A Kidney Disease–Friendly Diet for Type 2 Diabetes

If you have type 2 diabetes and chronic kidney disease (CKD), your diet will be a huge part of your treatment. That’s true whether your kidneys are in the mildest or most-severe stages of decline.

Most of the same healthy eating decisions that are recommended for the treatment of diabetes will also support kidney health. But your doctor may also tell you about certain special things to watch out for, like adjusting how much protein or salt you can eat.

But having both diabetes and kidney disease means there are additional things to consider, says Edith Yang, RDN, a diabetes and kidney disease specialist in Monrovia, California. “We want to make sure that your blood sugar is controlled by balancing carbohydrates with enough — but not excessive — protein. Depending on the stage of kidney disease, we may recommend a slightly lower amount of protein per day,” she says.

When you’re following a healthy diet for diabetic kidney disease, keep in mind that many of the key principles that are true for a diabetes-friendly diet are also true if you also have kidney disease, says Joseph Vassalotti, MD, chief medical officer at the National Kidney Foundation.

“For most, we recommend shifting the diet to include more plant-based foods like fruits, vegetables, legumes, and nuts, and limiting highly processed foods, red and processed meats, and sugar-sweetened beverages,” he says. “A Mediterranean diet or DASH diet are two we recommend.”

Following these guidelines, he says, will help you address your health needs without having to track your sodium or protein consumption, which can be challenging or frustrating.

When putting together your plate, Yang recommends following the MyPlate method. That means filling half of your plate with non-starchy vegetables, one-quarter with starchy vegetables or whole grains, and the remaining quarter with lean protein.

Here’s an example of a 7-day diabetic kidney disease diet meal-plan. It was created with help from Yang, as well as Allison Beach, RDN, a certified renal–nutrition specialist in Carrollton, Texas, and information provided by the American Diabetes Association:

In advanced kidney disease, your doctor may recommend further changes to your diet. “High potassium and phosphorus are more common with lower levels of kidney function,” says Dr. Vassalotti.

The changes can seem tricky, because these minerals are found in so many healthy ingredients. Fruits and vegetables are natural sources of potassium. Dairy, poultry, and legumes are dietary sources of phosphorus. These foods are still considered healthy for someone with diabetic kidney disease.

Yang says that the best way to reduce your mineral intake is to pass on highly-processed foods, which can be dense sources of potassium, phosphorus, and sodium. Even with advanced CKD, it’s important to favor whole foods like fruits, vegetables, and plant-based proteins.

Following a personalized diet is the best way to ensure that you’re getting the nutrients you need while limiting others for your kidney health, all while managing your diabetes and blood sugar. “I recommend that patients see a registered dietitian,” says Vassalotti. “They’re very underutilized, but very helpful.”

• A diet that’s healthy for people with both diabetes and kidney disease prioritizes non-starchy vegetables, fruit, lean and plant-based proteins, and heart-healthy fats. It also limits processed foods and foods that are high in sodium and sugar.
• For those in later stages of kidney disease, it may also be necessary to manage your intake of potassium and phosphorus. Kidney failure and dialysis will bring even more diet changes.
• Balancing your kidney health with your blood sugar and other health issues can get challenging. Experts recommend consulting a registered dietitian-nutritionist for individualized meal-planning advice.