Diabetic with CKD

[scaredwife]

DH is a diabetic with CKD.

He has been told to limit protein, sodium and potassium for the CKD. The problem is that I struggle to find things for him to eat because the diabetic diets is practically opposite the CKD diet. Any advice?

THANK YOU!!

[Quickfeet]

It will be hard for him. When you put the two diets together so many of your favorite foods disappear.

We basically need to control our intake of protein, sodium, potassium, phosphorus, and fluid. Be prepared to be told to increase or decrease your intake on these things. For a long time I was restricted on my protein and potassium, but now I have to be careful of having too little.

Speak with a dietitian, they are there to help. The more questions you have for them the better they can help you.

It sounds like he isn't on a strict renal diet yet. So he most likely can have some of all the naughty list in moderation. Watch his labs and find a balance between good blood work and moderate amounts of his favorite foods.

Never starfruit, not even a bite.

Please also consider, "what's good for the heart, is good for the kidneys." Vascular problems are the major killers for Kidney patients. Our disease along with treatments, medicines, and side affects are rough on our blood vessels and heart.

I am not diabetic so I wont go into specifics on foods. To the much wiser members here please correct me if I was wrong about anything.

[okarol]

All about diet and nutrition - The diabetic dialysis diet

What is a diabetic dialysis diet?

The diabetic dialysis diet is specifically for patients who have stage 5 CKD, also called end stage renal disease (ESRD), in addition to diabetes. The diet’s goal is to manage blood glucose levels and help you feel your best.

What can I eat?

Like the other dialysis diets, the diabetic dialysis diet is filled with nutritious foods. You will work closely with your dietitian to create a balanced eating plan that will feature high quality proteins and the proper balance of carbohydrates and fats to meet your individual needs.

What can’t I eat?

Your diet will have restrictions regarding foods that contain high amounts of phosphorus, sodium and potassium. But because of your diabetes, your carbohydrate intake will be tightly controlled in order to manage your blood glucose levels. High sugar foods increase blood glucose. All carbohydrate containing foods (including bread, cereal, pasta, rice, starchy vegetables, fruits, juices and many sugar-free desserts) increase blood glucose levels. Therefore, the total amount of carbohydrate you eat will be balanced with your medicines and activity level. Your dietitian may teach you a system called carbohydrate counting to keep your carbohydrate intake balanced.

Why do I have to eat this way?

Your dietitian and doctor will advise you to eat this way in order to reduce the risk of other health problems associated with diabetes and kidney disease.

How does it help?

Diabetes affects your entire body. It can cause nerve damage, problems in blood circulation and blindness as well as kidney disease. By following this eating plan carefully, you can control your blood glucose levels and lessen the likelihood of developing other diabetes-related problems. Your body can remain healthy and strong.

Phosphorus is not cleared well through dialysis. It can build to high levels in the bloodstream and cause complications such as weak bones, heart problems, joint pain or skin ulcers. Too much or too little potassium can cause muscle weakness and heart failure. By controlling foods that contain these minerals, you lessen the risk of developing additional complications.

Sodium causes your body to hold onto more fluid and raises your blood pressure. It also makes you thirsty, causing you to drink too much fluid. You may feel uncomfortable and short of breath. When this excess fluid is removed during dialysis, you can feel dizzy and weak afterwards. Eating less sodium can help you feel comfortable before and after your dialysis sessions.

Uncontrolled blood glucose can also increase your thirst. You will be encouraged to check your glucose and keep it controlled to help manage your thirst.

What about fluid intake?

Your dietitian will recommend a specific fluid allowance, based on your health, remaining kidney function, level of activity and the type of dialysis you choose.

How long do I have to follow the diabetic dialysis diet?

You will follow the diabetic dialysis diet for as long as your doctor and dietitian recommend.

How do I know if the diabetic dialysis diet is working?

You’ll know if the diabetic dialysis diet is working not only by how you feel, but through lab test results. Diabetics are instructed to monitor their own blood glucose levels through a simple test using a home blood glucose monitoring machine. If you do not have one, ask your doctor for a prescription for a glucose monitoring machine and testing strips. You’ll be able to see whether or not your blood glucose levels fall within an acceptable range at anytime.

Another test, called a hemoglobin A1c or A1c test, is performed by your doctor. This test measures the average blood glucose level over three months. The results can tell you how well your diabetes has been controlled. Your diet may require changes when your A1c level is too high.

In addition to controlling your diabetes, your diabetic dialysis diet is designed to help you with your kidney disease. By sticking to your fluid allowance, eating the recommended foods and watching your phosphorus, sodium and potassium intake, plus taking your prescribed medications, you will eat better and should feel better and stay healthier.

Your dietitian will also monitor your health and conduct a nutrition assessment when you start on dialysis and then every year after. This assessment will check for any signs of nutrition problems, changes in weight and energy levels plus any problems that may interfere with eating. It will include a nutrition plan individualized for your personal needs.

If I follow the diabetic dialysis diet will my kidneys get better?

No diet or treatment can reverse the damage done to the kidneys. The diabetic dialysis diet will keep you healthy by managing your blood glucose levels and lessening the chances of other complications resulting from diabetes and kidney disease.

from Davita.com

[Chris]

Well diabetes and CKD made the diet worse that's for sure. Shopping for snacks to buy led to bland food. Thus when cooking, spices (natural), garlic, lemon juice, butter/margarine help
 
Avoiding protein wasn't the hard part, it was eating the right veggies that were on the low to medium side of the acceptable list of foods to eat and the new fluid restrictions. Breakfast seems the eaisest to plan, dinner the hardest, and lunch so so with the old standard of no salt/low salt Turkey or Chicken sandwiches with a side of veggies and fruit
The best thing to do is to find what he likes most and what he hates and use the list of high, medium, and low K, phos, and salt foods that can be eaten and plan meals for a week at a time when shopping with maybe a couple cheat foods if labs are good.

[jbeany]

Renal friendly, diabetic safe menu plan:

Bring cardboard box to store to transport groceries.  Select and purchase your favorite foods, including cheese, potatoes, chocolate, peanut butter, orange juice, marbled steak, canned chili, tomatoes, coca-cola, bananas, candy and cookies.

Load cardboard box in car, take groceries home and throw them into the trash. 

Sit down at the table and eat the cardboard box.

 

Or, check out this cookbook -
http://www.culinarykidneycooks.com/cookbook.htm

[Quickfeet]

That diet sounded really good at first

[MooseMom]

Actually, my doc told me that if I ate nothing but cardboard, having CKD meant that I'd still have high cholesterol.  So I guess even cardboard boxes aren't safe to eat.  I have to eat statins instead.

[Chris]

But with cardboard, you would atleast get your daily dose of fiber. 

[Quickfeet]

Any good recipes for cardboard chili?

Moosemom, add fish oil or flax seed oil to your card board. It will help lower the bad fats and raise the good ones. Seriously though, I was taking simsvastatin for 6 months with very little improvement. I added fish oil to my daily pills for thirty days. My cholesterol fell below 200. my triglycerides were cut in half, and my good fat raised up to normal.