Kidney Disease and Diabetes

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1 Kidney Disease and Diabetes What is diabetes? Diabetes is a disease where your body cannot properly store and use food for energy. The energy that your body needs is called glucose (sugar). Glucose comes from some of the foods that you eat which can affect your blood sugar level. Kidney Disease and Diabetes Diet information may be confusing if you have diabetes and kidney disease. Choosing healthy food is important for people who have both diabetes and kidney disease. The overall goal is to make healthy food choices that you can maintain over a lifetime. Your renal diet should provide a variety of foods and should consider your cultural differences and your usual eating routines. If you have been diagnosed with diabetes you will need to continue to follow your renal diet. You will need to limit salt. You may need to limit phosphorus and potassium, depending on your kidney health. As well, your daily protein amount may vary depending on your stage of kidney disease. If potassium is restricted in your diet, choose fruits and vegetables from the lower and medium potassium group. If you need a phosphorus restriction it is important to limit dairy foods, fast food and processed foods. See the phosphorus handout provided by your dietitian for other foods high in phosphorus. Talk with your dietitian to make a plan that works for you.

2 What is Blood Glucose? Blood glucose (sugar) is the amount of glucose in your blood at a given time. To control your blood glucose you will need to eat regular balanced meals throughout the day, be active and take your diabetes pills and/or insulin. Which foods turn into sugar in the body? Sweets such as desserts, candies, jams, syrups, white and brown sugar and honey. Sugar-containing beverages such as fruit juices (even unsweetened), juice/drink crystals, regular soft drinks, iced tea and lemonade. Starchy foods such as breads, hot and cold cereals, pasta, rice, dried beans and lentils, peas, corn, potatoes and yams. Fruit including fresh, canned, and frozen. Milk products including milk (plain or flavored), yogurt, evaporated milk and ice cream. To find how much sugar is in the food you are buying look on the Nutrient Facts Table of the food label. The amount of sugar will be listed as carbohydrate. Which foods do not turn into sugar in the body? Protein foods including meats (red meat, poultry, and fish), eggs, peanut butter, nuts, cheese, cottage cheese and tofu. Low starch vegetables including lettuce and other leafy vegetables, broccoli, cauliflower, celery, green and yellow beans. Limit foods that are very high in added sugar such as candies, desserts, fruit drinks, regular soft drinks and other sugar-containing beverages.

3 Tips for Healthy Eating Eat three meals per day at regular times and space meals and snacks no more than four to six hours apart. You may benefit from healthy snacks. Eating at regular times helps to keep blood sugar levels stable. A healthy snack can include salad, peanut butter and crackers, a small fruit, homemade muffin, and cut up low potassium vegetables. Limit high sugar food like potato chips, candy, donuts, cake, and pastries. Include starchy foods at every meal like whole grain breads (60% whole wheat) and cereals, rice, noodles, or potatoes. Choose an amount the size of your fist for grains and starches. Limit sugars and sweets such as table sugar, regular pop, fruit juice, desserts, candies, jam and honey. Eating or drinking high sugar foods will raise your blood sugar level. Artificial sweeteners such as Equal, Splenda,Truvia or Sugar Twin can be helpful. Include fruits and vegetables with your meals as they are very high in nutrients and a good source of fiber. If you are on a potassium-restricted diet, choose lower-potassium fruits and vegetables. Buy canned fruit packed in water or its own juice. Avoid canned fruit packed in syrup. Limit high fat foods, such as fried food, chips and pastries. High fat foods may contribute to weight gain. A healthy weight helps with blood sugar control and helps keep your heart healthy. If you are thirsty drink water, diet soft drinks (lower phosphorus ones), coffee or tea. Try to avoid fruit juice, regular pop or other beverages that are high in sugar. Limit alcohol. Alcohol can lower or raise your blood sugar too much. It may also interact with your medications. Add physical activity to your life. Regular physical activity will improve your blood sugar levels. Talk to your doctor about what activities are safe for you.

4 Sample Menu Breakfast ½ cup hot/cold cereal with ½ cup berries ½ cup milk 1 slice *toast 2 tablespoons peanut butter 1 cup tea/coffee/water Lunch 1 cup homemade soup 1 sandwich with (2 slices *bread, lean chicken/meat/fish, and 1 tsp non-hydrogenated margarine) ½ cup coleslaw salad or sliced cucumbers ½ cup strawberries 1 cup tea/coffee/water Dinner ½ cup white pasta or 1/3 cup white rice ½ cup vegetables (e.g. steamed broccoli or green beans) 1 *small dinner roll 1 tsp non-hydrogenated margarine Lean meat/chicken/fish ½ cup grapes or 1 medium apple 1 cup tea/ coffee/water * If you are still feeling hungry, you can try adding a little more protein or low potassium vegetable to your plate. These foods will not increase your blood sugars. Evening Snack 1 small homemade muffin or ½ *sandwich * 60% whole wheat, light rye or white bread Adapted from Canadian Diabetes Associations -- Just the Basics

5 Why Check Blood Sugars? Provides a quick measure of how much sugar is in your blood. Helps determine if you have high blood sugars or low blood sugars. Helps you and your health care team to decide if you need to make changes in your diet and/or medication. Blood Sugar Testing You will need a blood-glucose meter to test your blood sugar at home. Talk with your doctor, diabetes educator or pharmacist about which blood-glucose meter is best for you. Bring your record of blood sugars to your doctor, pharmacist or dietitian appointments. Blood sugar targets vary depending on your age, medical condition and other factors. Ask your doctor what your blood sugar targets should be. How can I manage my diabetes? Living well with diabetes includes: Healthy eating Checking your blood sugar regularly Taking required medications Staying active Dietitian Name: Phone Number:

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