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AKI (Acute Kidney Injury) and Hypo Risk

hellobear007

Active Member
Messages
38
Location
Cambridgeshire
Type of diabetes
Type 1
Treatment type
Pump
On Sunday I was again rushed to hospital with a massive hypo that was untreatable at home.

After again receiving fluids and dextrose via IV I was given blood and stool tests.

It turns out an underlying infection and bowel inflammation (awaiting further tests) along with dehydration has caused AKI (Acute Kidney Injury)

My diabetes nurse told me today that with AKI the kidneys can excrete insulin, leading to an increased risk of hypoglycemia.

We are given fact sheets of sick day rules, DKA etc but I feel that education and guidance (not just to patients but health professionals too) is needed for AKI and how to adjust insulin ) medication accordingly.

More info herehttps://www.thinkkidneys.nhs.uk/aki/blog/diabetes-and-acute-kidney-injury-the-perfect-storm/

I am now down to a 40% basal and taking it easy while I await my gastro teams input.
 
hellobear007 said:
My diabetes nurse told me today that with AKI the kidneys can excrete insulin, leading to an increased risk of hypoglycemia.
Click to expand...

How does that work for a T1 who no longer produces insulin....? The kidneys can produce insulin?????
 
EllieM said:
How does that work for a T1 who no longer produces insulin....? The kidneys can produce insulin?????
Click to expand...

There are several studies out there outlining the kidney's part in glucose homeostasis. It's not an area I have spent any time reading up on myself, but a search throws up quite a bit, including this: https://jasn.asnjournals.org/content/18/10/2623
 
I wrote a reply and cannot locate it on this thread.
@hellobear007, so sorry that this has happened to you.
In hindsight things are so much clearer.
I think you meant that when your kidneys failed they stopped excreting insulin which had already done its job.
The accumulation of insulin led to hypos.
 
DCUKMod said:
There are several studies out there outlining the kidney's part in glucose homeostasis. It's not an area I have spent any time reading up on myself, but a search throws up quite a bit, including this: https://jasn.asnjournals.org/content/18/10/2623
Click to expand...
From that article
Insulin is also metabolized by the kidney, and reduced renal function prolongs the half-life of insulin and can contribute to hypoglycemic events.
Scary stuff
 
So I would suppose for a T2 with kidney damage there could be a similar scenario an increase in insulin in the system causing problems especially for insulin dependent T2's.
 
Yes that is correct. You explained it much better than me lol
 
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