How can diabetics avoid kidney stones?

Welcome back to the Kidney Stone Diet Podcast, the show about reducing your kidney stone risk and living your best life. I'm your host and fellow student, Jeff Sarris.

Hello, I'm Jill Harris, your kidney stone prevention nurse.

Yeah, we're back for another listener question. This is This has been great. I actually didn't give the voicemail, the phone number on last episode.

So, I'm going to say it right now so I don't forget. If you have a question that you'd like Jill to answer on the a future episode of the show, just call 773-789-8763 and you can leave a voicemail and we will play it on the show and get you get your answer right over to you in an upcoming week.

But yeah. So, should we just dive right in?

Let's go, baby. Let's see what we got here.

This week we have Sue Ellen.

Sue Ellen.

Hi, Sue Ellen. I'm in Texas. I just wondered what kind of information you could have on the high oxalate plus being type 2 diabetic?

Foods just kind of don't correlate together. So, I would appreciate any information. Thank you.

Managing High Oxalate Foods With Diabetes

Bye.

Yep. This is something I deal with every single day. So, one has type 2 diabetes and their healthcare provider, whether it was a doctor, nutritionist, dietitian, whatever, has given them things to eat.

Eat spinach, eat almonds. Now, the patient has, which makes sense because they have diabetes. So, we want to lower carbs, we want to get their protein in there with every meal, and we want to, you know, vegetables.

So, all that makes sense that they're told that. Nuts are a good, healthy fat. All these things will help blood sugar spiking,

Insulin spiking, all of it. So, that's great. The problem is when we give patients this information, they hear one thing.

Eat as many spinach and nuts as you want, whatever you want, eat as much protein as you want. This is all helping your blood sugar issues. So, because this is healthy advice that they're getting, people like to extrapolate out and say,

The more spinach and the more almonds I eat, the healthier I'll be, the better my diabetes will be under control. Whether it's diabetes or whatever protocol, whatever lifestyle change somebody has given you, the directions need to be clearer, clearer. This doesn't give a patient the right to eat as much as much as they want,

Even though it's healthy food, but that is what we do. More of that vegetable will bring me more health. Spinach, I was told Jill, is a very healthy.

Almonds are a good fat. Avocados, wonderful. So, soon enough, people then make kidney stones.

Now, also, diabetes and kidney stones go together.

This is not uncommon that Forget about the food, okay? Just these diseases, when you have kidney stones or when you have diabetes, one can make more for the other, okay? So, they go hand-in-hand.

Kidney problems, so. And chronic kidney disease, all of these things can increase your odds of forming kidney stones, okay?

So, how do we balance these things out? Then you meet somebody like me who's saying, "Get off spinach. Never have it again." But there's also a heck of a lot other things I say.

There's a lot of things I say, which is why everyone you know, likes my rants. I'm not just saying a few things. I'm saying a lot of things.

Why? Because lifestyle changes require a lot of things,

A lot of things. It's not just 1 2 3 easy-peasy. If that were the case, nobody would be overweight.

Nobody would be suffering the way they do. It just wouldn't be. There wouldn't be a new fancy diet every day and the diet industry would not be making billions and trillions of dollars.

There just wouldn't be. So, we need to understand how we're talking to people and giving them more a little bit more information than just do this, do that, do this.

How do I do this? How much do I do this? You said this lab or this is low.

How low is it? I say these things all the time because these are the things that I'm dealing with every single day, all day long. So, if you have type 2 diabetes, you should There's not much I'm going to say you can't have with stones.

Here's what I'm going to tell you, you cannot have spinach anymore. "I love it, Jill." What? It's over 600 mg a cup.

I'll say this a lot, too. Once you boil or saute that cup down, it's as big as my dental floss. What is worth eating?

So, we usually do three, four, five cups because why, again? More spinach, more health. Remember Popeye?

I'm sure he had stones. You just didn't hear about that behind the scenes.

Okay. So, the only things I would when I have a diabetic patients, I tell them, "Look," they come to me very overwhelmed and they say, "So, I was eating a lot of spinach and almonds, all kinds of nuts, and I was eating them all day long. And," and this is a big one, "and I didn't get my daily calcium every day." This is even bigger than the oxalate issue because once you take away just a few foods

And on kidneystonediet.com, I have the list of foods I want people to avoid and it's a very short list. And so it's not a problem. Take away a few foods, bring in your calcium, meet the goals of the Kidney Stone Diet, and it's not going to interfere very much at all with your diabetes.

Do you have to lessen your protein? Yes, you can't eat a side of beef every day. So, I know maybe you've been told to eat some protein with every meal and you can absolutely do that,

Because what we're telling you to limit is just your meat protein. You want to get some yogurt, we ain't counting that. So, you want to get your protein needs met every Again, kidneystonediet.com, everything free, go to that website, that's my website.

You go to the blog, you'll read all this stuff. Go stay on this YouTube channel, go to Spotify. It's not like we don't have stuff all over the internet for you to get free information.

So,

It is not difficult. You have to lower your carbs as a diabetic, so you have to pay attention to that. That's not really going to mess around with your kidney stone part of things.

