Dietary intake in type 1 diabetes at different stages of diabetic kidney disease

Abstract

Diet plays an important role in the kidney health of individuals with type 1 diabetes. However, not much is known about dietary practices at different stages of diabetic nephropathy. We aimed at investigating food intake, dietary patterns, and nutrient intakes in individuals with type 1 diabetes differing in renal status. Methods: Data were available from 1874 individuals with type 1 diabetes (45% men, age 48 ± 13 years). Diet was assessed at the levels of food items and diet patterns (diet questionnaire), and energy and nutrient intakes (food record). Six groups were formed based on the eGFR or dialysis and transplantation status. Results: Reductions in liquid-milk product and salt consumption, and increase in special diet adherence were observed at the early stages of eGFR decline. Reduced coffee consumption was observed after eGFR was <30 ml/min/1.73 m 2. With advancing kidney failure, rye bread consumption decreased, but that of wheat bread increased. Compared to those with intact kidney function (the index group), the Fish and vegetable diet pattern scores were higher in individuals with mildly-to-severely decreased eGFR. Instead, the Sweet pattern scores were lower than in the index group in all other groups. Energy intake was lower in all groups compared to those with intact kidney function. Advancing kidney failure was associated with reductions in protein intake per body weight, and in the intakes of sodium, potassium, calcium, and phosphorus. Conclusions: Differences in the dietary intake are seen already at the early stages of kidney function decline.

Assessment of dietary intake by self-report in adult patients with type 1 diabetes treated with a personal insulin pump

“…The Guidelines indicate that protein intake should constitute about 15-20% of total calories, without details concerning sources. In our analysis, these values were within the normal limits; the reduction of intake of protein is recommended in the case of chronic kidney disease [37]. The sodium intake was above the recommended range, 126.6% (98.0%-154.4%) vs. 155.4% (116.2%-208.2%), p=0.05 (0.0458) (Table 4).…”

Recombinant ling zhi-8 enhances Tregs function to restore glycemic control in streptozocin-induced diabetic rats

“…This triggers intense hunger and leads to food intake increase in T1D patients or T1D model. [ 30 ] Meanwhile, excessive glycosuria can cause water loss, which leads to an increase in water intake. [ 31 ] In this study, it was found that rLZ‐8 could mitigate body weight loss and reduce the food and water intake of diabetic rats, suggesting that rLZ‐8 improve the quality of life in diabetic rats.…”

Exercise and nutrition in type 1 diabetes: Insights from the FinnDiane cohort

“…Recently, we have also examined dietary patterns specifically across different kidney function strata. We have shown that already early in diabetic kidney disease, with estimated glomerular filtration rate (eGFR) only mildly reduced (60-89 ml/min/1.73m 2 ), differences in eating patterns exist in type 1 diabetes ( 54 ). The general conclusion from our analysis was, that there is an overall trend towards healthier food choices upon advancing kidney disease, limiting salt intake and sweet food items ( 54 ).…”

“…We have shown that already early in diabetic kidney disease, with estimated glomerular filtration rate (eGFR) only mildly reduced (60-89 ml/min/1.73m 2 ), differences in eating patterns exist in type 1 diabetes ( 54 ). The general conclusion from our analysis was, that there is an overall trend towards healthier food choices upon advancing kidney disease, limiting salt intake and sweet food items ( 54 ). Importantly, caloric intake was significantly reduced already with mildly reduced glomerular filtration rate and although the average BMI was not in the range of obesity (≤27 kg/m 2 , in all eGFR groups).…”