A Clinical Review on Nutritional Requirements and Assessment for Type 2 Diabetes Mellitus with Chronic Renal Disease

Curr Diabetes Rev. 2020;16(9):922-930. doi: 10.2174/1573399816666200211120402.

Abstract

Background: A significant correlation exists between type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD), where up to 40% of diabetic patients suffer from CKD as a direct result of diabetic complications. The management of diabetes in CKD patients can be challenging due to their need for disease-specific diets, as well as increased risks of complications due to malnutrition, which is why their dietary needs and nutritional requirements require attention to detail, and have to be assessed and tailored according to the patient's needs.

Objectives: This systematic review aimed to assess nutritional requirements for type 2 diabetes mellitus patients with chronic renal failure.

Methods: In this review, 85 articles were screened, and 22 articles were then analyzed and selected as per the study criteria. PRISMA guidelines were used to select and screen the articles. Data search included a PubMed search using MeSH terms, and a literature review through the Cochrane library and the British Medical Journal.

Results: The study highlighted the important nutrients and minerals needed to be maintained within a specified range in accordance with the patient's needs and conditions. In addition, dietary restrictions must be set to prevent disease progression and deterioration. Dietary intake in hemodialysis patients must be carefully calculated based on their needs, with tight monitoring of their blood glucose. Protein intake in hemodialysis patients should be determined based on risk-to-benefit ratios.

Conclusion: Dietary requirements should be individualized based on the patient's disease severity and progression. Assessment of the patient's previous and current diet, as well as matching it with their dietary requirements and preferences is crucial.

Keywords: Diabetes mellitus; chronic kidney disease; chronic renal failure; nutritional assessment; nutritional recommendations; nutritional requirements.

Publication types

  • Systematic Review

MeSH terms

  • Diabetes Mellitus, Type 2* / complications
  • Diet
  • Humans
  • Kidney Failure, Chronic* / therapy
  • Nutritional Requirements
  • Renal Insufficiency, Chronic* / complications