Proper Nutrition for the Type 1 Diabetic

Since diabetes is a condition that is strongly connected to the foods we eat, most people think there is a special diet diabetics must follow. Surprisingly, there is no real “Diabetic Diet Plan.” Specific foods aren’t forbidden, and receiving this diagnosis doesn’t mean a lifetime of bland, unexciting food. Rather, the best diet is one high in fruits, vegetables, and whole grains, with small amounts of animal products and sweets. Sound familiar?

It’s important to understand, however, that the fact that a diabetic’s ideal food intake is the same as everyone else’s ideal food intake doesn’t mean a diabetic doesn’t have special considerations. It’s vital to keep Blood glucose levels as consistent as possible, which means careful planning and monitoring. When a person is first diagnosed, it can take some time to understand how different foods affect the body’s blood glucose levels, and time to develop the ideal routine for optimum management. Also, since carbohydrates have the biggest effect on blood glucose levels, they need the most attention.

Planning Your Plan
Whether you are the parent of a child with type 1 diabetes or an older person trying to get a better handle on your own needs, there are a few simple things to do:
  1. Educate yourself. You must learn the food groups and where each food you choose fits. You also need to understand the makeup of different foods—for example, how many grams of carbohydrate in grapefruit, the nutritional value of a croissant versus a whole-grain slice of bread, etc. A registered dietician or nutritionist is an invaluable aid in getting you started. There are also books and magazines and literature available from your doctor to help you.
  2. Use a food record form. Keeping track of all the food and beverages consumed, as well as blood glucose levels before and after eating, is the best way to understand your or your child’s needs.
  3. Standardize the eating plan. Portion sizes are important, so that’s another factor to learn. You may be surprised to find that your usual “serving” of pasta is three or four measured servings.Meals should have food from all the food groups spread throughout the day, and should be eaten regularly, at the same time each day, with the same amounts of food each day. So while your breakfasts may vary in actual food items, they should always contain the same amount of protein, dairy, grain, and/or fruit each day.
  4. Plan ahead. You’ll find it’s easiest to keep control when you plan several meals at a time, or at least an entire day ahead.
  5. Don’t discount beverages.Water is as necessary to a diabetic as it is to any person. It contains no carbohydrates or calories. Beyond that, however, beverages are an important factor in your planning. You must account for sweetener and milk in coffees and teas, and be careful about fancy drinks that may contain sugar. Watch out for carbohydrate content in “hidden” places, like flavored waters and diet drinks.
  6. Alcohol is fine to drink, but in moderation. Know that alcohol on an empty stomach can dangerously reduce blood glucose levels. Hypoglycemia (low blood sugar) symptoms also mirror drunkenness, so it’s best to never let drinking get that far. Always eat food while drinking an alcoholic beverage.
Ways to Plan and Monitor Glycemic Index
The glycemic index (GI) is a tool that ranks Carbohydrate-containing foods based on their effect on blood glucose levels. Foods that rank low generally cause the blood glucose to fluctuate only a little, while foods that rank high do the opposite. The more refined a food is, the higher its GI; the more fiber it has, the lower its GI. As you might imagine, foods that are high in simple sugar like cake, white breads, baked goods made from white flour, etc., are high GI, though some whole foods (like potatoes) can be even higher. Most vegetables are low in carbohydrate and don’t even have a GI value.

The glycemic index can be a valuable tool to help you control your blood glucose levels. However, different people can react very differently to the same foods, despite expectations based on the “high” or “low” GI label. Also, what else is eaten at the same time, how the food is cooked, and so on may also alter the effect of the food. Some dieticians consider the GI a more difficult way to plan and monitor because of this complexity.

Carbohydrate Counting
As mentioned, carbohydrates have the greatest effect on blood glucose levels. Therefore, counting carbohydrate grams for each meal and snack is an easy way to plan your meals and regulate your blood glucose. By knowing how much carbohydrate is in each serving of dairy, grain, and fruits and vegetables, you can standardize how much you eat at each meal and in a whole day. Consistency is key.

Servings
Servings can help you standardize your food plan. A serving of different kinds of whole grains, for example, will contain the same number of carbohydrates and provide the same mix of nutrients, vitamins, and minerals. Knowing what a serving entails can also make substitutions and comparisons easier from meal to meal.

Specific Food Groups
The number of servings to be eaten each day from the different food groups will vary from person to person depending on age, weight, individual goals, and individual blood glucose reactions to specific foods. There are some basic things to keep in mind for each group, however:

Fats, Oils, Sweets
Diabetics are at higher risk for heart disease and stroke, to which high-fat diets contribute. Keep saturated fats out of your diet, using small amounts of poly- and monounsaturated fats and oils. Don’t be fooled by the lack of carbohydrate in these foods—that doesn’t mean you can eat as much as you want with no effects. Sweets are not forbidden to a diabetic, but as they are usually highly refined and high in simple sugar and carbohydrate, they must be carefully incorporated into the overall meal plan. When you eat a donut, you’ll need to make adjustments to the amounts of other carbohydrates you eat at the same time, and possibly to your Insulin dosage and timing.

Meat and Meat Substitutes
Animal-based proteins do not contain carbohydrates and are great sources for certain nutrients. The amount any person needs is fairly low, however, and meats also contain higher levels of fats and cholesterol. Plant sources of protein do contain carbohydrate and must be taken into consideration, as well.

Dairy
It may be surprising to learn that dairy foods are high in carbohydrate and must be carefully incorporated. They can also be high in fat, so choosing low-fat versions or very small portions of higher-fat versions of milk, cheese, and yogurt is best.

Fruits and Vegetables
Most vegetables are low in carbohydrate and high in fiber and nutritional value, and are therefore an important part of a diabetic’s meal plan. Fruits contain fruit sugar and can therefore cause confusion about their effect on blood glucose levels. However, they are high in nutritional value so they are an important part of a balanced diet. They should be treated like any other carbohydrate.

Grains
Foods from the grains group will provide the bulk of any person’s healthy diet, even a diabetic’s. These contain the highest levels of carbohydrate and will therefore have the biggest effect on blood glucose levels. However, whole grains and starchy vegetables (such as potatoes or beans) balance that effect by being high in fiber, vitamins, and minerals and are low in fat and cholesterol. Space these out throughout the day and choose the least refined items for maximum nutrition.

Eating at School
Type 1 diabetes is usually diagnosed in childhood. Parents who are in control of their child’s health will be concerned about school time, the biggest portion of your child’s day. Here are some things to consider:
  • Meet with everyone who will have a hand in your child’s education, preferably before school starts each year. This includes teachers, physical education staff, the school nurse, and cafeteria staff.
  • Prepare a 504 plan to protect your child’s rights.
  • Be sure everyone understands your child’s need to eat at times that might not be generally approved.
  • Provide food kits and medication supplies, and a plan for glucose monitoring.
  • Educate yourself on the cafeteria’s offerings, and decide whether to incorporate that into your child’s meal plan or to supply only packed meals from home.
  • Investigate resources available to you to ensure your child gets the best possible care while in school.
We have just scratched the surface of a diabetic’s nutritional needs and considerations, but you now have a framework upon which to base your own specific, individualized planning. Type 1 diabetes requires constant lifelong attention, but with careful preparation and understanding of your personal situation, you can develop a very manageable routine.