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Diabetes, Kidney Disease, and Medical Nutrition Therapy

How working with a registered dietitian can benefit people with type 2 diabetes and kidney disease.

People with type 2 diabetes and/or kidney problems should consider working with a registered dietitian nutritionist (RDN), also sometimes called a registered dietitian.

Medically reviewed in April 2022

Type 2 diabetes (T2D) is a metabolic disorder that occurs when the body becomes insulin resistant. Insulin is a hormone the body requires to metabolize carbohydrates and make glucose, the primary source of energy for cells and systems throughout the body.

When a person is insulin resistant, the body has difficulty moving glucose from the blood into cells that need it. This can result in chronically high levels of glucose in the blood, which can cause damage to different parts of the body—the eyes, the heart and blood vessels, the nervous system.

It can also cause damage to the kidneys, a condition known as chronic kidney disease (CKD). In people with diabetes, CKD is often referred to as diabetic nephropathy.

An estimated one-third of people who have diabetes (type 2, as well as type 1) have kidney disease. Diabetes is also the leading cause of kidney failure—which requires treatment with dialysis or kidney transplant.

One of the most dangerous things about CKD is that you will not feel it happening—in the early stages where treatment is crucial, it does not cause any noticeable symptoms.

The only way to check on the health of your kidneys is to have regular blood work and urinalysis that checks the health of your kidneys. These tests should be a part of your routine checkups with your healthcare provider.

If your bloodwork does show signs of kidney damage, you will likely be referred to a healthcare provider who specializes in the treatment of kidney disease. This specialist is called a nephrologist.

Additionally, you should consider working with a healthcare provider called a registered dietitian nutritionist (RDN), also sometimes called a registered dietitian.

Medical nutrition therapy
As the name implies, medical nutrition therapy (MNT) is an aspect of healthcare that uses nutrition to treat a health condition. It is used to treat a variety of health conditions, including type 2 diabetes and chronic kidney disease (as well as cardiovascular disease and obesity). MNT is overseen by a registered dietitian.

The term registered dietitian is sometimes confused with nutritionist. A key difference between the two roles is that registered dietitians have licensing and accreditation to provide medical nutrition therapy.

For people with type 2 diabetes and chronic kidney disease, MNT may involve assessing a person’s current nutrition and creating a personalized eating plan to help them meet their treatment goals, such as lower blood pressure, balanced blood glucose levels, or losing weight.

It can also teach a person with these conditions how to build meals around foods that are good for the health of their kidneys—and avoid eating habits that can be harmful to the kidneys, such as eating too much sodium, protein, potassium, and phosphorous.

If you have T2D and have CKD, check if your insurance plan covers medical nutrition therapy.

Working with your healthcare provider
Even if medical nutrition therapy isn’t covered by your insurance plan, or isn’t an option at the moment, you should still talk to your healthcare provider about nutrition, including the foods you eat and how eating habits can affect your kidneys.

Remember that keeping diabetes and blood pressure well controlled will prevent damage to the kidneys as well as the rest of your body. Follow your treatment plan, attend all healthcare appointments (with all healthcare providers), and keep up to date on tests that monitor your blood glucose levels, blood pressure, and cholesterol.

Most people with T2D will need to take medications to manage the condition. In addition to medications to control glucose levels, there are also medications for people with diabetes that can help protect the heart and kidneys.

Article sources open article sources

Mayo Clinic. "Type 2 Diabetes."
Centers for Disease Control and Prevention. "Insulin Resistance and Diabetes."
National Institute of Diabetes and Digestive and Kidney Diseases. "Chronic Kidney Disease (CKD)."
Centers for Disease Control and Prevention. "Diabetes and Chronic Kidney Disease."
MedlinePlus. "Kidney Failure."
NHS. "Chronic Kidney Disease."
MedlinePlus. "Diabetic Kidney Problems."
Jennifer Huizen. "What is a nephrologist?" MedicalNewsToday. October 16, 2019.
National Institute of Diabetes and Digestive and Kidney Diseases. "Collaborate with a Registered Dietitian."
NCI Dictionaries. "Medical Nutrition Therapy."
National Institute of Diabetes and Digestive and Kidney Diseases. "Nutrition for Advanced Chronic Kidney Disease in Adults."
PublicHealthDegrees.org. "Dietitian vs. Nutritionist: Degree and Careers Comparison."
Centers for Disease Control and Prevention. "Diabetes and Kidney Disease: What to Eat?"
Centers for Disease Control and Prevention. "Medial Nutrition Therapy."
National Kidney Foundation. "Diabetes and Kidney Disease (Stages 1-4)."
American Heart Association. "Newer Type 2 diabetes medications have heart and kidney disease benefits, too."
Mayo Clinic. "Diabetic nephropathy (kidney disease)."

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