Leena Watts
Healthy eating is an important part of managing diabetes, as it can help control blood glucose (blood sugar) levels and prevent further health complications. While there is no one-size-fits-all diet for diabetes, there are some general guidelines that can help. These include eating a variety of healthy foods from all food groups, controlling portion sizes, and making informed food choices that are low in sugar and other simple carbohydrates. For those taking insulin, carbohydrate counting can also be a useful tool to determine insulin dosage. In addition to diet, other aspects of a healthy lifestyle, such as regular physical activity, adequate sleep, and quitting smoking, are also important for managing diabetes.
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What You'll Learn
Carbohydrate counting
CC can be done manually or automatically, depending on the patient's experience. The accuracy of carbohydrate content prediction is crucial, and patients' adherence to the prescribed regimen is essential for positive outcomes. This method offers superior glycemic control and flexibility compared to other food planning techniques. It is especially beneficial for children and teenagers with type 1 diabetes, as it can improve metabolic control without adversely affecting weight or insulin requirements.
The amount of carbohydrates needed varies depending on body size, activity level, appetite, and hunger. There is no one-size-fits-all answer, and a personalised approach is necessary. A registered dietitian nutritionist (RDN/RD) or Certified Diabetes Care and Education Specialist (CDCES) can help determine the ideal carbohydrate intake and create a tailored eating plan. This plan should consider the specific needs and abilities of the patient, with small achievable changes implemented first.
Recent studies have shown that diabetic patients often misestimate their carbohydrate intake, which can lead to higher HbA1c levels. However, after a training session in ACC, HbA1c levels decreased, demonstrating the effectiveness of ACC and insulin bolus calculation in lowering HbA1c and improving glycemic control. While some patients may find CC challenging, others appreciate the flexibility and increased meal choices it provides.
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Portion control
A portion-controlled diet can help individuals with diabetes control their body weight and blood glucose levels. For example, a randomised control trial found that a portioned meal box (PMB) was effective in assisting patients with diabetes in improving portion control. The PMB was set according to the individual's energy requirements.
The Diabetes Plate is another tool that helps individuals with diabetes portion their meals correctly. It involves filling half of a nine-inch plate with non-starchy vegetables, a quarter with lean proteins, and a quarter with quality carbohydrates like starchy vegetables, fruits, whole grains, or low-fat dairy. This method can be customised to the individual's food preferences and helps to simplify healthy eating.
In addition to portion control, it is important to focus on adding healthy fats (like monounsaturated and polyunsaturated fats) to the diet to help lower cholesterol and protect the heart. These can be found in foods like olive oil, nuts, avocados, and some types of fish. It is also recommended to make healthy swaps, such as choosing nutrient-dense foods that are rich in protein, healthy fats, vitamins, minerals, antioxidants, and fibre.
It is important to note that dietary advice for individuals with diabetes should be tailored to their specific needs and ability to implement changes. A multidisciplinary care team, including endocrinologists, nurses, pharmacists, and dietitians, is often required to successfully manage diabetes and prevent complications.
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Individualised lifestyle changes
The first step is to consult a healthcare professional, such as a doctor, physician assistant, or nurse practitioner. They may refer you to a diabetes educator or a registered dietitian (RD) who can provide medical nutrition therapy (MNT). This therapy includes counselling to help create and follow a meal plan. The dietitian will consider your specific needs and abilities to implement change, and they may suggest starting with small, achievable changes.
The plate method is a useful tool to help control portion sizes and blood glucose levels without the need for strict carb counting. This method involves dividing a 9-inch plate into three sections:
- Non-starchy vegetables (such as leafy greens, peppers, carrots, or green beans) should make up half of your plate.
- Carbohydrate foods that are high in fibre (such as brown rice, whole grains, beans, or fruits) should make up one-quarter of your plate.
- Protein foods (such as lean meats, fish, dairy, tofu, or other soy products) should make up the final quarter.
In addition to a balanced diet, other lifestyle changes can help manage diabetes. These include regular physical activity, getting enough sleep, quitting smoking or tobacco use, and maintaining a healthy weight. These changes can be challenging, so it is beneficial to seek support from family, friends, and other trusted people in your community.
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Medical nutrition therapy
The American Diabetes Association (ADA) emphasizes that MNT is fundamental to the overall diabetes management plan. The need for MNT should be reassessed frequently by healthcare providers in collaboration with patients, with special attention during times of changing health status and life stages.
MNT implemented by a registered dietitian is associated with A1C reductions of 1.0–1.9% for people with type 1 diabetes and 0.3–2.0% for people with type 2 diabetes. The best mix of carbohydrates, protein, and fat depends on the individual metabolic goals and preferences of the person with diabetes.
Diet and lifestyle recommendations are cornerstones of advice to prevent and manage diabetes. However, there are recognized barriers to heeding advice and implementing lifestyle changes. It requires open and honest communication between the healthcare practitioner and patient and cannot be delivered by giving a person a diet sheet in a one-size-fits-all approach.
Nutrition therapy for diabetes should be complemented by evidence-based guidance from healthcare teams, allowing patients to make healthy food choices that meet their individual needs and optimize their overall health.
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Healthy fats
Oily fish, such as sardines, are another excellent source of healthy fats, providing omega-3 fatty acids that support heart health and may help reduce inflammation and increase insulin function. The American Diabetes Association recommends that people with diabetes consume fish, especially fatty fish, twice a week.
Nuts and seeds are also rich in healthy fats, specifically MUFA and PUFA. These foods can contribute to a feeling of fullness, reducing the temptation to overeat and aiding in weight management. Additionally, healthy fats can help improve cholesterol levels, further supporting heart health and reducing the risk of cardiovascular complications associated with diabetes.
It is important to remember that healthy fats are calorie-dense, so portion control is crucial. They should be incorporated as part of a balanced meal plan, along with a variety of nutrients from fruits, vegetables, lean proteins, whole grains, and dairy or dairy alternatives. Consulting with a healthcare professional or a registered dietitian is recommended to create an individualized meal plan that includes healthy fats and considers personal health goals and needs.
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Frequently asked questions
There is no one-size-fits-all diet for controlling diabetes. Eating healthy to control blood glucose does take some effort, but it can help you live a healthier life. It is recommended to eat a variety of healthy foods from all food groups, including fruits and vegetables, healthy fats, and nutrient-dense foods.
You can manage diabetes through diet by working with a healthcare professional to create a meal plan that works for you. This may involve seeing a registered dietitian or diabetes educator who can help design an eating plan. The plan will consider what to eat, how much to eat, and when to eat.
There are some basic guidelines that apply across all eating plans for diabetes. It is recommended to eat non-starchy vegetables, lean meats or plant-based proteins, healthy fats, and quality carbohydrates. Fruits are also a good option, as they provide vitamins, minerals, and fiber without the added sugar.
To keep your blood glucose under control, you may need to cut back on sugary foods and drinks, such as candy, cookies, cake, ice cream, sweetened cereals, and canned fruits with added sugar. Drinks with added sugars, such as juice, regular soda, and energy drinks, should also be limited.
Diet can help control diabetes by keeping your blood glucose, blood pressure, and cholesterol levels within the ranges recommended by your healthcare provider. Healthy eating can also help you have a better relationship with food and improve your overall health and well-being.
