Diabetic Inner- City Kidney Patients Eat Less Sugar and Grains but Also Fewer Healthy Nutrients Than Non-Diabetic Patients

We evaluated dietary intake in patients with kidney disease with and without diabetes in inner-city Brooklyn clinics. A face-to-face survey was conducted in a random convenience sample of pts from CKD (23) and transplant (45) clinics. Diet was studied by 24-hour recall using ASA24 software. Healthy Eating Index was calculated using the HEI-15 score and the DASH index as standard. Between group comparison was by t-test unless noted. There were 37 males (54%) and 31 (46%) females, 56 (82%) Black, 24/62 (24%) received SNAP benefits. 24 (53%) transplant (TXP) and 13 (57%) CKD pts had diabetes (DIAB). By Chi square, DIAB were more likely to make < $20 K/yr (58% vs 23%, P = 0.015) and be unemployed (89% vs 61%, P = 0.018). DIAB were older (61.8 ± 1.6 vs 50.3 ± 2.25 yrs, P < 0.0001). Creatinine was 1.86 ± 1.09 mg/dl. HbA1c was 11.1 ± 3.1, time with diabetes 206.03 ± 26.9 months. Blood pressure, BMI, albumin, potassium and total cholesterol did not differ but HDL was lower (DIAB 41.8 ± 3.5 vs 55.1 ± 4.3, P = 0.026). DIAB ate fewer calories (1386.5 ± 83.9 vs 1779.9 ± 129.1, P = 0.014), carbohydrates (131.8 ± 10.8 vs 211.8 ± 13.4, P < 0.0001), sugar (41.5 ± 5.2 vs 89.4 ± 9.5, P < 0.0001), added sugar (5.4 ± 0.86 vs 10.15 ± 1.89, P = 0.02) and refined grains (3.01 ± 0.43 vs 4.61 ± 0.59, P = 0.035), less fiber (11.1 ± 1.0 vs 16.1 ± 1.4, p-P = 0.006), vitamin C (49.7 ± 8.9 vs 110.2 ± 23.3, P = 0.014), fruit (0.37 ± 0.1 vs 1.96 ± 0.6, P = 0.009), potassium (1928.3135.8 vs 2578.1 ± 224.9, P = 0.014), magnesium (229.3 ± 16.8 vs 304.4 ± 32.9, P < 0.05) and calcium (548.3 ± 60.1 vs 738.6 ± 67.9, P = 0.04). There was no difference for DASH (3.6 ± 0.15 vs 3.9 ± 0.18) or HEI score (57.8 ± 1.9 vs 59.4 ± 2.3) or dairy, meat, total protein, fat or sodium intake. In our population: 1. DIAB pts reported more unemployment and lower income. 2. DIAB pts ate fewer total calories, but similar intake of protein and fat. 3. DIAB pts ate fewer carbohydrates, sugars, added sugars, and refined grains but did not have lower BMI and diabetes control was poor, with lower HDL values. 4. DIAB pts also ate less fresh fruit, potassium, calcium, magnesium, fiber and vitamin C. 5. Education of our pts with kidney disease and diabetes should reinforce positive dietary habits but encourage overall healthy eating that includes fruits and fiber, as patients may be focusing on restricting sugar and carbohydrates to the detriment of other nutrients. None.