Diet plays an important role in the treatment of both diabetes and kidney disease. You should consult your doctor or a dietitian to help you develop a plan to meet your specific needs. In general, a diabetic renal diet controls the amount of carbohydrate, sodium, potassium and phosphorus you eat each day. You may also need to adjust the amount of protein you eat, even if you are not on dialysis.
Starches and Breads
Starches and breads contain carbohydrates. Some items can also be a source of sodium and phosphorus. One serving of a starch or bread contains about 15 g of carbohydrates. The amount of carbohydrates you need to eat at each meal depends on your calorie needs and blood sugar goals but can range from 45 to 75 g, according to dietitian Treena Hansen with Providence Health Care in British Columbia, Canada. Starch choices and serving sizes on your diabetic renal diet include one slice of white bread; 3/4 cup of unsweetened, refined-flour, ready-to-eat cereal; 1/3 cup of white rice or pasta; one 6-inch corn tortilla; five unsalted crackers; half of a hamburger roll; and 1 oz. of bagel.
Refined-flour food items contain less phosphorus. High intake of phosphorus can weaken your bones and lead to heart problems, according to DaVita. In addition, high quantities of sodium cause your body to retain fluids and increase your blood pressure. Read food labels to help you find low-sodium food products.
Starchy Vegetables
Each serving of starchy vegetables contains 15 g of carbohydrates. When on a diabetic renal diet, choose low-potassium starchy vegetables to limit your intake of potassium. High levels of potassium can be dangerous, leading to heart failure and death. Low-potassium starchy vegetable choices and serving sizes include 1/2 cup of peas or corn.
Fruit
Fruit contains both carbohydrates and potassium. Each serving of fruit provides 15 g of carbohydrates. Low-potassium fruit choices and serving sizes include a small apple, 1/2 cup of unsweetened applesauce, 17 small grapes, half of a large pear, 1 1/4 cups of whole strawberries, 1 cup of blueberries or raspberries, 3/4 cup of pineapple and 1 cup of watermelon. Talk to your doctor or dietitian about how much fruit you should eat each day on a diabetic renal diet.
Dairy Products
Milk contains carbohydrates, phosphorus, potassium and protein. Your renal diet should limit milk intake to 4 oz. a day, according to DaVita. A 4-oz. serving of milk contains approximately 6 g of carbohydrates and 4 g of protein. Choices and serving sizes for other dairy products include 1/2 cup of plain or sugar-free yogurt and 1/2 cup of buttermilk.
Nonstarchy Vegetables
Nonstarchy vegetables can be a source of potassium, and each serving contains 5 g of carbohydrates. A serving size is equal to 1/2 cup. Low-potassium vegetable choices include asparagus, beets, broccoli, Brussels sprouts, cauliflower, cucumbers, eggplant, snow peas, green beans, iceberg lettuce and summer squash. Use fresh or frozen produce to limit your intake of sodium. Your doctor or dietitian will determine how many servings of vegetables you can eat each day on a diabetic renal diet. Hansen recommends limiting your intake of these vegetables to 1/2 cup per day.
Meats and Meat Alternatives
Meat and meat alternatives provide your body with protein. If you are not on dialysis, you may need to limit your protein intake to 0.6 to 0.8 g per kilogram of body weight. If you are on dialysis, you have higher protein needs and need 1.1 to 1.4 g or more per kilogram of body weight. Use more fresh meat and meat alternatives to limit your intake of sodium. High-quality sources of protein include poultry, fish, beef, pork, eggs and low-sodium cottage cheese.
Fats
Fats add calories without much salt, potassium, carbohydrates or protein. One serving of fat contains 45 calories. Healthy choices for the renal diabetic diet include 1 tsp. of low-sodium butter, margarine, oil or mayonnaise and 1 tbsp. of regular cream cheese. Hansen recommends including one to two servings of fat at each meal.
References
- British Columbia Provincial Renal Agency: Meal Planning Made Easier for Diabetes and Renal Diseasee
- DaVita: Diabetes and Kidney Disease
- MayoClinic.com: Your Diabetes Eating Plan: Exchange Lists
- "Krause's Food, Nutrition and Diet Therapy"; L. Kathleen Mahan, et al.; 1996
- DaVita: Potassium and Chronic Kidney Disease
- DaVita: Phosphorus and Chronic Kidney Disease
