Sticking to a Kidney and Diabetes Diet

If you find yourself wondering how you can make a renal and diabetic diet work for you without cutting out all of your favorite foods, you’ve come to the right place.

What’s the connection between Kidney Disease and Diabetes?

Diabetes is the leading cause of Chronic Kidney Disease (CKD) in the US, making up about 44% of new cases(1). Type 1 and Type 2 Diabetes can both lead to CKD, especially if they aren’t well controlled.

We know that consistent poor control of blood sugar can cause long term kidney damage. We also know that nearly half of people living with CKD have diabetes too.

Diet is important in managing both kidney disease and diabetes. So, it should be easy to find information on a kidney-diabetes hybrid diet, right?

I wish that it were so.

Controlling Diabetes Increases kidney function

As high blood sugar can decrease kidney function, we also know that controlling blood sugar can increase kidney function(2) - yay!

The CKD kidneys are stressed enough, we don’t want to add to their load by allowing blood sugar to stay elevated long term.

High blood pressure and Diabetes and CKD

You may also have high blood pressure. As the 2nd leading cause of Kidney disease, high blood pressure is a very common diagnosis for people looking into the kidney diet. 

It’s easy to panic because you’re worried about adhering to 3 different diets:

• A low sodium diet for high blood pressure

• A carb controlled diet for diabetes

• And a renal diet
  

But, I have good news.

The renal - or kidney diet - is already designed to treat high blood pressure. It is already a low sodium diet. That means that is has less than 2300mg of sodium per day. So, you don’t have to do anything differently to make your kidney diet low sodium.

Convenient, right?

Blending the Diabetic and Kidney Diets

We’ve addressed why keeping diabetes well controlled can help to maintain, if not, improve, kidney function. Now, let’s talk about the how.

If we want to stick to a renal diet for diabetes, there are a few things to be mindful of.

• Limiting carbs at meals based on recommendations from your dietitian

  • Your needs may be more or less depending on your activity level, but common recommendations vary between 30 and 60 grams per meal.

• Pairing high sources of carbohydrates with fat, fiber, and/or protein

  • Carbs break down slower when they are in the presence of fat, fiber, and protein. This is why your RD may recommend pairing a carbohydrate - like an apple - with a protein, fat, or fiber-rich food - like peanut butter.
    

Pairing carbs can keep sugar from rising too quickly in the blood stream and then causing a crash later.

Note: Pairing carbohydrates is one of my favorite blood sugar mangement techniques to teach because it focuses on adding foods to the diet instead of taking them away.

Other Factors That May Affect Your Blood Sugar and eGFR

Medications

While it would be nice if we could control Diabetes and CKD with diet alone, that is not the reality for many. Medications play an important role in controlling kidney disease and diabetes.

It is important to always, always, always talk to your doctor if you are having difficulty taking or getting your medications. If a new prescription causes unpleasant side effects or if it costs too much, let your doctor know.

When I worked in dialysis, I saw patients daily who would tell me that they never started a medication because it was unaffordable, so they never picked it up.

The problem with this is that those medications are prescribed for a reason. Just not taking them and not saying anything to your healthcare team can have dire consequences. 

Name brand medications may offer savings coupons on their websites and if that isn’t enough, your doctor may be able to change you to a medication that is more affordable or better covered by your insurance.

But, your doctor can’t fix a problem that they don’t know exists. 

Exercise

Exercise - as tolerated and cleared by your provider - can be very helpful for both kidney function and for blood sugar control. 

Exercise benefits blood sugar control by helping the body to use sugar more quickly and effectively to fuel the cells than it would have otherwise. (3)

Moderate to vigorous physical activity - again, as tolerated and cleared by your physician - is also recommended for at least 150 minutes per week for cardiovascular protection in kidney disease. (4)

This means that regular exercise can keep your heart, kidneys, and blood vessels strong.

My favorite exercise to recommend is a brisk walk after dinner to promote healthy digestion and blood sugar control. It’s a great way to get outside and relax after a busy day and maybe get a loved one to join for some one-on-one time?

Of course, if you’re from the deep South - like myself - after dinner weather could be miserrably hot or it could be a hurricane. You never know. 

In that case, light housework is better than nothing. Load the dishwasher, get a load of laundry started, run the vacuum! Any activity is better than none at all. 

Summary

This has been a lot of words to say: taking care of your diabetes is an important part of taking care of your kidney disease. The Kidney and Diabetes diets can - and should! - be complementary to one another. 

If you find that you’re having trouble making both of these diets work for you, reach out to a renal dietitian for help. The best part about our job is helping someone to understand their diet so that they can be excited about food again.

So, reach out and make a dietitian’s day!

P.S. You can also check out my Dietitian-designed 7-day Renal Diet Meal Plans! I just added one specially designed for people on the Diabetes and Kidney Disease diets and I'm adding new ones all of the time!