Co-Author: Fatima Tariq
Why diabetic meal planning is important for diabetes type 1 patients? Experts recommend all people living with diabetes make nutrition therapy a part of their diabetes treatment plan.
Many people are hit hard by the reality of life, and develop life threatening conditions from a very young age. A teenager-Chandler Bennett who was diagnosed with type-1 diabetes mellitus in October 2004 whilst sharing her story with NHS UK said, “I thought everyone at school would think I was injecting drugs”.
Although she is optimistic about life and has learned to manage her condition by calculating the carbohydrate content in her food and by adjusting insulin but in the beginning it was not easy for her just like every other diabetic.
“When I was diagnosed, my first thought was, ‘Oh my God, why me?’ I used to be terrified of injections, so that side of it completely scared me. I was self-conscious at first. I didn’t want to inject myself in front of everyone. I thought it was going to be embarrassing and everyone at school would think I was injecting drugs in the middle of lunch. If I hadn’t taken the medication, my blood sugars would have risen and I would have started to feel dizzy. If I’d continued not taking insulin, I would have gotten ill, probably thrown up and eventually I would have died.”
Just imagine what a trouble it would be to calculate the amount of carbs for every food that you eat and to select an insulin dose to nullify that. That’s too much Math and Yes! it’s not easy. When you have type-1 diabetes you cannot produce insulin on your own and have to inject insulin after every meal or snack according to the carbohydrate content. Ms. Bennett used to have one unit of insulin for every time she ate 20g of carbohydrates. 20g of carbs are present in just one plain piece of toast.
All of us normally tend to ignore the blessings that we have around ourselves, like the chocolate I am trying to not look at right now. While for some people life is not that easy. They have faulty genes that are transferred from their parents to them, who to blame for this? Such genes fail to perform their task and leave the person on the verge of life threatening diseases.
Diabetes type-1 is one of them. In this type of diabetes the immune system of the body mistakenly destroys the Beta cells in pancreas that are important forproducing insulin i.e. a hormone that transports glucose into the cells from the blood stream. Therefore, in the absence of insulin the glucose levels in blood spike up leading to severe health complications, according to U.S. National Library of Medicine.
Although it’s a process that one learns with time on trial and error basis but here are three important risk factors associated with diabetes those if taken care of can minimize the extent of the damage caused by this potential harmful situation. These are:
- The serum glucose levels measured over a period of three months via A1C test
- Blood pressure
- LDL cholesterol levels
General recommendations for type-1 Diabetes for keeping glucose levels in control
It has been observed that following these simple recommendations,marked decrease in the results of A1C test can be achieved. These include:
- Strictly following the prescribed meal plan
- By adjusting insulin dose for meal size and content
- Managing glycemic control efficiently and preventing weight gain
- Avoiding excess night time snacking
- Consistency in day-to-day carbohydrate intake at meals and snacks
- Balancing Nutritional content of foods
- Monitoring meal-insulin timing
- Exercise to maintain your blood glucose levels
Diabetic Meal Planning For Diabetes Type 1 Patients
The very first rule that should be kept in mind whilst planning diet for type-1 Diabetes is keeping the glucose level in check and understanding the involvement of major biomolecules which confer the increment in the blood glucose levels. There are three major biomolecules; proteins, fats and carbohydrates which affect the blood glucose levels. However, the degree of the involvement of each molecule in raising the blood glucose levels differs greatly.
Monitoring Major Biomolecules
Proteins, fats and carbs are the major biomolecules which affect the blood glucose level differently.
An interesting fact about fats is that they have no direct effect on the glucose levels but they slows down the digestion rate and delay the time period of rise of blood glucose. Moreover, it has been observed that eating a high fat meal can elevate the blood glucose level up to 12 hours after the meal. Therefore, fatty meals are not a good option for diabetics.
Moreover, it should be noted that the diabetes diet should not contain more than 300 mg per day of total cholesterol. The calories consumed from fats should not exceed 25 to 35 percent and minimal caloric intake i.e. recommended to be 7 percent should be taken from trans-fats.
Proteins on the other hand, do not affect blood glucose levels unless eaten in excess quantities. Generally not more than 6 ounces in each meal is recommended for diabetics.The exact amounts to be taken from proteins are set to be between 15 and 20 percent of total calories consumed per day.
However, type-1 diabetics having certain kidney problems e.g., the chronic kidney disease or CKD should take extra care and are advised to eat a low-protein diet.
