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 label will tell you exactly how many grams of carbohydrate and fat are in a serving of food.
TYPE 1 & TYPE 2
How do I deal with comments such as, “Are you allowed to eat that?”
Your family and friends mean well. Here are some strategies for you to use when others seem to be overly concerned with what you’re eating and drinking:
Recognize your own feelings. Part of adjusting to diabetes is recognizing the difficult emotions that come with it. How do you feel about the lifestyle changes and pressures of self-care?
Recognize the feelings of family and friends. Your family and friends are also adjusting to your diabetes and the ways it affects them. They may feel anxious, intimidated, guilty, or overwhelmed.
Use positive reframing. Change the way you see the situation. If you feel angry at someone’s comment, take a moment to acknowledge your own feeling and then the other person’s feeling. Then look at the situation in a positive way. For example, you may say, “Thanks for reminding me. I know you want to help. I’ve already planned to adjust my insulin (or exercise) to handle the additional calories and carbohydrate in this food.”
Develop an interaction plan. Changing years of old thinking and communication patterns takes time. In a calm moment, discuss a new way to talk about food and diabetes issues.
TYPE 1 & TYPE 2
Now that sugar is no longer forbidden for people with diabetes, can I eat all the sweets I want?
It’s true that the carbohydrate in table sugar can have the same effect on your blood glucose as any other carbohydrate, such as that in bread, potatoes, or fruit. Different carbohydrates do raise blood glucose in different ways; however, for blood glucose management, it’s more important to focus on the total amount of carbohydrate you eat, rather than on where it comes from. You substitute sweets into your meal plan for other carbohydrates—don’t add them on top.
No, don’t have sweets at every meal. Sugary foods don’t have the nutrients, vitamins, and minerals that your body needs to be healthy. That’s why we call these calories “empty” and list these foods as extras in the food pyramid. If you include sweets in a meal, eat a small serving and check your blood glucose before and 1–2 hours after you eat to see how it affects you. Keep an eye on your weight and blood glucose levels over time. Hold back on the sweets if you see your numbers creeping up.
TYPE 1 & TYPE 2
I went to lunch with three friends who also have diabetes. We all follow different types of meal plans. What happened to the “diabetic” diet?
Just as there is no one medication that works for all people with diabetes, there is no single meal-planning approach. The standard 1,800-calorie preprinted diet sheet is gone. Individualization is the key to effective diabetes management.
The best meal plans are designed by you and an RD and are based on your health, other medications, activity level, and treatment goals. Your friend with type 1 diabetes may be taking multiple insulin injections and using the carbohydrate counting approach with frequent blood glucose monitoring. Her food choices would be quite different from those of your friend with type 2 diabetes who has high blood fat levels and needs to lose weight. She may be trying to lower her carbohydrate intake and increase the monounsaturated fats in her diet by eating more nuts, olives, or canola oil. And the friend who works a swing shift is probably using an entirely different approach to the timing and food choices in her meals and snacks. The important thing is to use a meal plan that works for you.
TYPE 1 & TYPE 2
I’ve heard that a low-carbohydrate, high-protein, high-fat diet will help me lose weight without cutting calories. Should I change from the high-carbohydrate, low-fat diet I’ve always followed?
Probably not. A low-carbohydrate diet is very difficult to follow for a long period of time. On this diet, you eat meat, eggs, and cheese but very few carbohydrate foods, such as pasta, breads, fruits, and vegetables. You eat too few fruits and vegetables to get all the vitamins and minerals you need.
The rapid weight loss on a low-carbohydrate diet comes from an unhealthy loss of water and muscle tissue. Side effects include dehydration, low blood pressure, and increased work for the kidneys. The high-fat foods certainly aren’t good for heart health. Other side effects include constipation, fatigue, and nausea. And as with all very restricted diets, once you go back to a normal way of eating, your weight is going to come back.
Until there’s more evidence, it’s probably best to continue with a balanced carbohydrate meal plan. If you have insulin resistance, you may do better substituting some monounsaturated fats for carbohydrates (see monounsaturated fats). Get your health care team’s help to decide on a nutrition approach for you.
TYPE 1 & TYPE 2
Will fiber help my diabetes management?
Fiber can keep your blood glucose from going high after a meal because it slows down the speed at which the food is digested. Foods that are high in fiber are good sources of vitamins, minerals, and other substances important for good health. A high-fiber, low-fat way of eating can also reduce your risk for cancer, cardiovascular disease, high blood pressure, and obesity. Fiber has a favorable effect on blood cholesterol, too.
Fiber in food is made up of two types:
