surgical dangers of infections and higher complications if stones are left unattended. Hence for people with diabetes, prevention is the best cure. Let's read more about the link of diabetes with kidney stones and the reasons behind the same.
Studies have revealed that the incidence of kidney stone formation is higher (more than double as per some studies) in people who have diabetes than those who don't. In people with diabetes, the acidity of urine becomes high due to problems in ammonia formation in the kidneys. The higher acidity leads to accumulation of uric acid stones as uric acid crystals precipitate and aggregate more commonly when the urine is acidic. More upper body mass index has been shown further to increase the acidity of urine in patients with diabetes. High level of sugar in the urine is often a breeding ground for bacteria and leads to frequent urinary infections. Urine infections are associated with something called struvite stones or infection stones.
Having known this, Dr Raman Tanwar (Secretary-General of Men’s Health Society of India and leading national Andrologist) tries to focus on why we need to prevent stone formation is diabetes.
We already know that diabetes causes damage to the kidneys. The high levels of sugar cause damage to the kidney filters regularly leading to widening of the pores of the kidney filters. This condition is called diabetic nephropathy. When stones form, they often block the passage of urine and clog the filters further increasing the damage to the kidneys. This double attack on the organ can be lethal, and patients may end up with dialysis or need for a kidney transplant. Struvite stones have the potential to grow very fast and block the entire collecting system of the kidneys. If kidney stones are detected in a late-stage, then surgery is the only option for patients to get rid of them.
Diabetic patients must always be aware of kidney stone prevention, and screening of the kidneys with ultrasound may be useful. Small stones can be easily removed or dissolved with medications, and surgery can be prevented. While reasonable sugar control is the key to reducing complications, Diabetics can also make specific changes in the diet to reduce the incidence of stone formation. Two types of foods have been suggested to be helpful, the Borghi diet and the DASH (Dietary Approaches to Stop hypertension). The DASH diet is particularly beneficial in patients with diabetes and includes more utilization of fresh fruits and vegetables, whole cereals, milk and milk products along with legumes and nuts. The diet restricts the intake of salt, sweet beverages and red meat and other processed animal products.
It has been seen that when patients take such a diet, the urine volume and urine citrate ( a stone inhibitor) increase. With these dietary precautions and maintaining strict diabetic control, we can prevent and treat kidney stone disease in diabetics.
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