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

Sep 28, 2026

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Comorbid type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) create major health burdens, especially across the Middle East and North Africa region. This review integrates evidence and clinical guidelines to support dietary management, including macronutrient distribution (carbohydrates, protein, fats), micronutrient control (potassium, phosphorus, sodium), and appropriate fluid intake. It assesses culturally adapted strategies for Gulf Cooperation Council populations, where refined carbohydrates and high sodium intake are common. Practical guidance also addresses Ramadan fasting and electrolyte management.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages13

Reading Time33 min

AccessFree to download

Abstract

Core Tip

Introduction

Literature Search

Dietary Management Overview

Macronutrients and Micronutrients

Fluid and Electrolyte Management

Ramadan Fasting Considerations

| W | J | N | World Journal of
Nephrology | | --- | --- | --- | --- | Submit a Manuscript: [https://www.f6publishing.com](https://www.f6publishing.com) World J Nephrol 2025 December 25; 14(4): 109875 DOI: 10.5527/wjn.v14.i4.109875 ISSN 2220-6124 (online) MINIREVIEWS Dietary management of patients with type 2 diabetes and chronic kidney disease: A comprehensive literature review Asmaa AlShammari, Ali AlSahow Specialty type: Urology and nephrology Provenance and peer review: Invited article; Externally peer reviewed. Peer-review model: Single blind Peer-review report’s classification Scientific Quality: Grade B, Grade B Novelty: Grade B, Grade B Creativity or Innovation: Grade B, Grade B Scientific Significance: Grade B, Grade B P-Reviewer: Hossain MS, Academic Editor, Researcher, Senior Researcher, Bangladesh; Liu Y, MD, PhD, Postdoctoral Fellow, China Received: May 30, 2025 Revised: June 7, 2025 Accepted: September 19, 2025 Published online: December 25, 2025 Processing time: 208 Days and 0.9 Hours Asmaa AlShammari, Dasman Diabetes Institute, Kuwait 91100, Kuwait Ali AlSahow, Division of Nephrology, Jahra Hospital, Jahra 00004, Kuwait Corresponding author: Ali AlSahow, MD, FASN, FRCP (C), Division of Nephrology, Jahra Hospital, PO Box 2675, Jahra 00004, [Kuwait.](Kuwait. alsahow@hotmail.com)[ alsahow@hotmail.com](Kuwait. alsahow@hotmail.com) Abstract Comorbid type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) pose significant global health challenges, particularly in the Middle East and North Africa region. This review synthesizes current evidence and clinical guidelines to inform dietary management, focusing on macronutrients (carbohydrates, protein, fats), micronutrients (potassium, phosphorus, sodium), and fluid intake. We evaluate culturally adapted strategies for the gulf cooperation council countries, where high rates of T2DM and CKD coincide with dietary practices high in refined carbohydrates and sodium. Key interventions include plant-based protein prioritization, glycemic control through carbohydrate moderation, and hearthealthy fats. Practical considerations for Ramadan fasting and electrolyte management are also discussed. Key Words: Medical nutrition therapy; Diabetes; Chronic kidney disease; Middle East and North Africa region; Cultural adaptation ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved. WJN [https://www.wjgnet.com](https://www.wjgnet.com) 1 December 25, 2025 Volume 14 Issue 4 AlShammari A et al. Dietary intervention in diabetes with CKD Core Tip: Effective management of type 2 diabetes and chronic kidney disease (CKD) in the Middle East and North Africa region requires culturally sensitive, evidence-based strategies. Protein intake should be tailored to 0.8–1.3 g/kg/day, emphasizing plant-based sources like legumes and soy to reduce kidney stress. Glycemic control focuses on reducing refined carbohydrates, choosing low-glycemic, high-fiber foods, and sequencing meals with carbohydrates consumed last. Hearthealthy fats such as olive oil, nuts, and fatty fish should replace saturated and trans fats to lower cardiovascular risk. Electrolyte and fluid management includes limiting sodium to less than ~~2 g~~ per day, restricting potassium and phosphorus from processed sources, and adjusting fluid intake based on CKD stage. Cultural adaptations are key, allowing for traditional foods like hummus and whole grains within Mediterranean or dietary approach to stop hypertension diet patterns. During Ramadan, care plans should be personalized with attention to hydration and medication adjustments to ensure safe fasting practices. Citation: AlShammari A, AlSahow A. Dietary management of patients with type 2 diabetes and chronic kidney disease: A comprehensive literature review. World JNephrol 2025; 14(4): 109875 URL: [https://www.wjgnet.com/2220-6124/full/v14/i4/109875.htm](https://www.wjgnet.com/22

FAQs

Why is dietary management important for patients with type 2 diabetes and chronic kidney disease?

Their coexistence increases risks of end-stage kidney disease and cardiovascular complications. Nutritional management helps slow disease progression and improve clinical outcomes by addressing metabolic and nutritional needs as CKD advances.

Which dietary components does the review focus on for managing these comorbidities?

The review emphasizes macronutrients—carbohydrates, protein, and fats—and micronutrients including potassium, phosphorus, and sodium, along with fluid intake decisions.

What adaptations are recommended for Gulf Cooperation Council populations and during Ramadan fasting?

The review highlights culturally adapted strategies for GCC countries, including meal pattern adjustments for glycemic control and appropriate fat selection. For Ramadan, care plans should be individualized with attention to hydration and medication adjustments to support safe fasting.

Sep 28, 2026

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