Diabetes Awareness Month: Nutrition Tips for Managing Type 2 Diabetes and ADPKD

In the United States, an estimated 140,000 adults currently live with autosomal dominant polycystic kidney disease (ADPKD), a rare, genetic condition that causes fluid-filled cysts to develop on and enlarge both kidneys, eventually leading to kidney failure. While this is a rare disease, ADPKD is actually the most common genetic kidney disorder and the fourth leading cause of kidney failure, which may require either dialysis or transplantation. For people living with ADPKD, maintaining a healthy lifestyle is vital to help slow progression of the disease.

There are a number of lifestyle changes including diet and exercise that health care providers can discuss with their patients to help delay disease progression, as well as mitigate the risk of developing additional health conditions—such as type 2 diabetes. November marks National Diabetes Awareness Month, an opportune time for health care providers and nephrologists to speak with their patients who have ADPKD about the elevated risks that may come with a co-occurring type 2 diabetes diagnosis, and how a healthy diet is a critical element of managing these conditions.

According to a recent study, ADPKD patients are at an increased risk of developing type 2 diabetes after a kidney transplant. The study, which was published in Canadian Journal of Diabetes, found that in patients who received kidney transplants, those with ADPKD had a higher association of new-onset diabetes than those who do not have ADPKD. Patients with diabetes and ADPKD also tend to have an earlier median age of death than those with ADPKD alone. Further, research shows that people living with both type 2 diabetes and ADPKD have an average earlier age for onset of hypertension. Given these significant risks, a healthy diet is imperative for optimal management of both conditions and potentially reducing the odds for these negative outcomes.

To decrease the risk of developing type 2 diabetes, or to manage both conditions, it is important that patients with ADPKD regulate their diet as an ongoing aspect of their care plan. Additionally, nephrologists should work in conjunction with primary care physicians when advising patients since they are often the first line in helping a patient manage type 2 diabetes. Guidance to those diagnosed with ADPKD may include modifying their diet by limiting their sugar, alcohol, caffeine, and salt intake. Additionally, it is suggested that patients working to prevent or manage type 2 diabetes focus on choosing whole grains and healthy fats as well as aim to eat at least one fruit or vegetable at every meal. Healthy eating habits are also critical for patients with ADPKD who may also be struggling with obesity as there are more risk factors for cardiovascular events, and it is more difficult for patients with obesity to qualify for kidney transplantation.

Patients with ADPKD should talk to their own health care team to discuss any specific dietary recommendations related to their condition and progress. These conversations are critical, especially during this time of the year when dense holiday meals often feature ingredients that may not be ideal for someone living with ADPKD and/or type 2 diabetes. While there may be plenty of healthy and enjoyable options for patients, it is important to be mindful of what is best for each patient to help them stay on track with their management routine. Fortunately, there are resources available for patients living with ADPKD to identify kidney-friendly recipes that help support a healthy lifestyle and nutrition-rich diet.

Another nutrition tip that health care providers should keep in mind for patients with ADPKD is to stress the importance of a healthy water intake level. Intake levels are dependent on each patient and should be discussed with a patient’s care team to find out what is right for them. Water has many potential benefits, including reducing the risk of kidney stones and preventing dehydration, which can worsen kidney function.

I encourage providers to use National Diabetes Awareness Month as a time to share important tips with patients on managing potential co-occurring ADPKD and type 2 diabetes diagnoses and maintaining a healthy lifestyle in the midst of enjoying family gatherings and comfort foods. While these nutrition steps may not seem complicated, incorporating them into a patient’s routine as soon as diagnosis is confirmed may make a difference in delaying disease progression and can reduce a patient’s increased risk of type 2 diabetes. The more knowledge that providers can help arm patients with, the greater opportunity they have to play an active role in managing their ADPKD.

Additionally, I encourage providers working with patients with ADPKD to visit www.bigkidneybigproblem.com, a resource created to further educate health care professionals on the condition itself and assessing disease progression.