However, for people with diabetes, the total amounts of carbohydrates consumed each day must be monitored carefully. Of the different components of nutrition -- carbohydrates, fats, and proteins -- carbohydrates have the greatest influence on blood sugar levels. Most people with diabetes also have to monitor total fat consumption and protein intake, too.
To keep your blood sugar levels in check, you need to make healthy food choices, exercise regularly, and take the medicines your health care provider prescribes. A dietitian can provide in-depth nutrition education to help you develop a personalized meal plan that fits your lifestyle and activity level, and meets your medical needs.
Is Your Type 2 Diabetes Under Control?
Learn the ABCs of a Diabetes Diet
The goal of nutrition for people with diabetes is to attain the ABCs of diabetes. The A stands for the A1c or hemoglobin A1c test, which measures average blood sugar over the previous three months. B is for blood pressure, and C is for cholesterol. People with diabetes should attain as near as normal blood sugar control (HbA1c), blood pressure, and healthy cholesterol levels.
Alcohol and Diabetes
Use discretion when drinking alcohol if you have diabetes. Alcohol is processed in the body very similarly to the way fat is processed, and alcohol provides almost as many calories as fat. If you choose to drink alcohol, only drink it occasionally and when your blood sugar level is well-controlled. It's a good idea to check with your doctor to be sure drinking alcohol is acceptable.
Diabetes and Glycemic Index
For years, researchers have tried to determine what causes blood sugar levels after meals to soar too high in those with diabetes. Potential culprits have included sugar, carbohydrates, and starches, among other foods. The glycemic index is a ranking that attempts to measure the influence that each particular food has on blood sugar levels. It takes into account the type of carbohydrates in a meal and its effect on blood sugar.
Foods that are low on the glycemic index appear to have less of an impact on blood sugar levels after meals. People who eat a lot of low glycemic index foods tend to have lower total body fat levels. High glycemic index foods generally make blood sugar levels higher. People who eat a lot of high glycemic index foods often have higher levels of body fat, as measured by the body mass index (BMI).
Talk to your doctor, a registered dietitian, or a diabetes educator and ask if the glycemic index might work to help gain better control of your blood sugar levels.
The glycemic load takes into account the effect of the amount of carbohydrates in a meal. Both the type of carbohydrate and the amount have an effect on blood sugar.
Eating Right With Diabetes
If you have diabetes, it's important to eat right every day to keep your blood sugar levels even and stay healthy. Here's some easy tips:
- Be sure to eat a wide variety of foods. Having a colorful plate is the best way to ensure that you are eating plenty of fruits, vegetables, meats, and other forms of protein such as nuts, dairy products, and grains/cereals.
- Eat the right amount of calories to maintain a healthy weight.
- Choose foods high in fiber such as whole grain breads, fruit, and cereal. They contain important vitamins and minerals. You need 25 to 35 grams of fiber per day. Studies suggest that people with type 2 diabetes who eat a high fiber diet can improve their blood sugar and cholesterol levels. Similar results have been suggested in some studies in people with type 1 diabetes.
Serving Sizes and Diabetes
Be sure to eat only the amount of food in your diabetes meal plan. Excess calories result in excess fat and excess weight. In people with type 2 diabetes, excess body fat means less sensitivity to insulin. Weight loss in overweight and obese people with type 2 diabetes helps improve blood sugars and reduces those risk factors which lead to heart disease. Your dietitian can help you determine the appropriate serving sizes you need, depending on if you need to maintain your weight, gain weight, or lose weight, and if you have high or low blood sugar levels.
- In women with gestational diabetes, it's important to eat multiple meals and snacks per day as recommended.
- Do not skip meals.
- Eat meals and snacks at regular times every day. If you are taking a diabetes medicine, eat your meals and take your medicine at the same times each day.
Note: If you are taking some of the newer diabetes drugs, some of these tips may not apply to you; ask your health care provider the tips you should follow.
The Sweet Truth about Food and Diabetes
You might have heard that, as a person with diabetes, you shouldn't have any table sugar. While some health care providers continue to promote this, many -- realizing that the average person lives in the real world and will probably indulge in a bit of sugar every now and then -- have adopted a more forgiving view. Most experts now say that small amounts of sugar are fine, as long as they are part of an overall healthy meal plan. Table sugars do not raise your blood sugar any more than similar amounts of calories from starches, which is found in many foods that we consume. It is important to remember that sugar is just one type of carbohydrate.
