11
Diabetes

Over two million people in the UK have diabetes, a condition which affects the control of sugar in the blood. This can result in high blood sugar levels which can damage the kidneys as well as other parts of the body such as the eyes. Diabetes is a common condition in people with chronic kidney disease (CKD) and often, but not always, a cause of the kidney damage. This means that many people who are diagnosed with CKD are already trying to keep to the dietary recommendations for diabetes. If you are one of them, you may be worried that you will have to cope with lots of additional or conflicting dietary advice for your CKD. Therefore, it may be helpful to know that the suggested diets for both CKD and diabetes are really very similar. This is because the shared main aim for the diet is to help to prevent and treat heart disease through healthy, balanced eating (see Box below). Control of body weight and blood pressure are two further shared goals. So the good news is that making these basic changes to your diet is worth doing – you can really improve your overall health as well as tackling the CKD.

Healthy living with diabetes

•Eat regular meals

•Have wholegrain starchy foods at each meal

•Eat more fruit and vegetables

•Reduce fat and fatty foods

•Reduce salt

•Reduce sugar and sugary foods

•Limit alcohol

•Keep to a healthy body weight

•Increase daily activity levels.

The one main area that people with diabetes sometimes find confusing is the advice on fruit and vegetables. They are generally encouraged to have ‘plenty’ – at least five 80 g portions daily. Five portions of fruit and vegetables a day are fine for most people with diabetes and CKD. The exception is those with high blood potassium levels who may need to limit their fruit and vegetables (see Chapter 6). This doesn’t mean that fruit and vegetables are not beneficial, just that they cannot be eaten as freely because of their potassium content. It is also important to note that potassium is not in itself harmful; usually it is considered to be positively beneficial. It only needs to be limited by those whose kidneys are not working well enough to control their blood potassium levels.

GLYCAEMIC INDEX

Starchy carbohydrate foods are converted into sugar in the body. This means that they will increase your blood sugar level. This happens at different rates, depending on the type and form of the food. The glycaemic index (GI) of a carbohydrate food is the rate at which the food is digested to release the sugar (glucose) it contains into the blood. Foods which have a lower glycaemic index are thought to be most beneficial for people with diabetes as the rise in blood sugar is slower and easier to control (Chapter 2 has more information about this).