Dietary management of patients with type 2 diabetes and chronic kidney disease: A comprehensive literature review

Table 1 Summary of macronutrient recommendations

Nutrient	Key recommendations	Evidence and considerations
Protein	General DKD: About 0.8 g/kg/day (non-dialysis); dialysis: 1.0–1.2 g/kg/day; prioritize plant-based proteins (e.g., soy)	High protein intake may increase GFR and renal strain; plant proteins may reduce proteinuria and mortality risk vs red meat
Carbohydrates	Individualized intake; minimize refined sugars; consider “carbohydrate-last” eating pattern	CL eating may reduce postprandial spikes; cultural adaptations (e.g., Mediterranean diet) can improve glycemic control
Fats	Limit saturated fats (< 7%) and trans fats (< 1%); replace with omega-3 fatty acids (fish, flaxseeds) and monounsaturated fats (olive oil, nuts)	Mediterranean/DASH diets could lower CVD risk and improve lipids; cultural models (e.g., Levantine diet) enhance adherence

CL: Carbohydrate last; CVD: Cardiovascular disease; DASH: Dietary approach to stop hypertension; DKD: Diabetic kidney disease; GFR: Glomerular filtration rate.