Diabetic kidney damage is usually due to changes in small blood vessels leading to the filtering system of the kidney or to the smaller blood vessels within the filtering system itself. It is a completely painless process and cannot be detected, even by a physical examination by a doctor.

Detection of early kidney damage, however, is possible by testing the rate at which the kidneys are leaking a protein called albumin into the urine. The urine is tested with a special test strip in the laboratory.

If kidney damage is detected, high blood pressure medications called ACE inhibitors help protect the kidneys from further diabetic kidney damage.

• People with diabetes have a higher chance of developing infections of the vagina, bladder and kidneys than people without diabetes.

• Bladder and kidney infections are more common in women because of the short length of the urethra, the tube taking urine from the bladder to the outside of the body.

• Germs can be massaged backwards up this tube in women during sexual intercourse and it is wise to empty the bladder after sexual intercourse to flush out any germs before they multiply.

• The urine and vaginal secretions or people with diabetes often contain increased amounts of glucose, particularly if the level of the glucose in the blood has been high. This provides an excellent source of food on which germs (bacteria and fungi) can grow.

• If the nerves to the bladder have been damaged by diabetes, the bladder may not empty completely when passing urine, leaving some urine inside the bladder where germs may multiply.

• Symptoms of bladder and kidney infections are:

• passing of small amounts of urine at more frequent intervals, day and night
• a burning discomfort or pain when passing urine
• backache is also an occasional symptom of kidney infection

• Infections of the bladder the kidney usually occur together. Antibiotics taken by mouth usually treat infections effectively.

• Prompt treatment of bladder and kidney infections is important as these infections, if allowed to continue, may result in chronic kidney damage.