Diet for diabetes and stage 4 CKD - very confusing.

Posted by valb68 @valb68, Feb 8, 2018

Anyone with diabetes (on insulin 1x per day) and CKD stage 4? I have a difficult time balancing the two different diets. Anyone else with this problem?

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@jsaling

It is difficult to figure out a RENAL DIABETIC DIET. The cookbooks I’ve found are for patients with DIABETES or CKD but do not take into account someone with both chronic diseases. You cannot choose one or the other but must consider both when meal planning since the limitations of each are quite different. I would greatly appreciate any suggestions. Thank you!

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I agree. Very hard. Since we have to look into Diabetic, High Blood Pressure plus all other factors like Potassium, Sodium etc etc. Not knowing why Kidney is failing? Why creatinine is high even with vegetarian diet?
Any one succeeded with particular diet?

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@cehunt57

@jsaling I also have both conditions. I got a referral from endocrinologist & nephrologist to land a nutritionist well versed in both conditions. I was blessed with resources for both. My hopes and prayers for you to find the same.

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Is this Nutritionist based off mayo? Would it be possible to share Nutritionist details.

Thanks a lot

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@lindes

I have Type II diabetes and CKD 3b. I recently met with my Mayo Rochester kidney doctor, and she told me to follow my diabetes diet, and keep salt and protein (any protein, animal and plant based) intake low. No other restrictions were given to me concerning my kidney problems.

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As you have read here, there are many more food restrictions to consider for type 2 diabetics and stage 3B. I also have a Mayo nephrologist in AZ, and I have touched Stage 4, and finally returned to Stage 3A because of medications of Torsemide on one occasion, and Farxiga on another. I watched the trends of my labs, put them into a spreadsheet with comparison of one drug and its effects on my trend. I did the same with the second drug when that was in use. Nephrologists, for some reason, think that these 2 drugs would help type 2 diabetics. For me that wasn't the case. When following dietary restrictions, please also look at your medications as a possible further cause of Stage 3B and perhaps touching Stage 4.

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@collegeprof

As you have read here, there are many more food restrictions to consider for type 2 diabetics and stage 3B. I also have a Mayo nephrologist in AZ, and I have touched Stage 4, and finally returned to Stage 3A because of medications of Torsemide on one occasion, and Farxiga on another. I watched the trends of my labs, put them into a spreadsheet with comparison of one drug and its effects on my trend. I did the same with the second drug when that was in use. Nephrologists, for some reason, think that these 2 drugs would help type 2 diabetics. For me that wasn't the case. When following dietary restrictions, please also look at your medications as a possible further cause of Stage 3B and perhaps touching Stage 4.

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My nephrologist at AZ Mayo is Dr. Mira Keddis. I think she's great - like her a lot!

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@ldrlaw

My nephrologist at AZ Mayo is Dr. Mira Keddis. I think she's great - like her a lot!

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Mine is Dr. Les Thomas but his NP Wanda is simply the best. In the many years of dealing with CKD, she is extremely knowledgeable like bringing up to me that the lab test for kidney function is more accurate with Cystatin C than eGFR. I researched that fact and she is exactly right. We talk so much on this forum of eGFR, but lab estimates of GFR can fluctuate from one lab to another. Just love my Mayo family of docs.

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@gingerw

@lindes With Stage 3b, my take is to also be watching food with high potassium, phosphorous, and calcium, along with the sodium and protein levels. Kidney disease can slide real quickly to lower levels of health, and higher stages of CKD. That's the biggest issue with kidney disease, in my own case and as many of us will attest to, also. Kidney disease often sneaks up on a person, and we learn to live well with decreasing kidney function, until [it seems[ all of the sudden, we can't.

Diabetes and high blood pressure appear to be the main contributing factors for chronic kidney disease. Other factors that people experience can be medication interactions [long term or not], lifestyle choices, or genetic factors [such as polycystic kidney disease]

@evdos Here are the links from @kamama94 She will tell us that some food labels have changed, so it does bear value to read carefully, and become your own best advocate.
https://cdn.prod-carehubs.net/n1/748e8fe697af5de8/uploads/2021/05/DIABETIC-AND-RENAL-FRIENDLY-VEGETARIAN-1.pdf
https://cdn.prod-carehubs.net/n1/748e8fe697af5de8/uploads/2021/05/DIABETIC-AND-RENAL-FRIENDLY-VEGAN-AND-NATIVE-AMERICAN-RECIPES-2.pdf
As for trusted websites to research for diet plans, check out
-National kidney nutrition guidelines based on your current stage https://www.kidney.org/nutrition
-American Kidney Foundation guidelines for diet and recipes - https://kitchen.kidneyfund.org/?source=google&medium=cpc&campaign=kidneykitchen&gclid=Cj0KCQjw166aBhDEARIsAMEyZh5XN0g5gDSF5SJigl9Q8juUvv3c0BXgXIsLHpjVdYXf6mDBild-MdIaAoT9EALw_wcB
-DaVita diet and nutrition [one of the two major players in dialysis] https://www.davita.com/diet-nutrition

Lots of reading material here! We're here to listen to questions/concerns/experiences you have! Remember, everyone is different. What may work for you, may not be suitable for others. And that's what makes Mayo Clinic Connect so valuable for everyone. In my case, not only do I follow a renal diet, I also need to consider my gout issue, so I have restrictions there. I really miss mushrooms! And, I was recently cleared to eat more potassium foods due to low levels in my system - yeah! for orange juice again!
Ginger

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My kidney problem is unchanged for over 3 years now. I know the cause of it was my very high consumption of prescription strength naproxen sodium, which metabolizes via the kidneys. about 3 years ago I got a spinal nerve stimulator implanted, and did not need any pain medication anymore. My kidney doctor at the Mayo in Rochester told me last week that I need to keep my protein intake down, and watch my salt intake, and she is fine with me concentrating in keeping the diabetes under control. I have an A1c of 6.6, and everyone of my Mayo docs are happy.

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@ruki

Is this Nutritionist based off mayo? Would it be possible to share Nutritionist details.

Thanks a lot

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@ruki the first and most helpful nutritionist I had was part of my local healthcare system (Park Nicollet/Health Partners in Twin Cities, MN). She was diabetic herself and was well versed in renal nutrition. My nephrologist told me that I should “eat for the labs”. By this he means things like potassium, calcium, sodium, phosphorus etc. He monitors my labs, blood pressure and medications. My endocrinologist monitors blood sugar and insulin. I have gastroparesis (a complication of diabetes) and was recently diagnosed with diverticulitis. There are opposite dietary recommendations for gastroparesis and diverticulitis. It is a bit of a slippery slope. Basically I avoid sodium; count carbs to calculate insulin bolus & go low carb; avoid saturated & trans fats that lead to high LDL, cholesterol & triglycerides; try to focus on “good” fats (those that raise HDL) and limit protein to the quantity needed for my size. I used to consume too much protein because it was low in carbohydrates. So far so good. When I was at Mayo (Rochester, MN) for pre-transplant (kidney) evaluation the nutritionist concurred that I was on the right track.

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