Managing diabetes requires close monitoring of carbohydrate intake, especially simple sugars, since they are responsible for blood glucose spikes. Diet sodas do not cause these spikes, and in this regard are a healthier alternative than regular soda. If you have kidney disease and diabetes, however, you may need to limit certain diet sodas or cut them out all together.
Pathophysiology of Kidney Disease
Kidney disease is characterized by the progressive loss of kidney function. The kidney is responsible for filtering the blood to maintain serum electrolyte levels, such as sodium, potassium and maintaining pH within normal ranges. Potassium and sodium are the chief electrolytes in the body and, along with phosphorus, are the focus of dietary restrictions with progressive renal disease. In regard to soda, potassium, sodium and phosphorus are of concern.
Acesulfame Potassium May Raise Potassium
Diet sodas may be sweetened with aspartame, sucralose, acesulfame potassium, or a combination of these. These chemicals are considered G.R.A.S., or generally accepted as safe, by the Food and Drug Administration. If your kidneys are compromised, however, you lose the ability to filter certain electrolytes and minerals. Diet sodas sweetened with acesulfame potassium contribute dietary potassium and can raise serum potassium.
High Blood Potassium
Blood potassium levels of potassium can rise dramatically due to compromised kidney function. Hyperkalemia results when blood levels of potassium are higher than 5.5 milliequivalents per liter of blood. Nausea is a mild symptom of hyperkalemia, while irregular heart and even cardiac arrest could occur. Critically high potassium can be life-threatening. Further, sodas may also contain high amounts of phosphorus and sodium, so people with renal disease need to be especially careful to limit the number of sodas they drink per day. Fluid restrictions may also necessitate limiting fluids.
Drink Diet Cola Mindfully
The common denominator in dietary restrictions for both kidney disease and diabetes are carbohydrates, so diet soda seems to fit well into the diet of a renal diabetic. Diet sodas can fit into your diet if you have both renal disease and diabetes, provided it fits within your prescribed diet, which may include potassium, fluid, sodium, and phosphorus restrictions. Reading labels is imperative and talking to a registered dietitian may be a good idea.
References
- "Journal of the American Dietetic Association"; Position of the American Dietetic Association: Use of Nutritive and Nonnutritive Sweeteners; American Dietetic Association; June 2004
- "American Journal of Kidney Disease"; Public Health Surveillance of CKD: Principles, Steps, and Challenges; N.R. Powe; March 2009
- Centers for Disease Control: National Chronic Kidney Disease Fact Sheet 2010
- "Ecletica Quimica"; Comparison of Potassium and Sodium Content in Diet and Non-Diet Soft Drinks by Using Capillary Electrophoresis with Capacitively Coupled Contactless Conductivity Detection; I.C. Guimares, et al; 2009
