Brenda Khan
Type 1 diabetes is a condition in which the pancreas does not produce enough insulin, resulting in high blood sugar levels. While there is no one-size-fits-all diabetes diet, diet and lifestyle changes can play a crucial role in managing type 1 diabetes and preventing serious health complications. People with type 1 diabetes are advised to focus on eating non-starchy vegetables, high-fiber foods, and healthy fats, while being mindful of their carbohydrate intake and portion sizes. Carbohydrates, or carbs, include foods like candy, sweets, sodas, breads, tortillas, and white rice, and they can cause a spike in blood glucose levels. Portion sizes vary from person to person, and it is important to consult a registered dietitian or diabetes educator to develop a personalized eating plan that considers individual needs and preferences. In addition to diet, exercise and stress management are also key components of successfully controlling type 1 diabetes.
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What You'll Learn
Carb counting
Carbohydrates, or carbs, directly influence blood sugar levels. The more carbs you eat, the higher your blood glucose level will be. Glucose comes from the food we eat, and our bodies need it for energy. Insulin helps glucose get into our cells. With type 1 diabetes, the body does not make insulin, so insulin management is crucial to controlling blood sugar levels. Carb counting is a tool for managing blood glucose levels.
There are three types of carbs: sugars, starches, and fiber. Sugars include natural sugar found in fruit, milk, and added sugar in soda and many packaged foods. Starches are found in foods like bread, tortillas, and white rice. Unlike sugars and starches, fiber does not raise blood sugar levels. Carbs are measured in grams, and nutrition labels on packaged foods will list the total number of carb grams. One carb serving is about 15 grams of carbs.
There are a few ways to count carbs, and the best method depends on your medication and lifestyle needs. You can use an advanced form of carb counting, which uses an insulin-to-carb ratio to calculate how much insulin is needed to manage blood sugar levels. This method is recommended for people on intensive insulin therapy, like those with type 1 diabetes. Another method is the Diabetes Plate Method, which involves limiting whole grains, starchy vegetables, fruits, or dairy to a quarter of the plate.
You can also work with a specialist to determine the best carb counting method for you. A registered dietitian nutritionist (RDN/RD) or Certified Diabetes Care and Education Specialist (CDCES) can help you create a personalised eating plan. They will consider your body size, activity level, appetite, and hunger to determine the ideal number of carbs per meal for you. This service, when provided by a dietitian, is known as medical nutrition therapy. Diabetes self-management education (DSME) sessions may also include creating an eating plan.
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Portion sizes
The first step to managing portion sizes is to be aware of how much you are eating. Keeping a food diary can be an effective way to do this, helping you to recognise your habits and stabilise your blood sugar levels.
The next step is to understand how many carbohydrates you should be consuming. Carbohydrates have the biggest effect on your blood sugar, so it is important to know which foods are high in carbs and to limit your consumption of them. The recommended intake of carbohydrates is 30-45 grams total per meal for women and 45-60 grams per meal for men. To put this into context, one slice of bread, one-third cup of cooked rice, or a tennis ball-sized apple contains approximately 15 grams of carbohydrates.
You can also use the plate method to help visualise portion sizes. Using a 9-inch dinner plate, fill half with non-starchy vegetables, a quarter with lean protein, and the final quarter with carb foods. This helps to ensure you are getting the right balance of food groups.
It is also important to read food labels carefully when monitoring portion sizes. The serving size listed on the label may not always be one serving, so you may need to calculate how much you are consuming. For example, if the serving size is listed as 5 crackers, but you eat 10, you need to double the listed nutritional information.
Finally, using smaller plates and bowls can be a helpful trick to make your portion sizes appear bigger, so you feel more satisfied with your meal.
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Fibre-rich foods
Fibre is a type of carbohydrate that is found mainly in fruits, vegetables, whole grains, and legumes. It is an essential component of a healthy diet and can provide a range of health benefits, especially for people with diabetes.
For those with diabetes, controlling blood sugar levels is crucial to maintaining health and preventing serious complications such as vision loss and heart problems. Fibre can be a helpful tool in managing blood sugar. Unlike other carbohydrates, fibre is not absorbed or broken down by the body, so it doesn't cause a spike in blood sugar. Instead, it helps to slow the rise in blood sugar levels after a meal. This is especially beneficial for people with diabetes, as they are at twice the risk of developing heart disease or stroke compared to those without the condition.
There are two types of fibre: soluble and insoluble. Soluble fibre becomes gummy or sticky as it passes through the digestive tract, helping to reduce cholesterol absorption. Insoluble fibre, on the other hand, doesn't dissolve and is beneficial for promoting bowel regularity.
