Living with both chronic kidney disease (CKD) and diabetes can sometimes feel like you’re trying to follow two completely different diets.
Perhaps you’ve been told to cut back on carbohydrates to help manage your blood sugar. Then you search online and read that protein might damage your kidneys, so you start eating less meat and fish too. Before long, you’re standing in the supermarket wondering what you’re actually supposed to eat.
If this sounds familiar, then this blog post is for you.
One of the most common things we hear from our clients is:
“I know I should eat differently for my diabetes, and I know I should eat differently for my kidneys… but I don’t know how to do both.”
The good news is that eating well for CKD and diabetes doesn’t have to feel this complicated.
With the right guidance, it’s absolutely possible to manage your blood sugar while supporting your kidney health. In fact, many of the healthy eating principles overlap far more than people realise.
In this blog post, we’ll explain the key principles of eating well with CKD and diabetes, clear up some of the most common myths we hear in clinic, and share practical advice we’ve found works well for the people we support every day.
Why it feels so confusing
Managing either CKD or diabetes can feel challenging. Managing both together often feels overwhelming.
People often come to us because they’re:
- Struggling to balance their blood sugar levels
- Feeling hungry after reducing protein
- Unable to lose weight and keep it off after being advised by their GP or diabetes team
- Feeling lost as they don’t know what to eat because it feels like every food has become “bad”
One client recently summed it up perfectly:
“Every website tells me something different. I am feeling so confused, I don’t know what I should be eating.”
We hear this time and time again.
Unfortunately, much of the information online rarely explains that advice varies depending on your stage of CKD, your blood test results, your diabetes treatment and your individual health goals.
That’s why one-size-fits-all advice often creates more confusion than confidence.
Our aim as kidney dietitians is to help you understand what matters most for your situation, so food starts to feel enjoyable again rather than something to fear.
Carbohydrates don't need to be the enemy
Carbohydrates are probably the area where we see the most confusion.
Many people tell us they’ve become frightened of eating bread, rice, pasta or potatoes because they’re worried about their blood sugar.
Some go even further and stop eating fruit altogether.
By the time we meet them, meals have often become very low in carbohydrates, leaving them hungry, lacking energy and wondering why they’re constantly craving snacks later in the day.
One of the first things we usually explain is that carbohydrates are not the enemy.
Your body uses carbohydrates as its main source of energy. The goal isn’t to avoid them completely. It’s to choose the right types, eat sensible portions and spread them fairly evenly across the day.
Choosing the right carbohydrates
We encourage you to think about carbohydrates in two groups.
Complex carbohydrates are digested more slowly and are usually higher in fibre. They can help you feel fuller for longer while producing a steadier rise in blood sugar levels.
Good examples include:
- Wholegrain bread
- Porridge oats
- Brown rice
- Wholewheat pasta
- Beans and lentils
- Wholegrain breakfast cereals
In contrast, foods high in added sugars are digested much more quickly and tend to cause sharper rises in blood glucose.
Examples include:
- Sugary drinks
- Sweets
- Cakes and biscuits
- Many desserts
These foods also tend to provide plenty of calories but very little fibre.
“Should I cut out carbohydrates?”
This is probably one of the most common questions we’re asked.
The answer is no.
In fact, one of the patterns we see most often is that people become so focused on avoiding carbohydrates that they unintentionally make their meals much harder to sustain.
Rather than removing carbohydrates, we usually encourage people to include moderate portions of high-fibre or complex carbohydrates alongside protein and vegetables at each meal. A moderate portion would fill up about a quarter of your plate.
“Are wholegrains bad for CKD?”
This is another misconception that has become increasingly common online.
After having diabetes for years, we’ve met people who’ve stopped buying wholemeal bread and replaced it with white bread as soon as they get diagnosed with CKD because they read that wholegrains were harmful for their kidneys.
This is usually because wholegrains have more potassium and phosphate than processed varieties – in fact they have more nutrients in general. However, wholegrains are still considered low in phosphate and potassium, and with the added benefits such as fibre and other nutrients, we would still very much recommend them over processed varieties such as white bread.
One of the nicest moments in clinic is when someone realises they don’t have to fear foods they’ve unnecessarily avoided for months.
Those “penny drop” moments are exactly why we love what we do.
Finding the right protein balance
Protein is another nutrient that causes a lot of worry.
We’ve met people living mainly on vegetables, white bread and cereal with a non-dairy milk because they were frightened to eat chicken, fish, eggs or cow’s milk.
Rather than removing protein altogether, we help people find the right balance.
