When I meet patients in my clinic, most of the discussion is around sugar readings, food habits, or medicines. What is often overlooked is that diabetes affects much more than blood sugar alone.
Among the organs most at risk are the kidneys. The challenge is that kidney damage usually develops quietly, without pain or warning signs, until it is already at an advanced stage. That is why I tell my patients that annual check-ups are not just a routine—they are essential for protecting long-term health.
Why the kidneys are at risk
The kidneys act like filters, removing waste and balancing fluids. In diabetes, high sugar levels slowly injure the delicate blood vessels that keep these filters working.
This condition, called diabetic nephropathy, does not cause obvious discomfort in the early stages. A person may feel normal while kidney function is steadily reducing. By the time swelling, tiredness, or changes in urination are noticed, much of the damage has often already occurred.
Diabetic kidney disease is strong among the family members with high penetrance in comparison to other diabetes complications.
What yearly tests can reveal
We don’t need to wait for symptoms. A few simple tests give us a clear picture of how well the kidneys are coping:
Urine albumin test: detects early protein leakage, often the first sign of kidney strain.
Serum creatinine and eGFR: measure how effectively the kidneys are filtering blood.
Blood pressure monitoring: crucial, since high blood pressure worsens kidney damage.
When done once a year, these checks can detect trouble long before the patient feels unwell. With early detection, treatment can be started to slow or even stop progression.
The hidden link with heart health
Kidney disease in diabetes is closely tied to blood pressure and heart health. Weakening kidneys often pushes blood pressure higher, and raised blood pressure further damages the kidneys, a harmful cycle. In addition, kidney problems increase the chances of heart attacks and strokes.
This is why monitoring kidney function is not only about protecting one organ but about protecting overall health.
Everyday steps that make a difference
Tests are vital, but lifestyle habits are equally important. I often remind patients that medicines alone are not enough; small daily choices matter greatly. Some key practices include:
Keeping sugar levels within target through diet, exercise, and medicines.
Monitoring and controlling blood pressure.
Cutting down on salt reduces strain on the kidneys.
Drinking adequate fluids without overloading the body.
Avoid frequent use of painkillers like NSAIDs, which can harm the kidneys.
These steps may seem simple, but over time, they protect kidney health in powerful ways.
Common myths among patients
Many patients believe, “If I have no pain, my kidneys must be fine.” Sadly, kidney disease is often silent until advanced. Another misconception is that once damage begins, nothing can be done.
The reality is that with early detection and proper care, many patients live active, healthy lives for decades. Even when dialysis or transplant becomes necessary, good management can delay that stage significantly.
Lessons from experience
I remember a man in his forties who reluctantly came for his annual diabetes review. He felt completely well but agreed to the urine test. It showed early kidney strain.
With medicines, diet changes, and blood pressure control, he has maintained healthy kidney function for over 15 years. On the other hand, I have seen patients who avoided follow-ups and returned only when swelling or breathlessness appeared; by then, much of the kidney’s capacity was lost.
These real-life examples show why regular monitoring is so valuable.
For anyone living with diabetes, kidney health cannot be left to chance. The disease may be silent, but it is not undetectable. A few simple tests, once a year, can mean the difference between stable health and crisis. My advice is: take your annual check-up as seriously as your daily medicines.
Your kidneys work quietly every single day. Care for them, and they will serve you for many years. By giving them attention now, you are protecting not just your kidneys but also your heart, your well-being, and your independence in the future.
Disclaimer: The views expressed in this article are of the author and not of Health Dialogues. The Editorial/Content team of Health Dialogues has not contributed to the writing/editing/packaging of this article.