Diabetes occurs when the body does not produce enough insulin or when it does not use insulin effectively. Management of this condition involves following a healthful diet, getting regular exercise and taking insulin if necessary. Kidney disease makes it difficult for the kidneys to filter waste and maintain normal electrolyte levels. This disease also requires dietary adjustments, making it a challenge for someone with both diseases to plan a healthful diet.
Kidney Disease and Diabetes
Diabetes causes approximately 44 percent of all new cases of kidney disease each year, according to the National Kidney and Urologic Diseases Information Clearinghouse. Diabetes increases the risk for kidney disease because high blood sugar levels cause the kidneys to filter excessive amounts of blood. This increases the amount of work the kidneys do and damages the filtering units of these organs.
Minerals
The kidneys filter minerals and waste products, but kidney disease impairs their ability to perform these functions. As a result, sodium, phosphorus and potassium build up in the bloodstream. High levels of these minerals cause serious problems. Too much sodium causes fluid retention and increases the risk of high blood pressure. Excessive amounts of phosphorus lead to decreased calcium levels and promote the formation of calcium deposits in the blood vessels. High potassium levels cause irregular pulse, weakness and cardiac arrest. Diabetics with kidney disease must limit the intake of foods that have high levels of sodium, phosphorus and potassium.
Carbohydrates
Carbohydrates have the greatest impact on blood sugar levels, so you should carefully monitor your intake of this nutrient. The carbohydrate counting method makes it easy to track how many carbohydrates you consume during each meal. Foods with 15 g of carbohydrate count as one serving, foods with 30 g of carbohydrate count as two servings and foods with 45 g of carbohydrate count as three servings. Eating the same number of servings at each meal helps keep blood sugar levels steady. Carra Moroni, a registered dietitian for the American Association of Kidney Patients, recommends eating three servings of carbohydrate at each meal. Diabetics with kidney disease need to use caution when selecting foods that contain carbohydrates, however. Some fruits and vegetables contain high levels of potassium, making them unsuitable for a diet used to manage kidney disease. You should avoid cantaloupe, tomatoes, bananas, fresh broccoli, potatoes and spinach in favor of apples, strawberries, cherries, bell peppers, carrots and onions.
Protein
Too much protein makes the kidneys work harder, so those with kidney disease should limit their consumption of high-protein foods. Because diabetes increases the risk for cardiovascular disease, diabetics need to limit their consumption of fatty meats. Some meats, such as luncheon meat and canned meat, also contain high levels of sodium. You should avoid peanut butter, nuts, bacon, luncheon meat, salami, organ meat and cheese in favor of seafood, eggs, lean meat, poultry and egg substitute.
Fluid Intake
Diabetics need to consume beverages that will not cause rapid blood glucose changes. Since kidney disease makes it difficult for the kidneys to maintain normal fluid levels, your doctor may recommend limiting the amount of liquid you consume each day. Water, clear diet sodas and unsweetened iced tea are suitable for a renal diabetic diet. If your doctor recommends limiting your fluid intake, drink small amounts of these beverages. You should also limit your intake of foods that turn into liquid when eaten, including ice cream, gelatin and ice pops.
References
- National Diabetes Information Clearinghouse: Diabetes Overview
- National Institute of Kidney and Urologic Diseases Information Clearinghouse: Kidney Disease of Diabetes
- American Diabetes Association: Kidney Disease (Nephropathy)
- Am. Association of Kidney Patients; How Can I Follow My Renal Diet and Diabetic Restrictions?; Carra Moroni; June/July 2006
- National Kidney Foundation: Nutrition and Chronic Kidney Disease
