Maintaining Good Diabetes Control

Provided by DaVita® Dietitians

For anyone with diabetes, the key to overall good health is controlling your daily blood sugar levels. Currently, the recommendation for blood sugar levels is 90 to 130 mg/dL before meals and less than 180 mg/dL within one to two hours after a meal. Ask your doctor what your particular blood sugar level goals should be.

How to maintain good diabetes control

Taking medication such as insulin or diabetes pills is not enough to manage your blood sugar levels when you have kidney disease. Below are recommendations that can help you control your diabetes.

Follow a diet designed for diabetes and kidney disease management

  • Eat a variety of high-quality proteins, starches, fruits and vegetables (low in potassium if prescribed).
  • Eat fewer salty and high-sodium foods.
  • Eat less fat. For instance, how you cook foods or what you choose at the grocery store can help you reduce fat.
    • Bake, broil, roast and grill meat, seafood or poultry instead of frying.
    • Choose fewer foods that are high in fat. Look for “reduced fat” on the label.
    • Use healthy fats, such as olive oil and canola oil.
    • Limit consumption of fried foods or high-fat foods.

Follow your designated meal times

  • Do not skip meals. Running on empty for a long time is not good for your blood sugar. Your renal dietitian can recommend snacks for you to enjoy between meals, if needed.
  • Eat meals at about the same time each day. On dialysis days, you may need to plan your meals around your dialysis schedule. Your dietitian can help you adjust your eating plan on those days.

You and your dietitian can fill out the times of each meal in the table below to help you keep track.

My normal meal times are:

My recommended snack times are:

Breakfast:

Mid-morning:

Lunch:

Midday:

Dinner:

Nighttime:

Follow the recommended serving sizes

  • Learn correct serving sizes and how to read food labels. Your dietitian can help you with this.
  • Measure or weigh foods until you can accurately estimate serving sizes

Balance your carbohydrate intake

  • Keep in mind that all carbohydrates turn into glucose (sugar) during digestion.
  • Your dietitian can help you recognize simple sugars, such as jelly, honey, sugar, syrup, jam, cookies, candy and cake with icing.
  • Starches that break down into glucose during digestion include rice, pasta, cereal and breads. Your dietitian can develop a meal plan that will incorporate both forms of carbohydrates.

Include more carbohydrate from whole foods than refined sugars.

Maintain a healthy weight with diabetes and kidney disease

  • Your dietitian can help you determine a healthy weight for you.
  • Goal weight: _________ (weigh after dialysis, before eating or drinking)
  • Regular exercise, at least 30 minutes a day, plays a big role in weight maintenance and blood sugar control.
  • If you need to gain weight, your dietitian can help you boost your calories so you can gain weight without losing control of your blood sugar. (If you are below your goal weight or losing weight without trying, ask your dietitian for help.)

Know your numbers when controlling diabetes

  • Check your blood sugar levels at least three times a day or the frequency recommended by your healthcare team. Suggested times to check blood sugars include when you wake up in the morning, two hours after your lunch meal and before bedtime:
  • Time I wake up in the morning: ______
  • Time I eat my lunch meal: ______
  • Time I go to bed: ______

If you take rapid-acting insulin before each meal, you may need to check blood sugar before each meal to determine how much insulin to take.

  • Write down all your blood sugar numbers in a logbook. This will help you and your healthcare team identify where adjustments in diet or medications might need to be made.
  • Know your hemoglobin A1C (A1C) level so you can identify how well you are managing your blood sugar levels over time. It is suggested that your A1C level run 7.0 or lower. Ask to have it checked every 3 months. Record your last A1C: __________.

Take control of diabetes

When you have diabetes and kidney disease, the goal is to maintain a healthy blood sugar level. Although it can be a challenge, there is a lot that you can do to achieve good blood sugar control. The keys to success include eating a balanced diet, taking medication as recommended, getting regular exercise, having regular blood sugar and A1C checks, and talking openly and honestly with your healthcare team. The more you manage your diabetes, the more likely it is that you’ll be healthier and feel better. To help spread the word about controlling diabetes, send your loved ones a no-cost DaVita E-Card today.

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