New Exchange Lists for Use in Planning Meals for Patients with Diabetic Renal Failure

Abstract

Food exchange lists are generally used in planning meals for patients with diabetes mellitus (DM) or chronic renal failure (CRF). Using DM exchange lists, patients can expect fairly exact energy intake, but relatively large errors in protein intake can be introduced. Using CRF exchange lists, on the other hand, patients can expect fairly exact protein intake, but relatively large errors in energy intake can be introduced.
Diabetic patients who developed nephropathy which turned into severe renal dysfunction are required a strict restriction not only on energy intake but also on protein intake in their diet. Therefore, neither of the lists is suitable for their meal planning. We have revised and re-arranged the list 3 and 4 as well as the supplements of DM exchange lists and newly prepared the exchange lists for patients with diabetic nephropathy with chronic renal failure (DM-CRF).
In the revised list 3, 40kcal energy and 6g of protein were contained in each 0.5 exchange. In the revised list 4, 80kcal energy and 6g of protein were contained in each 1 exchange. Foods in supplemental lists were classified into three groups according to their protein contents. Meal planning based on these DM-CRF exchange lists was easy, and errors in the energy and protein intake were intermediate between those of DM exchange lists and CRF exchange lists.
It was concluded that the new DM-CRF food exchange lists were suitable for meal planning of diabetic patients with severe nephropathy.