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July 8, 2004

Complications, Meal Planning, Food and Diet

Question from Melvindale, Michigan, USA:

I've had type one for almost 24 years now and I've been very blessed. I have no complications. I had a laproscopic Roux-en-Y (gastric bypass) back in October 2003 and probably should've asked this question then, but I honestly didn't think about it and was really excited that I'd been approved for such a wonderful tool to fight my obesity. Since the procedure, I've been told to get in at least 68 grams of protein per day, after taking into account the malabosorption induced by the surgery. Is a type one diabetic at greater risk for renal problems based on high protein intake alone? I know that all renal patients are very limited in their protein intake.

Answer:

You bring up a good point. This also comes into play as more people adopt a high-protein meal plan to fight obesity and also have diabetes. Although there is not a large amount of literature on this in recent years, there is good evidence to suggest high protein delivered to the kidney is not a good thing as it may accelerate diabetes-related changes. You are in a position where you want to keep the weight off and also maintain your muscle mass. The protein content can be followed with the idea that you have your albumin level in your urine monitored carefully. If this rises, you may need to consider the use of one of the class of medications that has actually shown benefit in preventing the progression of diabetes-related changes in the kidney. In your situation, there is a big difference in what you eat versus what the kidney sees because of the malabsorption issue.

JTL