Diabetes and kidney disease have a close relationship, with the presence of diabetes increasing the risk of renal disease. Because diabetes and kidney disease require special dietary restrictions, proper nutrition plays a role in managing both conditions. Following a renal diabetic diet helps to preserve kidney function and control blood glucose levels. This reduces the risk of serious complications.
Diabetes & Renal Disease
The National Kidney and Urologic Diseases Information Clearinghouse reports that diabetes causes nearly 44 percent of the new cases of kidney failure reported each year. Diabetes damages the filtration units of the kidneys, resulting in reduced function. As kidney function declines, the kidneys do not maintain normal balances of fluids, electrolytes, minerals and waste products in the body. Adherence to a special diet becomes more important as kidney disease progresses.
Renal Diabetic Diet
The renal diabetic diet combines the principles of a diet for diabetes and a diet for renal patients. The renal portion of the diet focuses on reducing the workload of the kidneys and preserving any remaining kidney function. This involves restricting the intake of sodium, protein, potassium and phosphorus. The diabetic portion of the diet focuses on maintaining normal blood sugar levels by controlling the amount of carbohydrates consumed each day.
Restricted Foods
Restricted foods on the renal diabetic diet contain too many carbohydrates or have high levels of sodium, protein, potassium or phosphorus. Milk products contain high levels of phosphorus, so avoid buttermilk, chocolate milk, ice cream, sweetened yogurt and frozen desserts. While some starches contain beneficial nutrients, they also contain too many carbohydrates for a diabetic.
Starches to avoid include whole-grain cereals, instant cereals, whole-grain breads, potato chips, biscuit mixes and salted crackers. Patients with kidney disease need to avoid high-protein foods such as cheeses, nuts, dried beans, cured meats and peanut butter. Despite the nutritional content of fruits and vegetables, many of them contain high levels of potassium. Patients on the renal diabetic diet should avoid bananas, cantaloupe, nectarines, broccoli, spinach, tomatoes, baked potatoes, winter squash and sweet potatoes.
Acceptable Foods
Several foods have acceptable levels of carbohydrates, protein and minerals for the renal diabetic diet. People with diabetes and kidney disease should limit their cholesterol intake to less than 300 mg per day and restrict total fat intake to 30 to 35 percent of their daily caloric intake, according to Colorado State University. Acceptable foods and beverages for the renal diabetic diet include poultry, eggs, lean meats, cottage cheese, water, clear diet sodas and low-cholesterol egg substitutes. Acceptable fruits and vegetables include cabbage, beets, eggplant, kale, celery, bell peppers, cucumbers, turnips, radishes and onions.
Monitoring
Regular laboratory tests help determine the effectiveness of the renal diabetic diet, and allow members of your care team to make any necessary adjustments. The basic metabolic panel checks the levels of glucose, electrolytes and waste products in the blood, allowing doctors to determine if you have your diabetes and kidney disease under control. If either condition worsens, you may have to restrict the intake of additional foods or limit your consumption of liquids.
