It is not uncommon for people with liver disease to have type 2 diabetes. When you have liver disease, your body may become resistant to insulin. Insulin is the hormone responsible for getting sugar from your bloodstream into your cells to supply energy. Insulin resistance leads to elevated blood sugars, which in turn leads to type 2 diabetes. Making changes to your diet can help you manage both your diabetes and liver disease, and improve your health.
Calories
Many people with liver disease have poor appetites, malabsorption and an altered metabolism, which affects their ability to adequately meet nutrient needs. Getting enough calories is important to help maintain weight, preserve lean body mass and prevent other complications such as infection. How much you need depends on your weight, activity level and disease state. In general, calorie needs range from 25 to 35 calories per kilogram of body weight. If you weigh 150 lbs., you may need 1700 to 2400 calories a day. Your doctor can help you determine your daily calorie needs.
Carbohydrates
When it comes to managing your diabetes, it is important to control your carbohydrate intake. Carbohydrates are the nutrients in food that have the greatest impact on your blood sugar. Foods containing carbohydrates include bread, cereals, grains, beans, fruit, milk, yogurt and sweets. Eating the same amount of carbohydrate at each meal can help you manage your blood sugars. The American Diabetes Association suggests starting at 45 to 60 g of carbohydrate at each meal. Your doctor or dietitian can help you determine your individual carbohydrate needs. Reading food labels and measuring your portions can help you track and control your intake.
Protein
Liver disease makes your body burn protein quickly, making it important that you get enough in your diet to meet your needs to maintain strength and muscle mass. Good food sources of protein for diabetics with liver disease include meats, poultry, fish and milk. These types of proteins contain all of the essential amino acids your body needs to make proteins. Meat, poultry and fish do not contain carbohydrates, and therefore do not affect blood sugar. Try to include 4 to 6 oz. of meat, poultry or fish. Milk and yogurt contain carbohydrates, so you need to make sure you balance your intake for blood sugar control. Try to include one to two servings of milk a day on your diet plan.
Sodium
Fluid retention can also be an issue for someone with diabetic liver disease, and limiting your sodium intake to 2,000 to 2,400 mg a day can help prevent your body from retaining fluids. When decreasing sodium in your diet, the easiest thing you can do is to stop adding salt to your food while cooking and at the dinner table. Instead, use salt-free herbs and spices to flavor your food. It also helps if you include more fresh foods in your diet, such as fresh meats, fruits, vegetables and grains, and limit your intake of processed foods. You should also read food labels to help you make the lowest sodium food choices.
References
- Liver Foundation; Nutrition and Liver Disease; Judith Fitzhugh
- "Krause's Food, Nutrition and Diet Therapy"; L. Kathleen Mahan, Sylvia Escott-Stump; 1996
- American Diabetes Association: Carbohydrate Counting
- National Institute of Diabetes and Digestive and Kidney Disorders; Cirrhosis; December 2008
