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Diabetes No. 1 cause of kidney failure

It was 1966 that Dr. Cesareo Vasquez, a 27-year veteran at Williams Health Care Center, first came into contact with diabetes. That was the year he met Sharon.

Sharon was a young woman who wanted to be a model. Vasquez was working as an intern at Oakwood Hospital in a suburb of Detroit, Mich. While there, he treated her for diabetes. Then he joined the Army and was transferred to Bellemont in 1969, where he was stationed for 18 months.

“That’s how I came to Flagstaff,” he said.

It was after returning to Oakwood that he ran into Sharon again.

“It was very, very sad to see the ravaging of diabetes,” Vasquez said. “It was devastating.”

Vasquez spoke about the disease to the Williams Diabetes Support Group on Feb. 1. He also discussed preventing kidney disease, the leading cause of kidney failure for diabetics.

End stage renal disease (ESRD) is a slow deterioration of the kidneys, a process known as nephropathy, in which the kidneys fail to remove waste from the body.

It is also a disease that affects approximately one-third of all diabetics, hitting type I diabetics the hardest.

“About 40 percent of people with insulin-dependent diabetes (type I) develop severe kidney disease and ESRD by age 50,” a National Institute of Diabetes and Kidney Diseases, pamphlet states.

Treating the whole patient is the goal all physicians should follow, Vasquez said.

“Some of the areas we, as physicians, fall short is checking for kidney disease,” he said. “What prevents kidney disease is looking for protein in the urine sample.”

These urine tests should check for protein and microalbumin.

“Early in the disease (ESRD), the filtering efficiency diminishes, and important proteins in the blood are lost to the urine,” the pamphlet said.

Vasquez said sometimes doctors are so busy they forget to treat all the patients’ needs.

“The bad thing is when we fall short — when care falls short,” he said. “You sometimes may need to remind us to specially handle diabetes problems.”

Patients that have kidney disease have to undergo either dialysis, which mechanically filters the blood like the kidneys would, or have a kidney transplant.

‘They have found that high blood pressure and high levels of blood sugars increase the risk that a person with diabetes will progress to ESRD,” the pamphlet states.

Treatment for kidney disease is connected to blood pressure medicines.

“Drugs used to lower blood pressure can slow the progression of kidney disease significantly,” the pamphlet states.

Kidney disease is a slow killer that usually takes years to develop symptoms, Vasquez said. He said checking for proteins can head off potential problems.

“Symptoms related to kidney failure usually occur only in the late states of the disease, when kidney function has diminished to less than 25 percent of normal capacity,” the pamphlet states.

Diabetics also need to have a hemoglobin A1C test, which averages blood sugars over a short period, and blood pressure taken every three months. Annually, Vasquez recommends a complete physical exam, complete eye exam, an examination of the feet and urine tests.

In 1999, 800,000 Americans were diagnosed with diabetes.

The disease is the most common cause of ESRD, resulting in about one-third of new ESRD cases.

“Even when drugs and diet are able to control diabetes, the disease can lead to nephropathy and ESRD,” the pamphlet said. “About 15 million people in the United States have diabetes, and about 50,000 people have ESRD as a result of diabetes.”

Locally, a group is forming to address diabetes issues.

“Diabetes Today is a seminar to bring awareness of diabetes to our community,” said Rose Marie Rincon, sponsor of the Williams support group. “I think if we get more community involvement it will help a lot.”

The seminar runs 8:30 a.m.-2:30 p.m. on March 31 at the Williams Health Care Center. So far representative from 11 groups in town have signed up to participate.

Anyone who wants to sign up for the seminar can call Rincon at 635-4897 to share their local diabetic concerns. The diabetes support group meets the first Thursday of every month in the lobby of the Williams Health Care Center.


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