Diet and Exercise Therapies for Patients with Diabetic Kidney Disease

Abstract

　Recently, low-carbohydrate diet (LCD) is becoming popular among diabetes patients due to its efficacy in glycemic and body weight control. While LCD might lead to excess intake of protein and lipid, a low-protein diet (LPD) has been recommended to preserve renal function in advanced renal stages. Thus, diabetes patients on LCD are forced to change their diet therapies in accordance with deterioration of renal function. Additionally, the reno-protective effect of LPD on DKD is controversial because several clinical trials regarding efficacy of LPD failed to show conclusive results. This might be associated with the difficulty to adhere to a daily LPD and the insufficiency of clinical data regarding the optimal amount of restricted protein intake. Exercise therapy as well as diet is important for better glycemic control. Mild exercise therapy such as walking in patients with DKD has been recommended. However, intensity of exercise needs to be determined considering the severity of other micro and macrovascular complications.