The Role of the Kidneys in Diabetes









When we speak of the pathology of diabetes, we often will mostly talk about extra glucose being introduced into the bloodstream by the liver, and we don’t talk about the role that the kidneys play in all of this.  It’s a substantial one though and is well worth noting and paying attention to.

Hypergycemia, high blood sugar, is considered to be the hallmark of type 2 diabetes, and it’s what we use to diagnose the disease.  Now as it turns out this is just one of several symptoms of the disease and is not the disease itself, but managing blood sugar is certainly part of managing the disease, not the whole thing like the medical profession believes, but an indication of our progress, over the long term that is.

For instance we never should be just seeking blood sugar improvement in the short term, without regard to what the long term consequences of our actions will be, and this is the mistake that the medical profession makes, and they don’t even care that their efforts fail in the long term, that they are futile, or even that they end up making the disease worse.

One example of this is in looking to manage blood sugar levels by further increasing our levels of insulin toxicity, which will indeed lower blood sugar for now, but accelerate the damage by accelerating insulin resistance, and require ever increasing amounts of insulin.  Finally you get to the point where the patient gets so messed up that all the medication we dare give them, and they are pretty daring, fails to provide satisfactory results.

The real reason behind this failure is the fact that by doing this, we worsen what is behind the high blood sugar, and it’s not a lack of insulin with type 2, it’s actually an excess of insulin, and an excess of a number of other hormones, particularly ones that are designed to elevate our blood sugar.

Insulin does play a role in keeping these hormones in check, keeping them from either getting too high or exerting too much upper influence on our blood sugar, as is the case with glucagon and adrenal hormones for instance, or it may cause hormonal problems simply by making us too fat, as is the case with leptin resistance.

In the end, what happens to our blood sugar is that it is raised up too much by our bodies secreting too much glucose into our blood, the sort of thing that is necessary to keep us from having dangerously low blood sugar, but in this case our blood sugar is too high already, but the body is acting like it is too low.  Higher blood sugar is the result.

Now a lot of this excess glucose secretion comes from the liver, primarily from having too much glucagon secreted from the pancreas to the liver, and the liver decides how much glucose to secrete based upon the ratio of insulin to glucagon, and even if insulin is high, if glucagon is higher, it will perceive hypoglycemia and react to that.

In the normal non fasting state, most of this extra liver glucose is in the form of glycogen, although some of it is also from a process known as gluconeogenesis, which is the way the body makes glucose out of non glucose sources, which include glycerol from the breakdown of fats, certain amino acids and certain byproducts of metabolism like pyruvate and lactate.

So regardless of whether you’ve eaten or not, or even eaten in a long time, this process regulates your blood sugar, and in the case of diabetes, can also over-regulate it to various degrees.  So you can have a fasting blood sugar of 250 for instance and not eat for several days and still be at 250, which mystifies some people but it’s only because they don’t understand this process.

As the time after a meal increases, and glycogen becomes depleted, in one to two days the liver solely relies on gluconeogenesis.  On the other hand, the kidneys also contribute to gluconeogenesis, and since the kidneys don’t store glycogen, all of their effects are by way of gluconeogenesis.

So I’ve got an article on this for those who are really interested in this which you’re welcome to check out, although this is quite technical.  These are not new discoveries, they just tend to get shuttered to the back room a lot in scientific discussions of glucose over-regulation but we do want to be aware of the kidneys and also aware of the things that drive them.

During the fasting state, after the meal has been digested, such as overnight fasting when one is sleeping, and in other situations where the interval between meals is longer than typical, about 55% of the glucose that enters our blood has been shown to come from gluconeogenesis.  People think that this only happens when you deplete glycogen, and while the liver will secrete mostly glucose from glycogen until its stores are depleted, the kidneys produce about a quarter of overall endogenous glucose secretion, and all of it is from gluconeogenesis.

Depending on the circumstances, the amount of glucose that our kidneys produce may be even higher, especially in diabetics.  If one’s adrenal hormone levels are high, this will really be the case, and adrenal hormones, like the kidneys, tend to be overlooked quite a bit.

While glucagon drives liver glucose, adrenal hormones drive kidney glucose, and while both are supposed to be suppressed by insulin, due to insulin resistance, this isn’t the case enough in type 2 diabetes.

Aside from high levels of adrenaline and cortisol driving up kidney glucose secretion, higher levels of growth hormone do this as well, and all of these really need to be paid attention to, especially growth hormone levels.  In diabetics, somatostatin levels are on the low side, and somatostatin is secreted in the delta cells of the pancreatic islets, alongside the alpha and beta calls, as well as in the delta cells of the gastrointestinal tract, and among the hormones it keeps in check are glucagon and growth hormone.

Injected somatostatin has been found to be extremely helpful in blood sugar regulation by the way, we just haven’t found a safe way to raise it, and leaving this to the pharmaceutical companies as we do, they are out to create a synthetic and unique compound that may be patented, which in itself is a dangerous pursuit, and is why all pharmaceutical drugs are toxic by nature.

So when you check your blood sugar, people usually think, well I consumed too much glucose.  Those more in the know may think that, in addition to that, my liver is putting too much glucose into my blood.  Those are only two sources though, and we also need to be aware that our kidneys are doing this as well, in addition to our gastrointestinal system also manufacturing extra glucose, and they all will continue to do this in spite of our blood sugar already being too high, and in spite of even just having eaten a big meal.

The kidneys actually increase gluconeogenesis after a meal, in normal individuals even, and with diabetes, they will increase it even more.  If they contribute 25% of the extra glucose in our blood, reigning this in more certainly has the potential to improve our blood sugar.

We are talking about healthy kidneys here by the way, the problems we run into isn’t from the kidneys themselves, it’s from excess hormones commanding them excessively, although looking to maintain kidney health is super important, as well as proper adrenal function, and the adrenals really take a beating in today’s stress filled modern world, and stress is just one factor here.

This all likely goes back to the gut as it usually does, and especially with reduced somatostatin release, and somatostatin is just one hormone that gets out of kilter with poor gut health, but it’s a pretty important one indeed.  Gut health is going downhill, diabetes is climbing, and the two really do go together.

Needless to say though, given the role of the kidneys in glucose metabolism, you want healthy kidneys, and you certainly don’t want them to be inflamed or infected.  A lot of diabetics have a lot of inflammation and many of them also have chronic urinary tract infections and this is all going to make the problems we already have worse.

It’s also a good idea to take supplements that strengthen the kidneys, things like milk thistle which help both the liver and kidneys, dandelion root, and astragalus.  Things that promote healthy uric acid levels like black cherry and alfalfa are also important, as well as things that alkalize the body like chlorella and spirulina.

We really don’t pay much attention to our kidneys and they are super important organs and especially if you are a diabetic.

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