Diet is one of the most important treatments in managing diabetes and kidney disease. If you have been diagnosed with kidney disease as a result of diabetes, you’ll need to work with a dietitian to create an eating plan that’s right for you.

This plan will help manage your blood glucose levels and reduce the amount of waste and fluid your kidneys process. Your dietitian will set the amount of daily calories you should consume. This will be further broken down into the right amounts of protein, fat and carbohydrates your body needs, at the same time lowering the amounts of sodium, potassium, phosphorus and fluids you will eat. This may sound complicated, but here are some tips to help you get the most out of your eating plan.

Know how much and how often

Your dietitian will give you specific nutritional guidelines to follow. Not only will these instructions tell you how much protein, fat and carbohydrate you can eat, these instructions will tell you how much potassium, phosphorus and sodium you can have each day. Because your diet needs to be lower in these minerals, you’ll be limiting or avoiding certain foods, while carefully planning your meals from the food choices recommended by your dietitian.

Read food packages carefully and make notes in your food diary. Patients are sometimes surprised at the amounts of hidden sodium in seemingly healthy choices like soup and low-fat frozen entrees. Popular diet colas, some teas and lemonades have sodium as well as phosphorus. Keeping track of this information can help you plan your meals faster and make better choices when you eat out, because you’ll know what you can safely eat.

Portion control is also important. Your dietitian will talk to you about the importance of serving size. Sometimes a patient eats what he believes is one “serving,” but it may actually count as three servings on the kidney diet. Your dietitian can give you tips about accurately measuring serving size.

Your dctor and dietitian will also recommend you eat meals and snacks of the same size and calorie/carbohydrate content at certain times of the day. This will help you keep your blood glucose at an even level. Your dietitian will have you space out foods throughout the day. For example, you can’t eat all your carbohydrates at one meal. This would cause your blood glucose levels to rise above acceptable levels. You’ll have a balance of carbohydrate, protein and fat for each meal.

Often people with diabetes have lower blood sugar levels as kidney failure progresses, especially with certain diabetes medications. Your dietitian may recommend between meal snacks to prevent low blood sugar. If you are having problems eating enough, your dietitian may recommend adding foods with extra sugar and fat to prevent low blood glucose and help maintain body weight. Your doctor may make adjustments in diabetes medication. It is important to check blood glucose levels often and share the results with your doctor, especially if you are having low blood sugars.

What can I eat?

Your dietitian knows the importance of variety and will give you options on the types of foods you can eat. Your diet will include a list of foods from different food groups to help you plan meals. Below is an example of food choices that are usually recommended on a typical renal diabetic diet. This list is an example only. It is based on sodium, potassium, phosphorus and high sugar content of foods included. Your own individualized diet may include additional foods or limit some of these recommended foods. Your blood test results, stage of kidney disease, size, nutrition status and dietary goals help determine your exact diet therapy. Remember to always ask your dietitian whether or not you can have any of these listed foods and make sure you know what the recommended serving size should be. Do not make any changes to your diet without your dietitian’s approval.

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