Protein is essential for maintaining muscle, supporting your immune system and helping you feel satisfied after meals. The goal is simply to avoid eating much more than your body needs.
One of the first changes we often recommend is paying attention to the type of protein you’re choosing.
Aim to try including more plant proteins such as:
- Beans
- Lentils
- Chickpeas
- Tofu
Or having more vegetarian sources of protein such as:
- Eggs
- Cottage cheese
- Greek yoghurt
Animal proteins such as chicken, fish and lean meat can absolutely still have a place too. We simply help people choose portions appropriate to their individual needs.
For many people with CKD Stages 3 and 4, protein requirements are around 0.8-1.0 g per kilogram of body weight each day. However, this can vary depending on your kidney function, nutritional status, your weight for your height and physical activity levels. For more information about how much protein is in foods, check out our blog post on protein and CKD.
That’s why personalised advice is so valuable.
Our goal isn’t to make you frightened of protein. It’s to help you eat enough to stay healthy without eating more than your kidneys need.
Want more expert advice like this?
Join our free weekly KidneyWise newsletter for practical, evidence-based advice to help you live well with CKD.
Each week you’ll receive simple nutrition tips, myth-busting guidance, symptom management advice and realistic strategies you can actually use.
Join the newsletter today and feel more confident managing your kidney health.
Choose healthier fats
Our main goal is to encourage people to focus on choosing healthier types of fat.
Healthier fats include:
- Oily fish
- Olive oil or rapeseed oil
- Unsalted nuts and seeds
- Avocado (if you’ve not been advised to follow a low potassium diet)
These foods contain unsaturated fats (monounsaturated and polyunsaturated fats), which can support heart health and help improve cholesterol levels. This is particularly important because people living with both CKD and diabetes have a higher risk of cardiovascular disease, so looking after your heart is just as important as looking after your kidneys.
At the same time, it’s sensible to reduce the frequency of foods that are higher in saturated fat, such as fatty meats, pastries, butter, most cheeses and many processed meats.
One thing we often need to point out to clients is that healthy fats such as olive oil are still high in calories. They’re nutritious foods, but portion sizes still matter, particularly if you’re trying to lose weight.
Go easy on the salt
If there was one dietary change that benefits almost everyone with CKD and diabetes, it’s reducing salt. Yet one of the things that surprises many of our clients is where most of their salt is actually coming from.
Very few people are adding large amounts of salt at the table. Instead, we often find it’s hidden in everyday foods such as breads, breakfast cereals, ready meals, sauces, processed meats, takeaways and convenience foods. It’s these foods that gradually increase salt intake without people realising.
One exercise we sometimes do with clients is to look at their typical weekly shop together. People are often surprised that making just a handful of swaps can significantly reduce their salt intake without changing everything they eat.
Don't skip meals
When someone wants to lose weight, skipping meals can seem like an obvious place to start.
In reality, we often find it makes things much harder as they often find themselves reaching for unhealthy snacks because they’re so hungry. Long gaps between meals can also make blood sugar levels much more difficult to manage.
Eating regular meals can help:
- Reduce large swings in blood sugar levels
- Improve appetite control
- Reduce evening snacking
- Support more consistent energy levels throughout the day
You don’t have to eat at exactly the same time every day. The aim is simply to avoid long periods without eating that leave you feeling overly hungry and make balanced choices much more difficult.
Focus on eating patterns
One question we’re often asked is:
“Is there one diet that’s best for both CKD and diabetes?”
People are sometimes surprised when we say we don’t usually recommend one specific diet.
Instead, we focus on helping people build an overall eating pattern that they can realistically maintain.
Research consistently shows benefits from a more plant-forward way of eating, such as:
Therefore, any eating pattern that encourages:
- Plenty of vegetables
- Fruit in appropriate portions e.g. 2 per day
- Wholegrains
- Beans and pulses
- Healthy fats
- Moderate portions of animal protein
- Fewer highly processed foods
Rather than becoming fixated on individual nutrients, we encourage you to step back and look at the overall picture.
One meal won’t determine your kidney health. It’s the pattern of eating you follow most of the time that has the greatest impact.
Weight loss without the overwhelm
Recently, we asked members of a Facebook group for people living with CKD:
“What’s your biggest challenge when managing CKD and diabetes?”
By far the most common answer was losing weight.
That didn’t surprise us.
Weight loss can feel particularly challenging when you’re trying to balance advice for two long-term conditions at the same time.
They’re worried about eating carbohydrates because of their diabetes, worried about eating protein because of their kidneys, and left wondering what’s actually safe to eat.
It’s easy to see how this can lead to frustration and, in many cases, giving up altogether.
