Treatment of Diabetes: The Diabetic Diet

There Are Several Aspects in the Treatment of Diabetes, Each One with a Very Important Role

The mainstays of diabetes treatment are:

  1. Working towards obtaining ideal body weight
  2. Following a diabetic diet
  3. Regular exercise
  4. Diabetic medication if needed


Note: 
Type 1 diabetes must be treated with insulin; if you have type 2 diabetes, you may not need to take insulin. This involves injecting insulin under the skin for it to work. Insulin cannot be taken as a pill because the digestive juices in the stomach would destroy the insulin before it could work. Scientists are looking for new ways to give insulin. But today, shots are the only method. There are, however, new methods to give the shots. Insulin pumps are now being widely used and many people are having great results.  

In this Article

Working towards obtaining ideal body weight
An estimate of ideal body weight can be calculated using this formula:

For women:
Start with 100 pounds for 5 feet tall. Add 5 pounds for every inch over 5 feet. If you are under 5 feet, subtract 5 pounds for each inch under 5 feet. This will give you your ideal weight.

If you have a large frame, add 10%. If you have a small frame, subtract 10%. A good way to decide your frame size is to look at your wrist size compared to other women's.

Example: A woman who is 5' 4" tall and has a large frame
100 pounds + 20 pounds (4 inches times 5 pounds per inch) = 120 pounds.
Add 10% for large frame (in this case 10% of 120 pounds is 12 pounds).
120 pounds + 12 pounds = 132 pounds ideal body weight.

For men:
Start with 106 pounds for a height of 5 foot. Add 6 pounds for every inch above 5 foot.

For a large frame, add 10%. For a small frame, subtract 10%. (See above for further details.)

Learn More about Treating Type 2 Diabetes

The Diabetic Diet
Diet is very important in diabetes. There are differing philosophies on what is the best diet but below is a guideline with some general principles.

Patients with type 1 diabetes should have a diet that has approximately 35 calories per kg of body weight per day (or 16 calories per pound of body weight per day). If you have a child who has type 1 diabetes, we encourage you to read our article about meal planning for children with type 1 diabetes.

How much do you know about the diabetic diet?

Patients with type 2 diabetes generally are put on a 1,500 to 1,800 calorie diet per day to promote weight loss and then the maintenance of ideal body weight. However, this may vary depending on the person's age, sex, activity level, current weight, and body style.

More obese individuals may need more calories initially until their weight is less. This is because it takes more calories to maintain a larger body, and a 1,600 calorie diet for them may promote weight loss that is too fast to be healthy.

Men have more muscle mass in general and therefore may require more calories. Muscle burns more calories per hour than fat. (Thus also one reason to regularly exercise and build up muscle!) Also, people whose activity level is low will have less daily caloric needs.

Generally, carbohydrates should make up about 50% of the daily calories (with the accepted range 40% to 60%). In general, lower carbohydrate intake is associated with lower sugar levels in the blood.

However, the benefits of this can be canceled out by the problems associated with a higher fat diet taken in to compensate for the lower amount of carbohydrates. This problem can be improved by substituting monounsaturated and polyunsaturated fats for saturated fats.

Most people with diabetes find that it is quite helpful to sit down with a dietitian or nutritionist for a consult about what is the best diet for them and how many daily calories they need. It is quite important for diabetics to understand the principles of carbohydrate counting and how to help control blood sugar levels through proper diet. Below are some general principles about the diabetic diet.

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Understanding Food Groups
There are 3 basic food groups: fats, proteins, and carbohydrates. The carbohydrates are the foods that can be broken down into sugar. It is essential to have all 3 food groups in your diet to have good nutrition.

1. Why Count Carbohydrates?
Carbohydrates make your blood glucose level go up. If you know how much carbohydrates you've eaten, you have a good idea what your blood glucose level is going to do. The more carbohydrates you eat, the higher your blood sugar will go up.

2. Which Foods Contain Carbohydrates?
Most of the carbohydrate we eat comes from 3 food groups: starch, fruit, and milk.

Vegetables also contain some carbohydrates, but foods in the meat and fat groups contain very little carbohydrates. Sugars may be added or may be naturally present (such as in fruits).

The nutrient term for sugars can also be identified by looking for -ose at the end of a word ( ie, glucose, fructose, and sucrose are all sugars). Look for these on food labels to help identify foods that contain sugar.

Below are some examples of carbohydrate grams for some common food items:

Food

Amount

Carb grams

Food

Amount

Carb grams

1 % fat milk

1 cup

12

yogurt fruited

1 cup

40

Bran Chex

2/3 cup

23

yogurt fruit

1 cup

19

Frosted Flakes

3/4 cup

26

Raisin Bran

3/4 cup

28

fruit juice

1/2 cup

15

bread/toast

1 slice

15

banana

1/2

15

sugar

1 tsp.

4

pancake syrup

2 Tbsp.

30

pancakes - 4

2

15

low-fat granola

1/2 cup

30

sugar-free syrup

2 Tbsp.

4

 

To make things easy, many people begin carbohydrate counting by rounding the carbohydrate value of milk up to 15.