- Lentils: About 37.5% of the carbohydrates in lentils come from fibre, which can help keep blood sugar stable. A 1-cup serving of cooked lentils provides 15.6 grams of fibre, along with 40 grams of carbohydrates and 18 grams of protein.
- Berries: Berries, such as raspberries and blackberries, are loaded with fibre and antioxidants. A 1-cup serving of raspberries contains about 9.75 grams of fibre and 17.8 grams of carbohydrates.
- Pears: A large pear provides nearly 6 grams of fibre.
- Avocados, green peas, broccoli, barley, and oats are also good sources of fibre.
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Reducing sugar intake
While sugar does not cause type 1 diabetes, and the condition is not linked to lifestyle choices, it is still important to keep blood glucose levels within a healthy range. This can be achieved through careful dietary management.
Firstly, it is important to understand the difference between natural sugars and added or 'free' sugars. Sugar is found naturally in fruits, vegetables, and dairy products, but food manufacturers often add sugar to their products, and we may add sugar to our food and drinks at home. These added sugars are the ones to look out for and cut down on. They are often hidden in foods such as baked beans, pasta sauces, ketchup, yogurt, and ready meals. Simple swaps, such as choosing unsweetened yogurt, can help reduce sugar intake.
It is also important to be mindful of sugary drinks, including pure fruit juices and smoothies. These liquids contribute to your free sugar intake, so it is better to eat whole fruits and vegetables instead. If you do opt for juice, limit yourself to one small glass (150ml) per day.
Another way to reduce sugar intake is to opt for healthier snacks. Instead of chocolate bars, sweets, cakes, and biscuits, try unsalted nuts, seeds, fruits, and vegetables. You can also experiment with reducing the sugar in recipes—most recipes will still work with less sugar.
Finally, managing portion sizes and overall calorie intake can help regulate blood sugar levels. The glycemic index (GI) can be a useful tool, as it measures how quickly carbohydrates break down during digestion and how quickly your body absorbs them. Choosing low GI foods (ranked 55 or lower) can help reduce blood sugar spikes. Adding protein or healthy fats to your meals can also minimize blood sugar spikes.
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Consulting a dietitian
Additionally, a dietitian can provide specific advice on carbohydrate intake based on your height, weight, activity level, age, food preferences, and other medical conditions. They can work with you to develop a daily meal plan that fits your individual needs and preferences. This includes helping you determine whether your medication regimen requires eating meals and snacks on a regular schedule.
Registered dietitians can also provide support for weight management, which is often a component of diabetes care plans. They can offer a weight-neutral approach, focusing on healthy behaviours rather than solely on weight loss. This helps individuals avoid fad diets and unsustainable weight loss plans, which can lead to frustration and weight cycling.
Furthermore, dietitians can collaborate with primary care physicians and specialists to integrate nutrition into diabetes care plans. They can provide medical nutrition therapy (MNT), which includes a nutrition diagnosis, therapeutic services, and counselling to help manage diabetes. MNT has been shown to reduce HbA1c levels and improve overall health.
It is important to note that learning to manage diabetes can be complex, and you may need multiple visits with a dietitian over several months, followed by yearly follow-ups, to ensure you are on track with your care plan.
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Frequently asked questions
Type 1 diabetes is a condition in which the pancreas doesn't produce enough insulin, a hormone that helps glucose (sugar) enter cells.
Diet helps control type 1 diabetes by keeping blood sugar levels within a normal range. Carbohydrates, especially high-carb foods like candy, sweets, sodas, breads, tortillas, and white rice, can increase blood glucose levels. Therefore, carb counting and choosing healthier carbs are important dietary strategies for managing type 1 diabetes.
There is no one-size-fits-all "diabetes diet," and individual needs may vary. However, certain diets like the keto (ketogenic), low-carb, Mediterranean, or plate method diet may help guide your eating patterns and keep blood sugar levels in check. Consulting with a registered dietitian or diabetes educator can help you develop a personalized plan.
It is recommended to consume non-starchy vegetables, high-fiber foods, such as fruits and whole grains, and healthier fats found in unsalted nuts, seeds, avocados, oily fish, and certain oils like olive oil and rapeseed oil.
It is advisable to reduce your intake of foods high in carbohydrates and low in fiber, such as white bread, white rice, and highly processed cereals. Additionally, limit your consumption of sugar, especially from sugar-sweetened beverages, and excessive salt to lower the risk of high blood pressure and associated health complications.
