101 Tips on Nutrition for People with Diabetes. Patti B. Geil
can also call the American Diabetes Association (800-342-2383), the American Dietetic Association (800-877-1600), or the American Association of Diabetes Educators (800-338-3633) for referrals. Many RDs are certified diabetes educators (CDEs) and have additional training in diabetes care.
TYPE 1 & TYPE 2
What should I eat until I can meet with the registered dietitian?
Eat the foods that are healthy for everyone—grains, beans, vegetables, fruits, low-fat milk, and meat. Cut down on foods and drinks with a lot of added sugar (soda, desserts, candy) and fat (fried foods, lunch meats, gravy, salad dressings). You do not need special or diet foods.
It is important to eat about the same amount of food at the same time each day. Don’t eat one or two large meals. Try to eat at least three small meals each day, especially if you are taking diabetes medication. You may need a snack between meals and before you go to bed. Avoid drinking alcohol until you learn how it fits into your diabetes treatment plan. Remember, you can make a big difference in your diabetes management through what you choose to eat. Before you see the RD, keep a record of everything you eat and drink for 3–5 days and bring this record to your appointment. This will help the RD personalize the meal plan for you.
TYPE 1 & TYPE 2
How often do I need to eat to keep my blood glucose levels near normal?
This depends on the type of diabetes you have, your medications, the amount of physical activity you get, and where your blood glucose level is at the moment. An RD can help you decide.
For people with type 1 or people with type 2 who use insulin: Have food in your system when your insulin is peaking. You may need three meals and an evening snack. If you take two injections of short-and intermediate-acting insulin, you may need three meals and three snacks. If you use rapid-acting insulin, eat within 15 minutes of taking your insulin. You may need a snack for physical activity (see Do I need a snack when I exercise?). A common mistake is not waiting a half hour to eat after taking regular insulin. If you start eating before insulin activity is peaking, you may have higher blood glucose levels after meals.
For people with type 2: Eat a small meal every 2–3 hours. When you eat smaller amounts of food, your blood glucose levels are lower after eating. Mini-meals spread throughout the day may help control your hunger and calorie intake, leading to near-normal blood glucose levels and weight loss. Your blood cholesterol levels will also be lower.
TYPE 1 & TYPE 2
What can I eat for snacks?
Choose from the same healthy foods that you eat at meals. Often, snacks are based on foods with 15 grams of carbohydrate per serving. Choose foods from the grain group, such as air-popped popcorn, baked tortilla chips and salsa, graham crackers, whole grain crackers, pretzels, bagels, or cereal. Fresh fruits and vegetables make excellent snacks, and they’re also portable! To make a snack more substantial, add a source of low-fat protein, such as low-fat or skim milk, reduced-fat peanut butter on a slice of whole wheat bread or a bagel, low-fat cheese on whole wheat crackers, or a slice of turkey breast on whole-wheat bread. Keep in mind, however, that although adding protein to your snack may ward off hunger, it does not increase blood glucose to prevent hypoglycemia, and it may add unwanted calories.
Be prepared! Always carry a snack with you in case of a delayed meal or unexpected change in your schedule. Snacks can be stashed in your desk, briefcase, backpack, or glove compartment. Having good food on hand will save you from hypoglycemia and from having to settle for less nutritious fast foods.
TYPE 1 & TYPE 2
How can keeping a food diary help my diabetes?
The food you eat raises your blood glucose. Until you write it down, you probably are not aware of how much or what you are eating. A food diary helps you make important decisions about your medication, meal plan, and exercise plan.
Record information you need. If you want to lose weight, measure your serving sizes and write down how many calories or fat grams you’re getting for several days. Looking up the nutrient values of foods helps you learn what nutrients each food gives you.
Keep records that are easy to use—a notebook, calendar, or form created on your computer. Write it down when you eat it; don’t wait until later.
Use the information. Bring your record to the next appointment with your RD. Look for patterns in your eating behaviors and blood glucose levels. For example, your records may show that high-fat snacks in late afternoon result in high blood glucose at dinner. Or you may notice that when your lunch is much smaller than other meals you are too hungry before dinner. You may want to adjust the size of lunch and decrease your afternoon eating.
Research shows that individuals who keep food and activity records are more successful in following their meal plan.
TYPE 1 & TYPE 2
Why are serving sizes important? Is there an easy way to remember them?
No matter what meal plan you follow—carbohydrate counting, exchanges, or the food guide pyramid—serving size is the key. An extra ounce of meat or a tablespoon of margarine doesn’t sound like much, but it can quickly add up to higher blood glucose levels and weight gain.
Begin by using standard kitchen measuring cups, spoons, and food scales until you train your eyes to see correct serving sizes. Once you’ve weighed, measured, and looked at 1/2 cup of green beans or 5 oz of chicken, you’ll have a mental picture no matter where you dine. Every few months, measure some servings again to keep your eyes sharp and your servings the right size.
Mental pictures can help you eat correct serving sizes.
| Food | Looks like |
| 1 cup pasta or rice | a clenched fist |
| 1/2 cup vegetables | half a tennis ball |
| 1 cup broccoli | a light bulb |
| 3 oz meat, chicken, or fish | a deck of cards or the palm of a woman’s hand |
| 1 oz cheese | two saltine crackers or a 1-inch-square cube |
TYPE 1 & TYPE 2
What should I be looking for on food labels—carbohydrate or fat?
Most people with diabetes should be looking at both carbohydrate and fat on the Nutrition Facts panel on food labels. Carbohydrate is what raises your blood glucose the most, so it’s important to you. Fat carries the most calories per gram, so it affects your weight. Also, diabetes puts you more at risk for developing heart disease. Eating foods lower in fat (especially saturated fat and trans fat) may help you lose weight and lower your risk for heart disease.
The total amount of carbohydrate and the type of carbohydrate you eat can affect your blood glucose. The carbohydrate listed in the Nutrition Facts can be from beans, vegetables, pasta, grains, and sugars (added or naturally present in foods such as milk and fruit). The food