In other words, one serving of starch, fruit, or milk contains 15 grams carbohydrate or one carbohydrate serving. Three servings of vegetables also contain 15 grams. Each meal and snack will contain a specific total number of grams of carbohydrate.

For example: Each gram of carbohydrate provides 4 calories. A person with diabetes on a 1,600 calorie diet should get 50% of these calories from carbohydrates. This would be a total of 800 calories of carbohydrates (at 4 calories per gram) spread out over the day. At 15 grams per exchange, this would be about 13 exchanges of carbohydrates per day.

The amount of food you eat is closely related to blood sugar control. If you eat more food than is recommended on your meal plan, your blood sugar goes up. Although foods containing carbohydrates (carbs) have the most impact on blood sugars, the calories from all foods will affect blood sugar.

The only way you can tell if you are eating the right amount is to measure your foods carefully. Also, it is important to space your carbohydrates out throughout the day to avoid sugar "loading." Measuring your blood sugar regularly also provides important feedback on how high your sugar went based on what you ate and your level of activity.

Where Do You Get Carbohydrate Information?
The "Nutrition Facts" label on most foods is the best way to get carbohydrate information, but not all foods have labels. Your local bookstore and library have books that list the carbohydrate in restaurant foods, fast foods, convenience foods and fresh foods. You will still need to weigh or measure the foods to know the amount of grams of carbohydrates present.

How Do You Count Carbohydrates?
Carbohydrates can be counted in number of grams or can be counted as exchanges. One carbohydrate exchange equals 15 grams of carbohydrates.

Free Foods
These are foods that you can eat without counting. A free food or drink is one that contains less than 20 calories and 5 grams or less of carbohydrates per serving. If your serving of a food contains more than 5 grams of carbohydrates, you should count it in your meal plan.

Examples of free foods:

  • Bouillon or broth
  • Carbonated or mineral water
  • Club soda
  • Coffee or tea
  • Diet soft drinks
  • Drink mixes, sugar-free
  • Tonic water, sugar free
  • Sugar-free hard candy
  • Sugar-free Jell-O
  • Sugar-free gum
  • Jam or jelly, light or low-sugar, 2 tsp
  • Sugar free syrup, 2 tsp

 You should spread out free foods throughout the day and not eat them in one sitting.

Fitting Sugar in Your Meal Plan
It is commonly thought that people with diabetes should avoid all forms of sugar. Most people with diabetes can eat foods containing sugar as long as the total amount of carbohydrates (carbs) for that meal or snack is consistent.

Many research studies have shown that meals which contain sugar do not make the blood sugar rise higher than meals of equal carbohydrate levels which do not contain sugar. However, if the sugar-containing meal contains more carbs, the blood sugar levels will go up.

Can I Eat Cake and Not Worry About It?
No! A slice of white cake with chocolate icing (1/12 of a cake or 80 grams weight) will give you about 300 calories, 45 grams of carbs, and 12 grams of fat. That is 3 starch servings and over 2 fat servings.

Before you have a slice of cake, ask yourself the following questions: Will that small piece of cake be satisfying or will I still be hungry? How will it fit into my meal plan? Do I have 300 calories to "spend" on this? Are there other choices I could make which would contribute less fat?

A 1/12 slice of angel food cake has less than 1 gram of fat and only 30 carbs. This may be a better choice.

Controlling All Carbohydrates
It is important to realize that sugar is not the only carbohydrate that you have to "control." The body will convert all carbohydrates to glucose, so eating extra servings of rice, pasta, bread, fruit, or other carbohydrate foods will make the blood sugar rise.

Just because something doesn't have sugar in it doesn't mean you can eat as much as you want. Your meal plan is designed so that the carbohydrate content of your meals remains as consistent as possible from day to day.

A Word of Caution
Although sugar does not cause the blood sugar to rise any higher than other carbohydrates, it should be eaten along with other healthy foods. If you choose to drink a 12-ounce can of a sugar-sweetened soft drink, that would use up about 45 grams of carba, and you wouldn't have gotten any nutrition (protein, vitamins, or minerals). What a waste of calories!

High sugar foods are more concentrated in carb. Therefore the volume would be smaller than a low sugar food. High sugar foods might not be a good choice if they will just tempt you to eat more. If you would rather eat larger portions, select low sugar choices.

Look at the differences in portion size you get for equal amounts of carbohydrate in these cereals!

Granola

Frosted Flakes

Corn Flakes

Cheerios

Puffed Wheat

1/4 cup

1/3 cup

3/4 cup

1 cup

1 1/4 cup

In addition, many sugar-containing foods also contain a lot of fat. Foods such as cookies, pastries, ice cream and cakes should be avoided largely because of the fat content and because they don't contribute much nutritional value. If you do want a "sweet," make a low-fat choice, such as low-fat frozen yogurt, gingersnaps, fig bars, or graham crackers and substitute it for other carbohydrates on your meal plan.