Being that one of the most common extrarenal diseases affecting the kidney is diabetes mellitus, diabetic renal diet has become a topic of interest nowadays.
Diabetic nephropathy, a progressive process, commonly leads to renal failure. About 30% of clients with end- stage renal disease have diabetes mellitus.
Researchers estimate that 25% to 50% of clients with insulin- dependent diabetes mellitus or type 1 diabetes have end stage renal disease within 10 to 20 years of beginning insulin therapy.
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Renal disease can also occur in the non- insulin- dependent diabetic client. The incidence of proteinuria (protein in urine) is about 25% after the 20 years of diabetes.
This diabetic renal diet is a nutritional therapy to emphasize the need for a team approach to enhance the ability of each patient with diabetes to achieve good metabolic control. In this way, by controlling diabetes mellitus, we can manage the progressive worsening condition to our kidneys thereby preventing end stage renal disease.
The kidney metabolizes 30% to 40% of insulin, and as renal function decline the degradation of insulin also decreases, resulting in a lower insulin requirement. Renal failure may be initially identified when the client is evaluated for recurrent insulin reactions.
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Researchers hope that exacerbation of renal disease can be slowed by the following:
- Carefully controlling hypertension.
- Adjusting insulin therapy and carefully monitoring blood glucose to maintain normal sugar level.
- Restricting dietary protein.
Regardless of diabetic control, however, renal failure inevitably develops within 5 to 10 years after the appearance of significant proteinuria.
These are some recommended dietary modification for patients with diabetes mellitus:
- Total calories- sufficient to maintain/achieve reasonable weight in adults, or meet increased needs of children, adolescents, pregnant and lactating women and individuals recovering from catabolic illness.
- Caloric distribution of 50- 70% of carbohydrates, 20- 30% of proteins and 20- 30% of fat.
- Cholesterol limit to 300 mg/day or less.
- Carbohydrates and sweetness
- Sodium limit to about 300mg/day, less for people with hypertension if renal complications.
- Alcohol- moderate amounts may be allowed, contingent on good metabolic control.
- Vitamin and mineral supplement- not necessary but may be given to individuals on reduced calorie diets (1200kcal/day or less)
There is no one diabetic diet that will suit the individual and the special need of a person with diabetes. The diet for an individual with diabetes can only be defined as a "dietary prescription based on nutrition assessment and treatment goals". However, the diabetic renal diet can serve as a guideline on how to manage and control diabetes mellitus thus prolonging renal disease.
Discover how to effectively manage your kidney disease with diabetes by following a simple and straightforward diabetic renal diet. Start managing your disease today!
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