Diabetes and Nutrition

How are diabetes and nutrition linked?

Diabetes is a disease in which levels of glucose (sugar) in the blood are higher than normal. There are 3 main types of food that provide energy to your body: protein, fat, and carbohydrates. Glucose is produced by the body from the foods you eat, mainly carbohydrates. When you consume carbohydrates, your glucose levels go up. What you eat can have a large effect on your blood sugar level. That is why diet can be as important as medication in controlling diabetes.  This does not mean that all people with diabetes need to follow the same diet. It also does not mean you cannot enjoy your food. However, it is helpful to understand how food affects your blood sugar and make changes in what you eat and how much you eat of each food, particularly foods that contain carbohydrates.

Controlling your weight is also important for blood glucose control. Losing weight makes your body more sensitive to insulin and helps your blood sugars. Diet and exercise are very important in keeping your weight healthy.

Nutrition is also important in controlling cholesterol and lipids and the risk of heart and vascular disease.

Changing your eating habits is not easy. Your doctor and/or a registered dietitian can help you make changes in your diet that work for you.

How can a registered dietitian help? 

A dietitian will help you understand the effect of different foods on your blood glucose and will work with you to make changes in your diet using foods you like to eat.  There is no one diet that fits all. A good dietitian will take into account your habits, preferences and traditions.

It is also helpful to follow up with the dietitian every few months or at least once a year to review what works and what does not work for you and make more changes.

What are carbohydrates?

Carbohydrates (carbs) are the starches, sugars, and fiber in your diet. Starch is in breads, pasta, cereals, potatoes, beans, peas, and lentils. Natural sugars are in fruits, milk, and vegetables. Desserts, sweetened beverages, and candy contain added sugars. Fiber is in all plant foods—vegetables, fruits, grains, and beans. Fiber also can help regulate appetite and absorption of food. 

Whole grains contain more fiber, vitamins, and minerals than refined grains, like white flour or white rice. Brown rice, wild rice, oats, corn, barley, whole wheat breads, whole wheat pasta, millet, and quinoa are some examples of whole grains. It is important to note that all carbs are not bad for you. 

Should I eat more or less carbohydrates? 

There is no set amount of carbohydrates you should eat. However, if your diet is rich in carbohydrates, reducing the amount you eat could help your blood glucose. Your doctor and/or your dietitian will help you decide the amount of carbohydrates that is right for you. The quality of the carbohydrates is also very important. Your doctor and your dietitian will help you understand the effect of different carbohydrates on your blood glucose and help you make better choices. In general, foods rich in fiber will cause smaller elevations of blood glucose. If you are on insulin, particularly if you have type 1 diabetes, it is also important to be able to count how many carbohydrates you are eating to adjust your insulin dose and avoid wide fluctuations of your blood glucose.

Are there any foods patients with diabetes should avoid? 

• Synthetic trans fats (vegetable shortening, fried foods, processed baked goods, cookies and snacks) increase the risk of heart disease
• Sugary drinks quickly raise blood glucose levels and have low nutritional value
• Juice is very rich in sugars and will elevate blood glucose fast; it is better to eat whole fruits
• Reined grains such as white flour and white rice; whole grains are better
• Added sugars
• Highly processed foods

Which foods are good for patients with diabetes? 

There are some foods that help better control blood glucose and have been shown to help patients with diabetes live longer:

• Increasing fiber in meals can help better control diabetes. Foods rich in fiber are whole grains, non-starchy vegetables, fruits, beans, peas, and lentils
• Monounsaturated and polyunsaturated fats (olive oil, nuts, canola oil)
• Omega-3 fatty acids (in fatty fish and fish oil) 

Are there any tools available that can help? 

Get familiar with reading nutrition labels on packaged foods. There is also a variety of internet based and electronic device apps that can help you find the nutritional value of your foods and also keep track of what you eat. 

Questions to ask your doctor

• How many grams of carbohydrate should I have at each meal and snack?
• Should I check my blood glucose level after meals?
• Do I need to lose weight? How much? 
• Should I see a registered dietitian? 
• Should I see an endocrinologist for my care?