Diabetes Nutrition

People often think that following a diet for diabetes means giving up foods they like and having to eat foods they don't like. But actually, you have choices. Try this exercise.

• Make four lists: foods you like, foods you dislike, foods that are "bad" for diabetes, and foods that are "good" for diabetes.
• Cross out the foods in the "foods I dislike" list. You don't have to eat them. You can eat any of the foods in the other three lists.

The fact is:

• There are no "good" or "bad" foods.
• You don't have to give up the foods you like.
• You may need to eat some foods in smaller amounts and less often to prevent high blood sugar. But you can learn to fit them into your diet.

Make a list of all the feelings you have about a diet for diabetes and why you have them. For example:

• You may feel guilty about eating certain foods, such as chocolate cake, if you think they are "bad."
• You may feel angry or resentful if you think you can't eat the foods you like.

Don't judge yourself by your feelings. It's what you do with them that matters.

Just identifying a negative feeling isn't enough to get rid of it. You'll need to do something. Record how you plan to deal with each negative feeling. Here are some ideas:

• Write about what you feel. Then read it aloud to yourself.
• Talk with your family, a friend, or your diabetes specialist. You may learn that your negative feeling is based on something that isn't true.
• Join a diabetes support group. Most people with diabetes have had negative feelings about the diet and are willing to share how they dealt with those feelings.

Your daily amount depends on several things, including your weight and how active you are. A registered dietitian or certified diabetes educator will help you plan how much carbohydrate to include in each meal and snack. For example, most adults can have 45 to 60 grams at each meal, which is 3 to 4 carbohydrate servings.

To count carbs, you need to know how many carbs are in each type of food you eat. Most packaged foods have labels that tell you how many carbs are in one serving. For foods that aren't packaged, you'll need to know standard portions of carbohydrate foods. Each serving size or standard portion has about 15 grams of carbs. Portion control is important.

• Measure your food portions. You won't always have to measure your food. But it may help when you're first learning what makes up a standard portion.
• Read food labels for carb amounts, and be aware of the serving size. If a package contains two servings and you eat the whole package, you need to double the number of grams of carbs listed for one serving.

By using the number of grams of carbs in a meal, you can figure out how much insulin to take. This is based on your personal insulin-to-carbohydrate ratio. For example, your doctor may advise you to take 1 unit of rapid-acting insulin for every 10 to 15 grams of carbs you eat. Here's how to figure out how much insulin you need:

• Say your meal has 50 grams of carbs, and your doctor told you to take 1 unit of rapid-acting insulin for every 10 grams of carbs you eat.
• Divide 50 by 10, which equals 5. You would need 5 units of insulin to keep your post-meal blood sugar from rising above your target level.

Keep track of what you eat, and test your blood sugar after meals and exercise. This can help you figure out what effect exercise and different types of food have on the amount of insulin you need.

• Protein, fat, and fiber don't raise blood sugar very much. If you eat a lot of these nutrients in a meal, carbs will change to glucose more slowly than they would with a meal that has a small amount of protein, fat, and fiber.
• Exercise affects blood sugar. It allows you to use less insulin than you would if you didn't exercise. Keep in mind that timing makes a difference. If you exercise within 1 hour of a meal, your body may need less insulin for that meal than it would if you exercised 3 hours after the meal.

Advanced carb counting takes into account the amount of fiber or sugar alcohols (a type of sweetener used in foods labeled "sugar-free") in a food. For example, if a food has 5 or more grams of fiber per serving, you can subtract half the amount of fiber from the total number of carb grams. A food that has 30 grams of carbs and 8 grams of fiber would be counted as 26 grams of carbs (8 ÷ 2 = 4, and 30 - 4 + 26).

If you use a rapid-acting insulin, you may want to consider sugar alcohols if there are more than 5 grams of them in the food. Divide the number of sugar alcohols in half. Then subtract that number from the total carb count.