Diabetes is a chronic medical condition characterized by elevated blood glucose levels. This occurs either due to the body’s inability to produce or utilise insulin (a hormone that regulates blood sugar) produced by the pancreas. Among the different types of diabetes, type 2 diabetes (T2D) is more common and often develops in adulthood. Lifestyle factors, genetics, and obesity are often associated with the development of T2D. Uncontrolled diabetes can lead to complications that affect many organs such as the heart, kidneys, and eyes.
According to Dr Pratik Das, Senior Consultant - Nephrology, Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, diabetes interferes with the filtering capabilities of the kidneys. For instance, did you know that diabetes is the leading cause of chronic kidney disease (CKD)? About one in three adults with diabetes suffer from CKD. Moreover, diabetes is often associated with a higher risk of hypertension (elevated blood pressure), which in turn exacerbates kidney problems.CKD is a slow-progressing condition with very few symptoms. Most people don't know they have it until it's too late and need to be put on dialysis or get a transplant to survive.
Therefore, managing diet and nutrition when you have T2D and CKD requires careful planning to balance blood sugar levels and support kidney function. Working closely with your healthcare team, including a registered dietitian or nutritionist, is essential to create a personalized plan tailored to your specific needs. Here are some of the ways to manage both conditions optimally:
Monitor carbohydrate intake: Pay attention to the type and amount of carbohydrates in your diet. Choose complex carbohydrates with a low glycemic index, such as whole grains, legumes, and vegetables. It is also essential to avoid refined carbs and processed sugars such as cookies, crackers, and soda.
Control portion sizes: Be mindful of portion sizes to help manage blood sugar levels and reduce the workload on your kidneys. Consider using measuring tools or visual cues to estimate appropriate portion sizes.
Moderate protein intake: Opt for high-quality protein sources, such as lean meats, poultry, fish, eggs, and plant-based proteins. Limit the amount of protein, as excessive intake can put additional strain on the kidneys. Your healthcare team will guide you on the appropriate protein level for your condition.
Manage sodium intake: Eating less salt/sodium is beneficial for diabetes and important for CKD. Over time, the kidneys lose their ability to balance sodium and water in your body. Eating less sodium will help lower your blood pressure and reduce fluid build-up, which is a common symptom of kidney disease. Moreover, eating fresh, home-cooked foods and limiting your intake of outside and packaged foods (which typically contain a lot of sodium) will help with both diabetes and kidney disease management.
Choose heart-healthy fats: Include sources of heart-healthy fats, such as avocados, nuts, seeds, and olive oil. Limit saturated and trans fats found in fried foods, processed snacks, and fatty cuts of meat.
Stay hydrated: Maintain adequate fluid intake. Consult with your healthcare team to determine the appropriate amount for your specific situation.
Limit phosphorus and potassium: Depending on the severity of CKD, you may need to limit foods containing phosphorus and potassium. Foods high in phosphorus include dairy products, nuts, and seeds, while high-potassium foods include bananas, oranges, and potatoes.
Eat smaller meals at regular intervals: Distribute your daily food intake to help stabilize blood sugar levels and avoid large fluctuations.
Managing both T2D and CKD requires a carefully crafted approach to diet and nutrition. Striking a balance between controlling blood sugar levels and supporting kidney function is crucial. Individualised plans, developed in consultation with healthcare professionals, can help navigate the complexities of carbohydrate intake, portion sizes, protein moderation, sodium control, and other dietary considerations. Regular monitoring and lifestyle adjustments are essential for effective long-term management.
