As of 2022, more than 130 million adults are living with diabetes or pre-diabetes in the United States.  Uncontrolled diabetes with high blood sugars can effect numerous organs in your body, including kidneys.  Diabetic kidney disease usually manifests as protein in the urine in the initial stages, then progresses to loss of kidney function.  The best way to try to manage the effects of diabetes on the kidney is to manage the diabetes itself.  Your family doctor and/or endocrinologist are key to this by dietary education and medication adjustments to best manage your sugars.  Certainly, you are key to watching your own diet and being compliant with your medications.  Evaluation and management by the nephrologist, however, can also help by making sure you are on specific medications focused on lessening the protein spilling, which ultimately will lead to protecting kidney function.