 Okay, if you have diabetes, I am sure that you are concerned whether your diabetes will affect your kidneys or not. It may or it may not. That depends on how you are dealing with your diabetes. And your kidneys are not only damaged from diabetes, but there are a lot of other factors that also cause kidney damage. Unfortunately guys, a lot of people don't know that they have kidney damage due to diabetes. And it happens in my practice all the time. When I bring that up, hey, you know, your kidney function has been down for a while. Oh, really? Nobody told me. And that's because really nobody wants to bring that up because it creates a lot of questions, a lot of confusion. And you know, doctors sometimes do not know what to tell the patient because it is hard to explain. And here I am, I'm going to try to explain to you right now. So let's go over how really diabetes affects your kidneys. Now initially, because of the excessive glucose in your blood that creates the inflammation in your blood vessels, make the kidneys get larger. So actually at the initial stages, we see that the kidneys are larger on ultrasound. And we see that actually the filtration rate that helps us to measure how much kidney function you have left actually goes higher. So it's actually paradoxical because your kidney function seems to be better than normal supraphysiologic, we call it. And then next thing you know is because of excessive blood flow and excessive inflammation taken over your kidney and your kidneys will start to die and will shrink down. And when you have real chronic kidney disease at stage three, stage four, your kidneys will look really small. That is because of the excessive pressure, excessive inflammation in your kidneys will damage the arteries, arterioles in your kidney slowly. Now that does not happen overnight. It is a long process. People do not understand that their diabetic kidney disease will happen if they don't control their diabetes starting from day first. And that can happen in the 10 to 15 years after diagnosis if they're not controlled. If they are controlled within the first 10 to 15 years, they have less to fear because the first 10 to 15 years is the most critical period. And since it's a long marathon, people tend to postpone their diabetes care. But if you do not do it today, if you do not control your diabetes today, tomorrow may be too late to save your kidneys. Now, uncontrolled diabetes generally brings uncontrolled high blood pressure and uncontrolled cholesterol as well. So if you are just controlling your blood sugars, but you are not paying attention to getting your blood pressure at the optimal level and getting your cholesterol levels at the optimal level, you will not be able to save your kidneys either. So I have, a lot of times, have to educate patients a lot about this because they really do not comprehend how complicated the situation is. It is not just blood sugars. I tell them it's like a tripod. If you do not control your high blood pressure and your high cholesterol, even if you're, you know, let's say your two legs are controlled, your blood pressure is controlled, your diabetes is controlled, but your cholesterol is high, that tripod is not going to stand. You will still have a problem. So I think like a gang with three members, so diabetes, high blood pressure, high cholesterol. As a result, I always treat my patients holistically. For me, holistic means treating as a whole, treating the whole entire thing that causes the problem. So the diabetes, high blood pressure, high cholesterol is a part of insulin resistance, is part of the whole metabolic syndrome process. As a result, we have to control all of them together. So as a result guys, so we have to act early, we have to act quick. Diabetes has five stages. Most of the time, doctors will tell them they have a problem when they are stage three. When they're stage two, they don't even mention it because it stirs the water and patients panic about it. And most of the time, really what they need to do is not going to change. Your kidney function is not going to come back. If it is already down, your job is to try to keep it at that level. Now when you have stage two or stage three kidney disease, you're not going to probably have a lot of symptoms. When you get to stage four, then you will start having swelling, then you will start having nausea, urea will accumulate in your blood due to this. Your potassium may go up, your bones may be affected, your calcium and bones may be affected from the kidney problems. So when you have advanced kidney disease, it can get very complicated, it can be very problematic. It's not just going to dialysis. Everybody is fearful of dialysis. The physical part of it going there, lying there for hours, people don't like that. But when you have chronic kidney disease or when you're on dialysis, you become anemic, you become tired all the time, you become nauseous all the time, your calcium goes off, your vitamin D goes off, your bones get weak, you start developing arterial problems. It is a huge risk factor for heart attacks and strokes. As a result, most people who end up with dialysis, they do not survive too long. A typical average number of years on dialysis is five years, just because advanced kidney disease and dialysis is a huge risk factor for vascular problems. Again, I'm not trying to scare you off thoroughly, but I think for those who are in the early stages of kidney disease or who do not have kidney disease but diabetes, it is the time right now. Do not wait, control your diabetes today. And again, if you need help, please call us at SugarMDs at remote diabetes care, the remote live monitoring, and we are always here as close as a text or an email and video chatting is always possible. Have a great day, guys.