Diabetes does not always result in kidney disease. Genetics, blood glucose control, and blood pressure are all factors that can influence the development of kidney disease. The better a person controls their diabetes and blood pressure, the less likely they are to develop kidney disease.

High levels of blood glucose cause the kidneys to filter too much amount of blood. This additional work makes it hard on the filters. They begin to leak after many years, and useful protein is lost in the urine. Microalbuminuria is the presence of small amounts of protein in the urine. Because the kidneys work hard to compensate for the failing capillaries, kidney disease does not cause symptoms until almost all function is lost. Furthermore, the symptoms of kidney disease are not consistent. The accumulation of fluid is frequently the first sign of kidney disease. Loss of sleep, a poor appetite, an upset stomach, weakness, and difficulty concentrating are additional signs of kidney disease.