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Diabetes and Kidney Disease

Moderate-Protein Diets
In people with diabetes, excessive consumption of protein may be harmful. Experts recommend that people with kidney disease caused by diabetes consume the recommended dietary allowance (RDA) for protein, but avoid high-protein diets. For people with greatly reduced kidney function, a diet containing reduced amounts of protein may help delay the onset of kidney failure. Anyone following a reduced-protein diet should work with a dietitian to ensure adequate nutrition.
Intensive Management of Blood Glucose
Antihypertensive drugs and low-protein diets can slow kidney disease when significant nephropathy is present. A third treatment, known as intensive management of blood glucose or glycemic control, has shown great promise for people with type 1 and type 2 diabetes, especially for those in early stages of nephropathy.
Intensive management is a treatment regimen that aims to keep blood glucose levels close to normal. The regimen includes:
  • Testing blood glucose frequently
  • Administering insulin frequently throughout the day on the basis of food intake and exercise
  • Following a diet and exercise plan
  • Consulting a healthcare team frequently.
Some people use an insulin pump to supply insulin throughout the day.
A number of studies have pointed to the beneficial effects of intensive management. One study involved 1,441 participants who had type 1 diabetes. Researchers found a 50 percent decrease in both development and progression of early diabetic kidney disease in participants who followed an intensive regimen for controlling blood glucose levels. The intensively managed patients had average blood glucose levels of 150 milligrams per deciliter -- about 80 milligrams per deciliter lower than the levels observed in the conventionally managed patients.
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