Since, carbs have a direct effect on the blood glucose levels therefore, the quantity and type of carbs should be chosen carefully to keep glucose levels in control.
Generally, 45-60 gram carbs are recommended at a time in one meal for diabetics. However, the exact quantity varies from diabetic to diabetic according to your blood sugar levels and should be asked from a registered dietitian.
By reading this article you would have come to know that how important is the carbohydrate counting for people with diabetes especially for type-1 diabetics, who cannot neutralize high amount of carbs without artificially administered insulin. Ideally, in perfect scenarios diabetes should try to adopt a low carb diet that is low in carbohydrates. Having said that, Low carb diets help to control the blood sugar levels which otherwise might be subjected to abrupt increase by consuming carb rich foods those which have high glycemic indexes.
There are two major methods of meal planning using carb counting technique.
- The first one is following a consistent carb meal plan with a consistent amount of insulin.
- The second entails changing carb intake with an adjustable amount of insulin.
One of the very useful tips is to keep the same amounts of carbs each day to keep blood glucose levels under control. Moreover, these should be eaten in moderation as cutting carbs completely out of the diet can have deteriorating effect on health.
Mostly it is recommended to read food labels carefully to count the number of carbs in each food product. But if you are consuming a homemade freshly prepared meal then low carb options should be used that have low glycemic index.
To sum it up, let’s recall that the daily recommended amount of foods containing carbs for diabetics i.e. 45-60 grams of carbohydrate per meal.
However, the exact amount of the carbs suggested for diabetics cannot be quantified due to individual differences in the individuals. It is advised to balance out the high glycemic Index foods with the low ones. Although it is not impossible to calculate the amount of carbs for each meal plan but it is better to get help from a registered dietitian in the beginning.
The Concept of Glycemic Index of Foods
Let’s understand this core concept in greater detail. So, glycemic Index (GI) is a measure of the rate at which foods raise the blood sugar level. Some foods have high glycemic index meaning their consumption can spike up the blood sugar levels immediately. Therefore, foods having lower GI are more suitable for diabetics because sudden shooting of blood sugar levels is adverse and can lead to complications in the absence of insulin.
American Diabetes association has divided the foods according to the glycemic index. These include:
- Low GI Foods (55 or less)
- Medium GI (56-69)
- High GI (70 or more)
Low GI Foods
The low Glycemic index foods which raise the glycemic index up to 55 or less are stone-ground are: whole wheat or pumpernickel bread oatmeal , oat bran, muesli pasta, converted rice, barley, bulgar, sweet potato, corn, yam, lima or butter beans, peas, legumes , lentils, fruits, non-starchy vegetables and carrots etc.
Medium GI Foods
The foods which raise blood glucose level up to 56 to 69 are whole wheat, rye, pita bread, oats or rice (brown, wild or basmati).
High GI foods
The foods which are considered as high glycemic index foods are white bread, bagel, corn flakes, puffed rice, bran flakes, instant oatmeal, white rice, rice pasta, macaroni and cheese, pumpkin pretzels, rice cakes, popcorn, saltine crackers melons and pineapple etc. All of these foods have been seen to elevate blood glucose to 70 or higher.
The term glycemic load is the practical estimation of the glycemic index of certain foods to check the extent of the increment in the blood-sugar levels after consumption of a specific food. It can easily be calculated by the help of a simple equation which works by multiplying a food’s Glycemic index in percentage by the number of net carbohydrates in a given serving. It can be mathematically indicated by the following equation:
GL = GI/100 x Net Carbs
It should be noted that the net carbs are equal to the total carbohydrates minus dietary fiber.
For diabetics who want to lose weight their meals should be planned with the inclusion of foods having a low glycemic index. Mostly nutritionists consider a glycemic index to be less than 10 suitable and above 20 as high for diabetics.
Diabetic Meal Planning: Nutritional Requirements For Hypoglycemia and Hyperglycemia
Hypoglycemia i.e. low blood glucose levels and hyperglycemia referring high blood glucose levels; are the two different conditions associated with type-1 diabetes and the nutritional conditions for both of these vary significantly.
A condition marked with low blood glucose levels.In order to overcome such situation an immediate glucose source should be taken and for that matter American Diabetes Association recommends consuming 15 to 20 grams of glucose or good carbs which do not raise the blood sugar levels abruptly.
Moreover, it is advised for such diabetics to check their blood glucose after fifteen minutes of the visible symptoms observed and if the symptoms still prevail then the above mentioned steps should be repeated.
