Eating and Diabetes
Diabetes is a life-long condition. It occurs when the pancreas does not make enough insulin and/or the body cannot use the insulin properly. Insulin is a hormone made by the pancreas that helps carry glucose (sugar) from the blood to cells in the body where it is used for energy. When not enough insulin is made or it cannot do its job properly, the body's cells do not receive their source of energy (glucose). This results in a high blood glucose level. Over time, high blood glucose levels can lead to heart, kidney, eye, nerve, and blood vessel problems.
Attention to diet and exercise, blood glucose monitoring, and sometimes pills and/or insulin injections are needed to manage diabetes. If you are overweight, losing weight can help improve your diabetes control. The information in this fact sheet will help you balance your diet to help you reach your goal blood glucose level.
Steps You Can Take
Follow these steps for healthy eating with diabetes:
1. Eat regular meals and snacks.
- Eat at least three meals every day, at regular times.
- Space meals 4-6 hours apart.
- Try to eat meals that are the same size, especially with the same amount of carbohydrate.
- Snacks may be needed between meals and/or before bedtime. This can be determined for each person based on many factors such as:
- the amount of time between your meals
- whether you take insulin and/or pills for diabetes
- your risk for low blood glucose
- your exercise level and weight goals
2. Plan balanced meals that have foods from at least three of the four food groups listed below:
- Vegetables and Fruit
- Grains and Starches (roti, bread, cereal, rice, pasta, bun, potato),
- Milk and Alternatives (milk, lassi, yogurt, soy beverage, evaporated canned milk)
- Meat and Alternatives (fish, poultry, meat, egg, dahl, raj mahn, cholay, soy beans, tofu, 100% natural peanut butter, unsalted nuts)
Imagine a dinner plate: fill half your plate with vegetables, ¼ with grains and starches, and ¼ with meat and alternatives. To complete your meal have a cup of milk (or milk alternative) and a serving of fruit. (For more information and a picture, visit www.diabetes.ca and search "Just the Basics".)
- See the fact sheet "Healthy Carbohydrates for Diabetes" (see "Additional Resources" section below) to help you figure out how much carbohydrate you can have and what foods fit into your eating plan.
- Enjoy a variety of different foods.
3. Limit unhealthy fats in your diet.
- Choose lean meats, skinless poultry, and low fat dairy products. Use firm tofu in place of paneer.
- Limit hidden sources of fat such as pastries or dessert, fried foods (pakoras, samosas, muttian, pakorian, bhujia) and snack foods (chips and some crackers).
- Include small amounts of healthy fats from canola, olive and soybean oils, soft non-hydrogenated margarines, nuts and seeds, 100% natural nut butters, fatty fish, and avocado.
- Choose cooking methods that use less fat such as baking, broiling, barbequing, or roasting. Avoid frying.
- Limit or avoid butter, ghee, lard, and coconut milk.
4. Eat more high fibre foods.
- Use 100% whole grain whole wheat flour and besan to make rotis, and choose brown rice instead of white rice. Add ground flax seeds to roti dough or to dahl, or sprinkle them on cereal or oatmeal.
- Use whole grain breads and high fibre cereals. Examples of high fibre cereals include: bran flakes, Muffets™, Total®, Fiber One® Weetabix™, Shredded Wheat™, Red River Cereal™, 100% Bran™, oat bran, and wheat bran.
- Serve dahl, cholay, raj mahn, and soybeans often.
- Enjoy more vegetables and fruits. Whole vegetables and fruit are better choices than juice.
5. Limit eating the following foods until you can discuss them with your dietitian. These foods are low in nutrients, and are often high in sugar and unhealthy fats.
- sugar (white and brown), honey, syrup, gurh, molasses, jam, jelly, marmalade, jello, pudding, custard, cakes, pies, pastries, donuts, ice cream, candy, chocolates, regular pop, tonic water, sweet cookies or muffins, sweetened condensed milk, burfi, gulab jaamun, jelabee, kulfi, kheer, laddoo, pinni.
6. Limit your salt intake. Don't add salt to foods when you are cooking or at the table. Avoid or limit salty processed foods and fast foods.
7. Drink plenty of water.
- Aim for about 2 - 3 litres (8 - 12 cups) of fluids each day.
- Diet pop or other drinks that have zero grams of carbohydrate noted on the nutrition label can be used once in a while.
- Exercise helps to control blood glucose levels. It also helps with weight control, heart health and blood fat levels, and improve your mood.
- Before starting your exercise program, see your doctor for a complete physical examination. You should also discuss your exercise plans with your diabetes program staff and dietitian. If you take pills or insulin to manage your diabetes, they may recommend checking your blood glucose level and adjusting your diet or medication before exercising.
- Try to be more active after meals as this helps control your blood glucose.
- People with diabetes should take care to drink water before, during, and after exercising, to prevent dehydration
- You should discuss alcohol use with your doctor. If you do drink alcohol, have only moderate amounts, and drink it with food. This helps keep blood glucose levels steady.
- A moderate amount of alcohol is up to 1-2 drinks/day and no more than 14 drinks per week for men or 9 drinks per week for women. One drink is the equivalent of 150 mL (5 oz) dry wine, 360 mL (12 oz) beer or 45 mL (1 ½ oz) liquor.
- The effects of drinking alcohol can hide the signs of a low blood glucose (hypoglycemia).
- Having low blood glucose from drinking alcohol is more common in people who use insulin or take pills for diabetes (for example glyburide or nateglinide). The low blood glucose can occur several hours after drinking alcohol, even up to 24 hours later. To prevent low blood glucose, have alcohol with food (including some carbohydrate containing food). It's also a good idea to check your blood glucose levels more often. Speak with your doctor or diabetes program staff. If you take insulin, they may suggest that you adjust the dose.
- There is not enough research to recommend extra vitamin, mineral, or herbal supplements to help people with diabetes. If you wish to take a supplement, a multivitamin/mineral supplement can be used, but remember, this does not replace a healthy diet. Discuss supplement use with your doctor or diabetes program staff.
11. Glycemic Index
- The Glycemic Index (GI) is a scale that ranks carbohydrate-rich foods by how much they raise blood glucose levels compared to eating plain glucose or white bread. The Glycemic Index can be a useful tool to help make decisions between foods containing about the same amount of carbohydrate. It is a good idea to choose low GI foods often. The South Asian diet often includes low GI foods such as lentils, vegetables, and dairy products. For more information, seearchive.diabetes.ca/files/GlycemicIndex_08.pdf
HealthLinkBC www.HealthLinkBC.ca Medically approved non-emergency health information and advice.
HealthLinkBC Files. Available at www.HealthLinkBC.ca/servicesresources/healthlinkbcfiles/.
Dietitian Services Fact Sheets available by mail (call 8-1-1) or at www.healthlinkbc.ca/healthyeating:
- Healthy Carbohydrates for Diabetes - Adapted for Punjabi Diet
- Healthy Eating Guidelines for People with Diabetes and Low Blood Glucose
Last updated: May 2011