Stay under your oxalate limit, whatever your doctor told you for that. Get your calcium needs met every day. Absolutely, have some protein with every meal to stabilize your blood sugar.

That's absolutely great, I do,

Just don't make it meat every single time. And when you have meat, make sure that you're eating the right amount of meat and seafood protein for you based upon your weight. Again, kidneystonediet.com, go to my blog or just go to Google and say, "How do you calculate my protein needs, and Jill?" It'll come up and there's a calculator for you to find out how many ounces of protein, meat protein, don't talk to me about no yogurt, totally separate thing, okay?

And then you can find out how much you are supposed to get. But it is absolutely not a problem. But you see, when we healthcare providers are telling people different things, again, it's not like everybody's getting together in a conference room and say, "Let's talk about Pam," all the doctors and nurses.

They're not. So, Pam is being berated or berated, bombarded with a bunch of different information that is very conflictual. And now she has two diseases, she has kidney stone disease and now she has diabetes.

And now she doesn't know what to do and she's overwhelmed. See, that's that's This is why I wake up every single day and do what I do for 21 years because this matters to me. It's It's sad that we're you know, we have to explain ourselves better as healthcare professionals, and it's unfortunate because time is not around for that.

You know, everyone's in and out of offices. This is why I did my best to make my own gig so you can actually spend time with people, figure out what their issues are,

Where their obstacles are, cuz everybody has different obstacles, and then help them maneuver them so they can feel better and then do better, right?

Yeah, definitely. So, when it comes to say, spinach and almonds and some of the things that she might be avoiding now, what are some alternatives that may satisfy a similar need, but work within the diet?

Yeah. So, you can have kale, and again, I don't want her to have you know, 10 cups of kale. It's low in oxalate, but just have a wide variety of vegetables, pretty much everything but spinach.

Beets are high, but again, maybe you want a few beets on your plate. Let me give practical advice here, what I'll tell my patients. Some people will come to me and say, "Jill, if I don't get a beet,

If I don't get a beet, I don't know what I'm going to do, but they're high, so I don't know what I'm going to do." And I tell them, "Look. There's sometimes there's vegetables on your plate that are being offered that are a little high in oxalate. They could be your favorite thing." And so what I will tell patients is, make a make like five or six different vegetables.

When I'm making vegetables for the week, I make them twice a week and I try to rotate them. So, I'll make a big batch of vegetables on Sunday and then I'll make another big batch of vegetables on Wednesday.

I try to get different ones, cuz there's so many you can have on a low oxalate diet. Kidneystonediet.com, look on the start page and you'll get your oxalate list, of course. And then, so get a variety, but say so many times in life, even though we're not supposed to do something, we want a little bit cuz it's that little rebel in us.

We're like, "I'm going to have that damn beet no matter what that fussy head girl says, I'm having it."

So, maybe then you have a bunch of veggies on your plate, but just a couple beets, two beets. And it makes you happy knowing they're there, and me happy knowing it's not a lot because they're super high in oxalate. And that's where you're going to put your non-dairy or dairy calcium source.

So, then you could say, "Well, why can't I do that with spinach?" Because it's hundreds, hundreds of milligrams of oxalate, over 600. It's not worth it. I can't sleep at night.

Look,

Could you Could you have a little bit of spinach? You could. I don't know why you'd want to, but I don't I take it away from people.

It's not worth it. People say, "You're just mean." Listen, I'm an Italian woman that can't have garlic. Yes, you heard me.

I can't eat garlic. I'm severely allergic to it, okay? It kills me.

So, when you tell me spinach is your favorite thing, and you can't have it, and you don't and I don't understand what you're going through. Oh, I do.

I do. And guess what? Garlic is in everything.

So, guess what I get to eat? Notebook paper and zucchini, all right? So, you're you're I know.

I know what you're going through. What else, Jeff?

So, I didn't know about the garlic allergy. That Was that something that came on later or was that

It came on after all my surgeries from my cancer. Okay. I mean, garlic always bothered me a little, but I know what people are like.

People are like, "I know I shouldn't have that, it causes me GERD, but I love it so much, I'm having it." Well, that's how I kind of was with garlic. And it I There's no way. Even a little bit of garlic powder, even It's terrible, I get so sick.

So,

No more. And that is just So, when people tell me "That's my favorite food," I'm like, "I know. I know it's the hardest thing when," and garlic is used in everything and it's so delicious, especially since I follow a low salt diet.

So, I'll always tell patients, "Use garlic," you know, but I can't do that, so it's it really bums me out, in all seriousness, I have to say. So, I understand when patients tell me, you know, "I can't have that and it makes me sad." I know. I know.

Oh, yeah.

And I'm a pain in the ass to cook for, too, by the way. I go over my mother's house. She's like, "Don't worry, there's no garlic, there's no garlic." I'm like, "Thanks, Mom." But they are, you know, everyone understands how sick I get, so they really are looking at packages.

They're turning it around, Buster Brown, and they're like, "Oh, my god, there's garlic in here, too." So, yeah, it's annoying when something's your favorite.

What do you do when you eat out?

I don't.

Not at all?

No. So, it's very rare, let's put it that way, just because of all my issues anyway, after all my bowel surgeries. I rarely eat out.

