Diabetes and kidney disease: what can I eat?

Enjoying your food if you have both diabetes and chronic kidney disease (CKD) is about eating a healthy, well-balanced diet. Cook from scratch whenever you can, so you know exactly what ingredients you're choosing, and consult your dietitian for advice that's tailored to you.

If you live with diabetes and have now been diagnosed with chronic kidney disease (CKD), you might feel overwhelmed at the thought of managing two "special diets".

You might have heard more diet restrictions being mentioned at some point down the line, and are wondering what it’s OK to eat.

The good news is that you can definitely still enjoy your food if you have both diabetes and CKD. It’s about arming yourself with the right information and making healthier lifestyle choices every day.

Is there a "diabetic diet"?

If you have diabetes or have been diagnosed with diabetes, you’ll know that your goal is to control your blood sugar (or glucose). And any food with carbohydrates (carbs) can raise your blood sugar as it breaks down to glucose when your body is digesting it.

  • With type 1 diabetes, it’s important you know how many carbs are in your food so you can adjust the amount of insulin you need to take.
  • If you have type 2 diabetes, knowing the carb content in your food is also a way to control your blood sugar levels.

But no two people with diabetes are the same, and everyone’s health situation is different.

“In general we actually tend to say there isn’t a specific diabetic diet,” says Colette Kelly, Diabetes Specialist Nurse, Liverpool Diabetes Partnership. “It’s about eating a well-balanced healthy diet with the appropriate proportions of the food groups. If you do that you will be cutting down on things like carbs, sugar and salt anyway.”

Do you need to eat differently if you have diabetes and early kidney disease?

The good news is that if you have diabetes and your kidney damage hasn’t progressed too far, you may not need to change too much of what you’re already eating.

“Generally speaking, a good diet for diabetics is perfectly good for early kidney disease,” confirms Professor Jeremy Levy, Consultant Nephrologist, Imperial College Healthcare NHS Trust.

“With early CKD a standard healthy diet with plenty of fruit and veg and relatively lower salt and relatively lower red meat is fine.”

Should I avoid foods high in potassium?

One of the kidneys’ jobs or functions is to remove excess potassium from your body through your urine (wee).

Potassium comes from food, but it can build up in your body if you have kidney damage. Hyperkalaemia is a condition where you have too much potassium in your blood, and it can affect the way your heart works.

“Some people in some circumstances – usually only with advanced kidney disease – need to avoid potassium,” says Professor Levy.

“Lots of people search online for ‘kidney diets’ and they see ‘low potassium’ and so they avoid foods high in potassium. But actually a low-potassium diet is irrelevant for most people with early kidney disease.

“Because potassium is in a lot of fruit and vegetables, diabetics with CKD end up avoiding those high in potassium which means they’re not having a healthy diet.”

Will my diet need to change as my kidney disease progresses?

Healthy diet for CKD stage 1 and CKD stage 2

If your CKD is stage 1 and 2 you will not be receiving a kidney replacement therapy like dialysis and you probably won’t need to make big changes to what you eat and drink already.

Healthy diet for CKD stage 3, 4 and 5 (not on dialysis)

If your CKD is at stages 3, 4 and 5 (and you are also not on dialysis) there won’t be any need to change your diet unless a dietitian or your doctor asks you to.

Healthy diet for CKD stage 5 (receiving dialysis treatment)

If you have kidney failure at stage 5, which means you may need to be on dialysis, you’ll need to make changes to your diet which a specialist dietitian will help you with.

What does a dietitian do?

We know that no two people with diabetes and CKD are in the same situation.

That’s why a specialist dietitian can give you support to help you if you do need to make any changes to your diet. You’ll see a dietitian via your GP or your hospital team.

“Every patient is different,” says Gabby Ramlan, a Diabetes and Renal Specialist Dietitian at Newham University Hospital at Barts Health NHS Trust. “When you see a dietitian they will give you advice that’s tailor-made for you.

“Once you’re diagnosed with diabetes, it’s quite straightforward. To control your diabetes you need to control your carbohydrate intake. But there isn’t a standard renal diet, as it depends on which stage your CKD is and what your blood test results show,” explains Gabby.

“No matter your diet preferences, there’ll be something you enjoy. I ask patients what they tend to eat in a typical day, and what foods they can’t live without. You may not be able to keep eating everything you want but there are always replacements we can make.

“Many patients with advanced CKD talk about not being able to drink coffee as it’s high in potassium. But you can actually have up to two cups of coffee a day safely. And people talk about bananas a lot, as again they’re high in potassium. But they’re not the only high potassium-containing food. You can still have them but in a smaller portion – like half a banana – as long as you’re within your daily dietary potassium allowance.”

Why is cooking from scratch a good idea?

The best way to know what you’re eating is cooking meals from scratch when you can. “That way, you know exactly what’s going into your food – including how much salt and spices are in there,” says Collette Kelly.

Salt affects blood pressure, which can be a problem for people with CKD.

“However, we know it’s not always possible to make your own food,” says Collette. “So on days when you might buy a ready meal, for example, it’s good to understand food labelling and the traffic light system. If you have a choice of two in the supermarket you’ll be able to judge which contains less fat, salt and added sugars and choose the healthier one.”

Everyone benefits from a balanced, healthy diet – not just if you have diabetes and CKD.

Eating well is about making changes you can stick to – and finding the right balance for your life as well as your health.

Kidney Kitchen has healthy recipes you can enjoy, whatever stage of CKD you are living with. All the recipes are suitable for you if you have diabetes, too.

This patient information resource has been made possible with a financial contribution from Bayer. Bayer has had no editorial input into or control over the content which has been independently owned and created by Kidney Care UK.