When you don’t have enough insulin, your body can’t distribute blood sugar properly. The resulting glucose buildup in your bloodstream can lead to several health complications, including chronic kidney disease.

Type 1 diabetes is a chronic autoimmune condition caused by a damaged pancreas. This leads to problems with insulin production.

Chronic kidney disease (CKD) that’s caused by type 1 diabetes is also known as diabetic kidney disease or diabetic nephropathy. This is a common complication that evolves gradually over the course of type 1 diabetes. More severe cases are associated with unmanaged diabetes.

Kidney disease may develop in people with diabetes when both nephrons and blood vessels in your kidneys get damaged from either high blood sugar (glucose) or high blood pressure.

Normally, the kidneys help filter waste products from blood and transfer them to urine.

High blood sugar from unmanaged type 1 diabetes can damage cells in the kidneys so they don’t filter as effectively as they should. This can cause you to lose protein in your urine. This is called microalbuminuria.

As kidney damage progresses, essential kidney functions such as filtering wastes from the body, decrease. This can cause a dangerous buildup of waste in your body.

While not everyone with type 1 diabetes will develop CKD, diabetes is considered the leading cause of CKD. It’s estimated that CKD affects 1 in 3 adults who have diabetes.

Aside from high blood sugar levels, other factors that may contribute to diabetic kidney disease include high blood pressure and a family history of the disease.

Diabetic kidney disease doesn’t typically cause symptoms until CKD has reached more advanced stages.

Symptoms of kidney disease may include:

  • foamy urine
  • loss of appetite
  • upset stomach
  • weakness
  • concentration difficulties
  • problems sleeping
  • swelling in the lower extremities

Tiredness, shortness of breath, and blood in your urine are also possible as CKD advances.

It’s important to see a doctor for regular checkups so they can help you prevent and manage CKD and other possible complications of type 1 diabetes.

You should also get medical help if you experience possible symptoms of diabetic kidney disease, or if you notice that existing symptoms are getting worse.

A doctor can diagnose diabetic kidney disease with a combination of urine and blood tests. In fact, anyone with diabetes should ask a doctor about getting these tests on a regular basis to help detect kidney problems before they reach more advanced stages.

Urine tests can help detect excess proteins that suggest kidney problems. Blood tests can help detect waste products that have built up in your bloodstream.

For example, a doctor can test for excess proteins in your urine and detect microalbuminuria before it progresses to end-stage renal disease (ESRD), or kidney failure.

There’s currently no cure for CKD. If you have diabetic kidney disease, the overall goal of treatment and management is to help prevent kidney damage from progressing further.

You may also help reduce your risk of complications from CKD, such as heart disease.

Treatment for diabetic kidney disease is most effective in its early stages. Ideally, you may begin treatment for CKD as a result of urine and blood tests before you even begin to experience symptoms of kidney problems.

Keeping blood pressure and blood sugar within ideal ranges can help prevent further kidney damage. Sodium-glucose transport protein 2 (SGLT2) inhibitors can help prevent further damage.

More advanced cases of diabetic kidney disease may require dialysis or a kidney transplant. This is necessary in ESRD, where your kidneys no longer function.

Research from 2021 found that diabetic kidney disease can cause premature death. Given the complexities in both diabetes and CKD, there’s no set timeline, particularly in type 2 diabetes.

The life expectancy for type 1 diabetes and kidney disease isn’t clear-cut. However, it’s believed that up to 40% of people with type 1 diabetes may experience more advanced kidney damage within 10–30 years.

A 2017 study found that more than 25% of people with type 1 diabetes developed ESRD within 40 years. The authors noted, however, that these rates have declined in recent decades due to early detection.

Diabetes management can help prevent kidney disease and other related complications.

In addition to diabetes medications, a doctor may recommend:

  • blood pressure medications
  • reducing sodium in your diet
  • limiting excess protein in your diet
  • getting regular exercise
  • weight management
  • quitting smoking if you smoke
  • avoiding alcohol

If you need support quitting smoking or drinking, a healthcare professional can help you build a plan that works for you.

High blood pressure is another complication associated with type 1 diabetes that can also increase your risk of developing diabetic kidney disease. In addition to urine and blood tests, a doctor will likely monitor your blood pressure to keep it below 140/90 mm Hg or below 130/80 mm Hg (depending on the guidelines followed).

A doctor may recommend that you avoid taking nonsteroidal anti-inflammatory drugs (NSAIDs), as these may damage your kidneys.

If you have diabetes, it’s important to speak with your doctor about your risk of developing kidney disease. Below are a few questions to help you start the conversation.

How long does it take for diabetes to damage kidneys?

It depends. Developing kidney damage from type 1 diabetes is variable and can range between 2 and 5 years after diagnosis. A doctor may recommend annual kidney testing if you’ve had type 1 diabetes for at least 5 years.

Everyone with type 2 diabetes should get tested for kidney damage every year regardless of when they were diagnosed.

What is the first sign of diabetic kidney disease?

Diabetic kidney disease often doesn’t have symptoms until the kidneys are significantly damaged. One of the first signs of kidney disease, however, is fluid buildup. Symptoms of fluid retention can include swelling in your arms and legs. Foamy urine is also a symptom.

Can you reverse kidney damage from type 1 diabetes?

Kidney damage cannot be reversed. However, lifestyle changes that support kidney health may help prevent further damage. These include taking your diabetes medications as directed, eating a nutritious diet, avoiding alcohol, and getting regular exercise.

How does diabetes cause kidney failure?

Diabetes can cause kidney failure when too much blood glucose damages your kidneys. This makes it so that they can no longer filter waste and they release too many proteins. High blood pressure related to diabetes can also contribute to kidney failure.

Can too much insulin damage your kidneys?

Insulin is a necessity for type 1 diabetes. While there’s no direct link between insulin and kidney damage, one 2022 study found that people with type 2 diabetes and advanced kidney damage were also more likely to take high levels of insulin.

Does type 2 diabetes affect the kidneys?

CKD isn’t a complication limited to type 1 diabetes. In fact, if you have type 2 diabetes, you may also be at risk of kidney complications. High blood glucose can damage your kidneys in the same way as with type 1 diabetes.

Kidney disease is a common complication of diabetes. With type 1 diabetes, kidney problems can develop over several years, but may progress more rapidly with unmanaged diabetes.

However, managing both your blood sugar and blood pressure can help decrease your risk of developing diabetic kidney disease. While early diabetic kidney disease is asymptomatic, annual testing can help a doctor detect problems sooner.