If I do, I tend to pick a salad with the dressing on the side or a lemon dressing and or grilled chicken that has I tell them my allergy, they listen to it. You know, thank god in the world that people really listen to food allergies and sensitivities. So, when you I tell them, I get very dramatic, " if you put garlic on my plate, you may have to call 911." And so they take that seriously.

And I'm like, "I know I sound like I'm joking, but I mean that." So,

So I'm, yeah. But I don't I maybe go out to eat maybe once every six weeks only because I can't get out of I can't get out of it because it's a something for somebody. But let's just say this, COVID was, for me, although it was disgusting and terrible for all of us and a huge stressor in our world, it made me feel a little less anxious about always having to say no to going out to eat.

So, that's another thing. I just want to put that here, even though probably people like, "We're done." I just want to put this here. I deal with people who have anxiety on a daily basis around food.

And I, after all my cancer surgeries and the things that I've gone through with my illness, I understand what it's like. I went on a weekend trip a couple weeks ago with my friend,

And we had a wonderful time. But there was one night we had to go out, and I have such anxiety before I go out, and then after I go out, like how am I going to feel? Am I going to make it home from the car ride?

I'm mortified. This is not my family, although this woman is like my family. I love her.

I'm with her family. I'm So, I understand when people say, "Look, I'm supposed to make all these changes," or "I have food allergies," or "People are asking me to go out to eat," or "I'm the only one in my family who's asked to eat like this, and it's daunting on the rest of my" I mean, I understand all that.

And what I really wish as a healthcare person, as a nurse, one of the reasons I stopped working in a hospital is because I really wanted to be able to spend time with people and listen to what they're telling me and feel them. Like, I get that, man. And if you If you're talking to somebody who doesn't understand that, well, it's It can be sad sometimes.

It could be isolating. It could be all those things. So,

Even though I make everything funny, because who wants to talk about kidney stones all day? Who wants to listen to it if it's not entertaining? Plus, it's just who I am.

But I'll tell you I have another side, and I'm deeply passionate about this because I have my own struggles with things. I was always like this before my cancer, but it was even It's even more pronounced now when somebody comes to me. Like, I totally I always sympathize, but now I so empathize with them.

I'm like, "Oh, my god. Bob, I know."

You know, and so we have that bond. It's very special. And because of the things that I deal with on a daily basis, it makes me feel heard and validated and loved, too.

So, everything I give to people, I get times 100 back.

Absolutely. And, yeah, if you want to work with Jill directly, head on over to kidneystonediet.com where you can find the prevention course and private consultations along with the group consultations. And, yeah, you can really, yeah, you can

Jill can share in this experience with you and help you through it because, yeah, you have the first-hand experience with dealing with some really troub- like difficult things.

Yeah, and things that one of the things that I love best is I get to have a job where, basically, I'm a fly on the wall, so I deeply value and am very protective over the things people tell me because, like I said, they're struggling. So, I take that very seriously, and it's you know, I like to provide a safe space for people.

I have that in the Kidney Stone Prevention Course and those group calls. It's a safe place, and it's a it's it's a support group where people can come and say, "Everybody here gets me,"

And that feels good. You know? So, and I get the same thing from it, so it's wonderful.

Absolutely. So, yeah, I think that's a great note to wrap on. And if you have a question for Jill, the phone number is 773-789-8763, and we will feature your question on a future episode.

So, thank you, Sue Ellen, for calling in. That was a wide-ranging episode, I feel like, but we really we But I feel like we really we talked about some good, serious things that are important to touch on. Like you said, it can't always be just sort of

Fun and lighthearted all the time. We have to talk about some things that are difficult conversations, so.

Well, here's the thing. It's like, you know, it's the basic laughter and tragedy thing, whatever that is. You know, you got to laugh your ass off, and then you got to be serious when it's time.

And the reason I like to have so much fun is because I know the other side of life. So, I get that balance of all of it. You need both.

You could never have as much fun in life if you didn't suffer so much, too, so you need both to really have the most robust life possible, I think, and to really understand people and empathize with them. It's very important. I feel everything that Jeff's like, TikTok girl.

No.

Oh, no.

Like everything I've been through, I, you know, it was terrible, but I get to use it in my career, and I get to help people, and they understand that I understand them, so I try to use whatever's been thrown at me and just use it, use it with every last breath that I have. Why wouldn't I, right?

Yeah, absolutely.

Thanks, Jeff.

Oh, yeah. Well, yeah, thank you everyone for listening. And if you're enjoying the show, be sure to subscribe on YouTube, check it out on Apple Podcasts, Spotify, hit like and leave a comment on the YouTube video because it helps a lot.

And, yeah, I think that'll do it for this week.

Yeah, I love when people comment. I always write back, so I'd love to hear from you. And Sue Ellen, thanks so much for the question.

It was great. I forget it by now because I went on so long, but

But, yeah, this was the about type 2 diabetes. Yeah.

Diabetes. Yeah. Yeah, I know.

I'm kidding. All right.

So, thanks again for listening, and we'll see you next week.

Bye, guys. Thanks, Sue Ellen.