Few examples of simple carbs containing 15 grams of glucose provided by American Diabetes Association are:
- 2 tablespoons of raisins
- Half cup or 4 ounces of juice or regular soda
- 1 tablespoon sugar, honey, or corn syrup
- 8 ounces of nonfat or 1% milk
- Hard candies, jellybeans, or gumdrops (for the exact quantity the food package should be checked).
A condition marked with high blood glucose levels that mostly occur due to consumption of carb rich and sugary food. The major issue in such condition is that the blood contains glucose in excess quantities. So, some measures should be taken to reduce the increased amounts. Some of which are as follows:
Cutting Down carbs
Since cabs are the main culprits associated with increasing blood glucose levels therefore, cutting down on the amount of food can also help. It is best that you get a personalized diet plan made for you by a registered dietitian. Moreover, if exercising and cut down of diet does not help then consult your doctor to make changes in the prescribed insulin levels or the current dose of your medicines.
The safest and the most effective way to reduce your blood sugar levels is through exercising. Normally, exercising is considered as a safe and beneficial practice for lowering your blood glucose. However, under specified conditions this might get risky.
Get Your Ketones Levels Checked
ADA recommends getting the ketone levels in your body checked if your blood glucose is above 240 mg/dl because presence of too much ketone in the body can elevate the blood glucose levels even more. Therefore, suggestions from your doctor should be taken for finding out a safest way to reduce the elevated blood glucose levels.
Monitoring Fibre Content In Foods
If you are a type 1 diabetic or family member of one then specialized foods entailing specific foods according to meals should be get planned by a registered dietitian.
The fibre content in meals play a very significant role in improving blood sugar levels as the fibrous foods e.g., fruits, vegetables, beans, and whole grains slow the absorption of sugar and reduces blood glucose and cholesterol levels.
Estimating The Insulin Dose From Fibre Content Of Food
The American Diabetes Association recommendswhen a serving of food has more than 5 grams of fiber, the grams of fiber should be subtracted from the grams of carbohydrates to calculate the insulin dose e.g., if a product contains 46 grams of total carbohydrates and 7 grams dietary fibre then the subtracting 7 from 46 would give the number of net carbohydrates is 39 grams.
It is believed that dietary fibre has less impact on serum glucose levels and is not absorbed fully and releases glucose into the cells more slowlyif a food has more than 5 grams of fiber per serving. For this matter you may want to initially subtract only half of the fiber and check your glucose level after meals containing high-fiber foods.
Foods To avoid
Your food choices matter a lot when you’ve got diabetes. Some are better than others. Nothing is completely off limits. Even items that you might think of as “the evil” could be occasional treats — in small amounts.
If you are a type-1 diabetic then try not to consume more than 2300 mg per day of sodium. Caution is advised because the increased salt content for diabetics have been linked with hypertension that is another serious disorder which goes hands in hands with diabetes.
Artificially flavored drinks
Fruit juices and sodas can result in increased sugar levels and might require a dose of insulin for compensation. Therefore, all such drinks should be avoided.
Both men and women are advised to drink moderate amount of alcohol entailing one serving per day for women and two servings per day for men along with planned food that does not affect blood sugar levels significantly. Alcohol consumption raises blood glucose levels slightly which are decreased after few hours. Therefore, it is advised to monitor blood glucose levels after drinking to determine if any changes in insulin doses are needed.
Maintaining Weight With Diet
The number of calories consumed each day determines the body weight by controlling blood sugar levels. Calculated calories each day can help achieve a healthy weight.
Weight should be measured on weekly basis to pinpoint the increase. Start limiting the food intake or increasephysical activities after increase of 2 or 3 pounds. In order to maintain a constant body weight 250 to 300 less calories should be consumed. Moreover, if your glucose levels remain consistently low then ask your doctor to increase the insulin dose rather than eating a snack.
Diet planning for type-1 diabetes can turn out be an overwhelming and confusing process at first but there is no need to worry yourself unnecessarily, as by adding low carb diets along with other simple diabetic foods in your daily diet you can easily reduce the chances of your blood sugar levels increasing abruptly.
The exact quantity of each food from the type-1 diabetic diet can be consumed but only after you have set a diet plan from a registered dietitian according to your blood sugar levels. Moreover, keep in mind that insulin doses should also be determined by a doctor for easy and trouble free management of the type-1 diabetes.