People with diabetes have the same nutritional needs as anyone else. Having diabetes will not prevent you from enjoying a wide variety of foods if you have a healthy meal plan. What you eat is closely connected to the amount of sugar in your blood. The right food choices will help you control your blood sugar level, blood pressure and cholesterol and it will also keep your weight on track.
What kinds of food can I eat?
A meal plan is a guide that tells you what kinds of food to eat at meals and for snack times and it should fits your schedule and eating habits. For most people who have diabetes (and those without, too), a healthy diet consists of 40% to 60% of calories from carbohydrates, 20% from protein and 30% or less from fat. It should be low in cholesterol, low in salt and low in sugar.
Please consult your professional diabetes care provider to create a special nutrition plan for you.
How much can I eat?
Portion sizes matter. Even if you eat very healthy meals, eating too much will make you gain weight, which is a factor in diabetes. The Diabetes food pyramid can help you make wise food choices. It divides foods into groups, based on what they contain. In general, at each meal you may have 2 to 5 choices (or up to 60 grams) of carbohydrates, 1 choice of protein and a certain amount of fat. Another way to control how much you eat is by following the proportional plate. A healthy plate should include ½ plate of low-carb vegetables, ¼ plate of lean protein and ¼ plate of fiber-rich carbs. For more specific advice, please consult your diabetes healthcare provider.
Keep a diet diary.
By writing down what you eat, when you eat it and how it affects your glucose levels, you can keep a better track of your diet. You should also check your blood glucose level about an hour to one-and-a-half hours after eating to see how your body reacts to various foods. Proper nutrition, coupled with diabetes exercise and medication, will help you manage your diabetes so that you can live a healthy diabetic life.
Counting carbohydrates is an essential part of diabetic meal planning. Because carbohydrates cause your blood glucose to increase, it is important for diabetics to monitor their carbohydrate intake. By calculating carbohydrates, diabetics can control the amount of carbohydrates they eat to better control their blood glucose level.
How many carbohydrates do you need?
For each meal, the suggested amount of carbohydrates is about 45-60 grams. The amount of carbohydrates also depends on how you manage your diabetes and how active you are on a daily basis. It is important that you talk to your healthcare provider to figure out the right amount for your lifestyle.
What foods contain carbohydrates?
The carbohydrates that we eat come from three main foods: fruit, milk and starch. In addition to these, vegetables also contain some carbohydrates.
Some examples of food containing carbohydrates are:
• Bread, cereal, rice, and crackers
• Milk and yogurt
• Fruit and juice
• Vegetables, such as potatoes and corn
• Dried beans, such as pinto beans
• Soy products
• Sweets and snacks, such as candy, cake, soda, chips, etc.
It is also important to understand that other than sugar and sweets, certain foods, such as rice, pasta, and bread will also increase your blood sugar. Your meal plan is designed so the carbohydrate content remains consistent on a daily bases.
How to count carbohydrates?
Many people start by learning to convert carbohydrates to grams. For example, 1 serving of starch, milk, or fruit contains 15 grams of carbohydrates, while 3 servings of vegetables also contain 15 grams of carbohydrates. Knowing this you can easily convert the carbohydrates to calories because 1 gram of a carbohydrate gives you 4 calories. Diabetics that are on a diet plan should only get 50% of their 1600 daily calorie intake from carbohydrates. In other words, each day, they should only eat up to 800 calories of carbohydrates. It is also important to remember to spread out your carbohydrate intake throughout the day to prevent wild fluctuations in blood sugar levels.
Where do you get carbohydrate information?
The best place to find carbohydrate information is under the label titled, “Nutrition Facts,” on the back of most packaged foods. With this information, you will still need to weigh or measure each serving you eat to determine the amount of carbohydrates present.
“Nutritional Facts” Label Reading
* Reference: Contra Service Health Service, Nutrition Topics, September, 2010.
For many people, eating out at a restaurant is a luxury. For diabetics, it can be a challenge, as it is essential to eat the right foods to control your blood sugar. The most important part is to eat moderate portions and make healthy choices to follow your overall diabetic meal plan.
Tips on Dining Out with Diabetes
• Before going out to eat, read for the restaurant’s menu for nutrition values
• Many restaurants serve large portions. Diabetics must remember to eat a controlled portion.
Choose the smallest meal size possible.
Share meals with friends or family when ordering large portions.
Do not allow yourself to get too hungry. Eat a small snack before so you will not overeat at the restaurant.
Request a take home container for the extra portions.
Prevent overeating by avoiding “all you can eat” buffets.
• Substitute for certain food items.
Instead of choosing fries or onion rings, choose a salad or vegetable dish.
Ask for sauces and salad dressings "on the side,” that way you will use less.
On a sandwich, substitute sauces with mustard, ketchup or fresh vegetables.
• Avoid the extras increase in calories and carbohydrates by staying away from foods, such as french fries or other fried foods. These can easily ruin the diabetic’s nutrition diet and goals.
• Request that your food be prepared with less sodium when ordering at the restaurant.
