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

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. 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 necessitate 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.

The effect of urinary essential and non-essential elements on serum albumin: Evidence from a community-based study of the elderly in Beijing

“…Furthermore, a systematic review and meta-analysis of 37 unique epidemiological studies comprising 348,259 participants support that elements including As, Pb, Cd, and Cu are associated with the increased risks of cardiovascular disease and coronary heart disease ( 49 ). Malnutrition intervention has been reported to improve these chronic disease statuses ( 50 , 51 ). In combination with these results, it was suggested that elevated essential and non-essential elements levels may increase the potential risk of cardiovascular disease in the elderly by promoting malnutrition.…”

Perspectives Concerning the Influence of Protein Intake for Renal Function in Diabetic Nephropathy

“…In recent years, diabetes, diabetic nephropathy, diabetic kidney disease (DKD), chronic kidney disease (CKD), and atherosclerotic cardiovascular disease (ASCVD) have been prevalent worldwide [1]. Among them, a protein-restricted diet has been often used for patients with impaired renal function.…”

Hypoglycemia and hyperinsulinemia induced by phenolic uremic toxins in CKD and DKD patients

“…On the other hand, recent reports showed controversial results that the C-peptide levels are increased in the ESRD patients 3 . Oher factors such as deterioration in nutritional status, changes due to diabetes medications 6 and reduced gluconeogenesis in the renal failure have been suggested 7 . Furthermore, decline in kidney function is also thought to induce insulin resistance 8 .…”