When eating sugar, keep these tips in mind:
- Read food labels. Learn how to determine how much sugar or carbohydrates are in the foods that you eat.
- Substitute, don't add. When you eat a sugary food, such as cookies, cakes, or candies, substitute them for another carbohydrate or starch (for example, potatoes) that you would have eaten that day. Make sure that you account for this in your carbohydrate budget for the day. If it is added to your meal for the day, then remember to adjust your insulin dose for the added carbohydrates so you can continue to maintain glucose control as much as possible. In other words, readjust your medications if you do add sugars to you meals.
- Sugary foods can be fattening. Many foods that have a lot of table sugar are very high in calories and fat. If you are watching your weight (and many people with diabetes must), you need to eat these foods in moderation!
- Check your blood sugar after eating sugary foods and talk to your health care provider about how to adjust your insulin if needed when eating sugars.
- Ultimately, the total grams of carbohydrates -- rather than what the source of the sugar is -- is what needs to be accounted for in the nutritional management of the person with diabetes.
Diabetes Diet Myths
Before you start a diabetes diet, get the facts. So many people believe that having diabetes means you must avoid sugar and carbohydrates at all cost, load up on protein, and prepare "special" diabetic meals apart from the family's meals. Wrong! Most individuals with diabetes can continue to enjoy their favorite foods, including desserts, as long as they monitor the calories, carbs, and other key dietary components and keep a regular check on their blood glucose levels.
Get the facts and start enjoying the foods you love on a diabetes diet.
What Is the TLC Diet for Diabetes?
People with diabetes who have abnormal cholesterol levels will likely be placed on a diet known as a "TLC" diet. The TLC diet will help reduce the intake of cholesterol-raising nutrients. As part of this diet you may be asked to lose weight and increase physical activity levels -- all of these are components that will help lower bad LDL cholesterol. Looking at food labels will help you become more knowledgeable about your intake of fats and cholesterol.
Specifically, the TLC diet calls for the following:
- Total fat consumption should be 25%-35% or less of total calories eaten per day.
- Saturated fats should be less than 7% of total calories eaten in a day.
- Polyunsaturated fats (from liquid vegetable oils and margarines low in trans fats) should be up to 10% of the total calories per day consumed.
- Monounsaturated fats (derived from vegetable sources like plant oils and nuts) should be up to 20% of total calories per day eaten.
- Carbohydrates should be 50%-60% of total calories per day eaten
- We should eat 20-30 grams of fiber per day. These can be derived from oats, barley, psyllium, and beans.
- The amounts of protein in the diet should equal about 15%-20% of total calories eaten per day.
- Cholesterol content of the diet should be less than 200 milligrams per day.
How Much Fat Is Acceptable on a Diabetes Diet?
People with diabetes have higher than normal risk for heart disease, stroke, and disease of the small blood vessels in the body. Controlling blood pressure and limiting the amount of fats in the diet will help reduce the risk of these complications.
Limiting the amounts of saturated fats, increasing the amount of regular exercise, and receiving medical treatment can lower bad LDL cholesterol. This has been repeatedly shown in medical studies to help people with diabetes reduce their risk of heart disease and reduce the risk of death if a heart attack does occurs in a diabetic person.
Artificial Sweeteners and Diabetes
Artificial sweeteners can be added to a variety of foods and beverages without adding more carbohydrates to your diabetes diet. Using non-caloric artificial sweeteners instead of sugar also greatly reduces calories in your favorite foods.
Artificial Sweeteners and Diabetes continued...
Keep in mind that foods with artificial sweeteners are not necessarily zero carbohydrates foods. Many have carbohydrates; therefore, you must read the food labels to determine the gram amounts per serving that these have in order to take into account the effect that these carbohydrates have on your glycemic control. Foods labeled with artificial sweeteners can affect your blood sugar.
As long as you are aware of the content of carbohydrates you can adjust your meal or medication to maintain blood sugar control. "Sugar free" means no sugar has been added, but you must remember these foods still contain carbohydrates which does affect your blood sugars.
Examples of artificial sweeteners you can use include:
- Other non-nutritive sweeteners
Pregnant or breastfeeding women should avoid saccharine, and people who suffer from phenylketonuria should not use aspartame. People with phenylketonuria are unable to metabolize phenylalanine, an amino acid that's a common part of many proteins.
Some artificial sweeteners -- such as xylitol, mannitol, and sorbitol -- have some calories and do slightly increase blood sugar levels.
The American Diabetes Association cautions that eating too much of any artificial sweetener can cause gas and diarrhea.