Question

my 61 year old Male patient with type 1 diabetes, CRF and retinopathy, who is in a pre dialysis condition, is sick of his exchange diet, what can I recomened to him ?

Answer 1

the person is old age with co morbidities like type 1 diabetis , chronic renal failure , retinopathy.

here the diabetes is type 1 , which means the person developed disease during young ages before 40 years , and this is insuline dependant, he has to take daily insuline in order to controll the glucose level in blood. his pancrese is not producing enough insuline

his long term uncontrolled sugar effect affects the body ,mainly kidney and leads to CRF and affects eyes leads to retinopathy.

damages to his kidneys and eyes already occured. dietary controll has still some imporatance for preventing its rapid progression .

the person should avoid foods with high glycemic index(how much sugar reaches in blood after taking some foods) such as boiled potato, french fries, white rice , sugary soft drinks , white bread., banana , dates , grape fruits ,  

more over his renal function also not good, so he should avoid food that increases blood potaium levles such as orange , apricots , cooked spinach , cooked brocoli, mushrooms , peas, cucumbers, more red meat. canned foods , avocados , eat less salt , less sodium

he can take brown rice ,which contain more fibres , these fibres not digested in body , does not increases blood sugar levels , olther food items like boiled eggs , fatty fishs , green leafy vegetables , yogurt , apples, red bell peppers , cran berries , blue berries, carrots . eat home made foods only small amounts frequent interval . use fresh foods . use right combination of animal and plant proptien, excess is not good for kidney. water use only 500 ml more than the  amound of urine produced and depond on lower limb edema .