The encouraging news is that weight loss doesn’t have to be dramatic to improve your health. Losing just 5-10% of your body weight can improve blood pressure, blood sugar control and cholesterol, all of which play an important role in protecting your kidneys.
For some people living with Type 2 diabetes, achieving a larger weight loss under appropriate medical supervision may even lead to diabetes remission or reduce the need for diabetes medication.
The key is focusing on changes you can maintain. In our experience, the people who achieve the best long-term results aren’t those who follow the strictest diets. They’re the ones who make small, realistic changes they can continue for years.
Some of the strategies we commonly recommend include:
- Following the healthy plate model: ½ plate non-starchy vegetables, ¼ plate protein (including plant and vegetarian sources of protein), ¼ plate high fibre complex carbohydrate
- Reducing portion sizes gradually rather than dramatically
- Including both protein and fibre at meals to help manage hunger
- Being mindful of high-fat foods, even the healthier ones
- Eating regular meals
- Slowing down and practising mindful eating
- Finding physical activity you genuinely enjoy
- Going for a walk after eating can help improve your blood sugars
- Prioritising good sleep, which plays an important role in appetite and blood sugar regulation
One of the most rewarding moments for us is when someone realises they don’t have to completely overhaul their life to improve their health. Instead, they discover that small, consistent habits really do add up over time.
Simple meal ideas
One question we’re asked in almost every consultation is:
“Can you just tell me what meals to cook?”
People often feel much more confident once they can picture what balanced meals actually look like.
Rather than trying to create the “perfect” meal, we encourage people to use a simple plate guide that works for most meals.
Aim for:
🥗 Half your plate: Non-starchy vegetables or salad
🍗 A quarter of your plate: Protein (including plant-based and vegetarian sources of protein)
🍚 A quarter of your plate: High-fibre complex carbohydrates
This isn’t a strict rule, and not every meal has to look exactly like this. Think of it as a helpful starting point that can be adapted to suit your preferences, appetite and lifestyle.
Here are a few ideas to inspire you.
🍽️ Breakfast ideas
- Porridge topped with berries and a sprinkle of seeds
- Wholegrain toast with peanut butter
- Plain yoghurt with fruit and homemade granola
- Overnight oats
- Vegetable omelette with wholegrain toast
🍽️ Light meals
- Lentil and vegetable soup with wholegrain toast
- Chicken, new potatoes and mixed salad
- Wholemeal pitta with hummus and salad
- Baked sweet potato with cottage cheese and salad
- Tuna pasta salad
🍽️ Main meals
- Grilled salmon with vegetables and brown rice
- Chicken and vegetable stir-fry with brown noodles
- Lentil and vegetable Bolognese with wholemeal pasta
- Tofu and vegetables with brown noodles
- Chickpea and roasted vegetable couscous
🍽️ Snacks
- Vegetable sticks with reduced-fat hummus
- A small handful of unsalted nuts
- Plain yoghurt with fruit
- Oatcakes with cream cheese
- A few squares of dark chocolate
Key takeaways
If you only remember a few things from this article, let them be these:
You don’t have to choose between protecting your kidneys and managing your diabetes.
Carbohydrates are not the enemy. Choosing higher-fibre varieties and appropriate portions is usually much more helpful than cutting them out completely.
Protein is important too. The goal is finding the right type and amount for your individual needs, not avoiding it altogether.
Healthy eating patterns matter much more than worrying about individual foods.
Small, sustainable changes consistently beat short-term perfection.
Perhaps most importantly…
You don’t have to work this out on your own.
One of the things we hear most often from our clients after their first consultation is:
“I wish I’d booked sooner.”
Not because we give them a long list of foods to eat and avoid, but because they finally understand how all the advice fits together.
Seeing someone move from feeling anxious and overwhelmed to feeling calm and confident is one of the most rewarding parts of our job.
That’s why KidneyWise exists.
Want personalised support?
If you’re living with both CKD and diabetes, you don’t need more conflicting information.
You need advice that’s tailored to your kidney function, blood test results, diabetes, medications and everyday life.
During our 1:1 consultations, we take the time to understand the whole picture before helping you build a way of eating that’s practical, enjoyable and evidence-based.
Whether your goal is improving your blood sugar control, slowing CKD progression, losing weight or simply feeling less anxious around food, we’re here to help.
Book a free 15-minute enquiry call to find out how personalised support could help you feel more confident about managing both CKD and diabetes.
Disclaimer: This advice is primarily for individuals with CKD Stages 3 & 4. It is solely educational and provides general advice only. It is not a substitute for seeing a registered dietitian or another qualified healthcare professional.
