In the context of the increasing incidence of diabetes, the number of patients with diabetic nephropathy is also increasing. Diabetic nephropathy can cause severe metabolic disorders in patients, which can lead to inability to work and even death. For patients with diabetic nephropathy, the knowledge of diabetic nephropathy is directly related to the quality of treatment compliance, and their own nutritional status is also related to the outcome of the disease. Therefore, it is necessary for patients with diabetic nephropathy to master relevant dietary knowledge.
Protein quality and quantity
The 2017 edition of “China Type 2 Diabetes Prevention Guidelines” mentions that for diabetic patients with normal renal function, protein intake can account for 15% to 20% of the energy supply ratio, ensuring that the ratio of high-quality protein exceeds one third. The recommended protein intake is about 0.8 g/(kg body weight·day). Excessive protein intake, such as >1.3 g/(kg body weight·day) is related to increased proteinuria, decreased renal function, increased cardiovascular and death risks; but less than 0.8 g/(kg body weight·day) protein Intake cannot delay the progression of diabetic nephropathy; for patients who have started dialysis, protein intake can be appropriately increased.
The source of protein should be high-quality animal protein, and compound α-keto acid preparations can be supplemented if necessary. Animal foods are mostly protein-rich foods, and most of them are high-quality proteins. Their amino acid composition ratio is in line with human needs, so the digestion and absorption rate of protein from animal sources is high; in addition, soybeans and their products in plant foods It is also a good source of high-quality protein and can be selected in moderation. Other plant-derived protein is not high-quality protein because the amino acid composition ratio does not match the human body’s needs. Excessive intake will increase the burden of kidney metabolism.
Carbohydrates account for 55%～60% of total calories
Diabetics should ensure a reasonable proportion of the three major nutrients (carbohydrates, protein and fat). It is not scientific to deliberately eat more or less of a certain type of food. The carbohydrate energy supply ratio should account for 50% to 65% of the total energy. In particular, physical activity intensity, body shape, disease and other factors should be taken into consideration to reduce energy intake when weight gain, and vice versa. Patients should choose more complex carbohydrates and whole grains, especially high-fiber vegetables, beans, whole grains, etc. The intake of monosaccharides should be strictly restricted, such as sucrose, maltose, glucose, etc. and foods containing more sugars, sweeteners that do not produce calories, such as xylitol, can be used.
Fat is mainly unsaturated
Reducing the intake of saturated fatty acids (SFA) and trans fatty acids can help reduce inflammation and endothelial dysfunction, improve hypertension and dyslipidemia, and benefit the prognosis. It is generally recommended that the daily intake of saturated fatty acids should be <7% of total energy. Therefore, patients with diabetic nephropathy should choose light foods with less oil and salt. Cooking dishes should be steamed, boiled, cold dressing, shabu-shabu, stewed, stewed, etc.; vegetable oils (mainly unsaturated fatty acids) should be used for cooking; When going to a banquet, try to choose meals according to the amount and food pairing at home. See salt limit Patients with diabetic nephropathy should pay special attention to the intake of salt due to the decline of renal function. It is recommended that patients limit salt intake to less than 6 g/day, but not less than 3 g/day. The specific intake depends on the patient’s condition: end-stage renal disease develops to a certain stage, often high blood pressure, manifested as edema or reduced urine output, limiting salt can effectively prevent the progression of complications; but if accompanied by vomiting When diarrhea, sodium salt should not be over-restricted, or even supplement. In addition, for patients with hyperkalemia, it is also necessary to limit potassium intake. Drink small amounts of water repeatedly The typical symptoms of diabetic patients are microalbuminuria in the early stage, and symptoms of varying degrees of edema will also appear. At the same time, high blood sugar can also cause thirst, and carelessness will lead to excessive water intake. Therefore, for patients with diabetic nephropathy, drinking a small amount of water several times a day can not only relieve thirst, but also avoid aggravation of edema. Can't drink or smoke Alcohol is relatively high in calories, and regular drinking will affect the stability of blood sugar in the body; and alcohol needs to be metabolized through the liver and kidneys, and drinking for a long time will harm the liver. In addition to alcohol, diabetic patients should also pay attention not to smoke, especially those with kidney disease. If you smoke during the treatment of the disease, it is easy to damage the blood vessels and nerves and implicate the kidneys.