• Read the menu creatively by ordering a fruit cup for an appetizer or a breakfast melon for dessert.
• Limit alcohol, which adds calories but no nutrition to your meal.
• If you overeat, be more active afterward.
How to Order at a Restaurant
• Select fresh fruits or vegetables
• Avoid soups with high sodium
• Eat less starchy food, such as bread, rice, or noodles
• Stay away from processed food, such as pickles and marinated vegetables
• Order salad dressing on the side and only use a small amount
• Avoid ordering too many cheese related appetizers
• Select an entrée meat, poultry, fish or shellfish that is cooked by broiling, grilling, or roasting
• Choose plain vegetables, potatoes, or noodles
• Request food to be cooked without salt or monosodium glutamate (MSG)
• Avoid heavy gravy or creamy entrees
• Skip the cheese, condiments, and special sauces at fast food restaurant
• Order items such as low-fat yogurt, fresh fruits, gelatin, and plain cakes
• Choose unsweetened tea, sugar-free soft drinks, skim milk, or water.
Things to bring along when eating out
When you go out to eat, make sure you have your necessary supplies, such as your blood glucose testing kit, snacks, medications, and insulin. A handy, quick reference food guide will also help in choosing healthy foods when eating out.
This information is a general guideline for eating away from home for diabetics. If you have other questions, please contact your health care provider or dietitian for detailed suggestions.
Fasting with Diabetes during Ramadan
A person with diabetes can fast during Ramadan. However, their chronic metabolic disorder can place them at high risk for various complications if their eating patterns, such as the amount of their meal and fluid intake, are greatly altered.
Here are some risks diabetics should be aware of:
Due to the potential risks listed above, if you wish to fast, you should talk to your doctor or healthcare professional about making the appropriate changes in your diabetic treatment plan.
Management of Diabetes during Ramadan
Exercise & Activity
Speak with your doctor or a healthcare professional before you start fasting. They may recommend changes regarding:
The changes will depend on how you fast, for how long, and how you break the fast. Discuss these matters with your doctor or healthcare professional so that they can better help manage your glucose and insulin patterns.
Blood Glucose Monitoring
Type 1 Diabetics
It is strongly advised not to fast during Ramadan if you are a type 1 diabetic patient.
If you insist on fasting, you will need two daily injections of NPH intermediate-acting insulin administered before the pre-drawn and sunset meals. This will be in combination with short-acting insulin needed for food intake during all meals.
Pregnant or Lactating Women
It is strongly advised not to fast during Ramadan if you are pregnant or lactating.
When fasting, blood glucose levels are low. However, post-meal glucose and insulin levels remain substantially higher in healthy pregnant women than in women who are not pregnant. You should be aware that elevated blood glucose levels during pregnancy are associated with increased risk for major congenital abnormalities. Although there is some controversy surrounding the subject, fasting during pregnancy is believed to carry a high risk of death and disability to both fetus and mother.
If you are pregnant or lactating and you insist on fasting, it is crucial that you speak with your doctor or healthcare professional. Together, you can work on receiving the special attention and strict monitoring that you require.
Breaking the Fast
It is pertinent that you end your fasting immediately if any of the following should occur:
If blood glucose levels drop dramati¬cally to 3.3 mmol/L (60 mg/dL) or lower.
If blood glucose reaches 3.9 mmol/L (70 mg/dL) in the first few hours after the start of the fast. Especially if insu¬lin, sulfonylureas, or meglitinides are taken at the pre-dawn meal
If blood glucose levels rise excessively to 16.5 mmol/L (300 mg/dL) or higher.
Diabetes must pay special attention during a cold, flu, infection or other illnesses. It can be difficult to control your blood glucose level because sickness can cause high blood glucose levels. Test your blood glucose every two to four hours while you are sick to make sure it is not too high or too low. Even when you do not have an appetite, you must still take your diabetes medicine and eat or drink food with carbohydrates.
Sick Day General Guidelines:
Insulin Adjustment for Illness:
Guidelines for taking insulin during sick days depend on which kind of insulin you take:
Sick Day Management Food Plan
Your body uses carbohydrate foods for energy, and when you are ill, the energy helps your body heal and prevent ketones. Try to follow your normal food plan, but when you are sick your appetite will not be like normal days.
Sick day food choices
When to call your doctor
Call your doctor if:
Diabetes Care for Children at School
Children spend most of their time at home and at school. Parents are well trained to help monitor and manage their children with either type 1 or type 2 diabetes. The school setting is a crucial step to diabetes management because it is important to have school personnel understand how they should provide care to students with diabetes.
School based diabetes management and key guidance
Helping Kids Fight Obesity
The rates of obesity and type 2 diabetes among children are increasing dramatically globally. Children are becoming more sedentary and eating more junk food than ever before. With the creation of handheld video games, computers and more television channels, children have more reason to stay indoor and sit for a long period of time. Along with the risk of developing diabetes for overweight children, other adult conditions such as high blood pressure and high cholesterol levels may also be developing.
How to Stay Healthy for Overweight Children?