Meal Planning for Diabetics

Macro nutrient Mix

It is very important to ensure a healthy diet and right mix of carbohydrate, protein and fat in diet plans of diabetic patients. Also the diets should be adjusted as per the individual’s preferences and metabolic goals. Goal should not only be to meet ones personal health needs i.e. weight loss or weight gain but also ensure that diet is planned in a manner to help maintain a strict control over Blood Sugar levels is maintained

Carbohydrate Content

Monitoring carbohydrate remains a key strategy in achieving glycemic control for Diabetics. Although a lot of times dieticians estimate calories based on the experience but at the same time following basic techniques should be adhered to ensure proper meal planning

  • Carbohydrate counting
  • Choices or food exchanges

General Dietary Guidelines for Diabetics

Dietary Fiber : In the planned diet aim should always be to include around 14 g fiber per 1,000 calories consumed. Although this may vary as per individual’s preferences but it should be ensured that at least 50% of grains included in ones diet are whole grains.

Sugar Sweetened Beverages

Sugary Drinks and Sweetened Beverages including carbonated drinks should be limited to an extent. In case person wants to drink diet colas should be preferred over normal carbonated drinks.

Saturated Fat for Diabetics

Saturated fat should constitute only ~7% of total calories consumed during a day.

Alcohol for Diabetics

Alcohol consumption if any should be restricted and done in moderation only

  • 1 drink per day for women
  • No more than 2 drink per day for men

To understand quantity of alcohol in various forms – please follow the following chart

1 Drink equivalent in various forms

Alcohol Type Strength Quantity that constitutes 1 Drink
Beer 5% 12 fl oz
Beer 7% 8-9 fl Oz
Table Wine 12% 5 fl oz
Port Wine / Sherry 17% 3-4 fl Oz
Cordial, Liquer or aperitif 24% 2-3 fl oz
Brandy 40% 1.5  oz
80 proof Alcohols 40% 1.5 fl oz

How to manage Hypoglycemia

Hypoglycemia is a condition when Plasma glucose levels drop to a level less than 70 mg/dL. In such cases the patient is advised to take 15-20 gms of glucose immediately; however, any type of carbohydrate with glucose can be used.

Sugar levels should be checked again after 15 minutes, if the levels are not back to normal then person should take another 15 gms. Once normalized, normal meal or snack can be had to prevent recurrence of hypoglycemia.

How to manage Diabetes on a day when Sick ?

When body is recovering from an infection or sickness we need to be more cautious as our dietary / eating habits get altered on a sick day. Hence it is a must to check Blood Sugar more often than usual i.e. every 2-4 hrs in a day. Aim should be to maintain Blood Sugar < 200 mg/dL. Patient should eat small meals and also increase the frequency of meals. It should be noted that even with little intake Blood sugar can rise which might require increased insulin. On a day like this patient shouldn’t exercise vigorously. Also if the medical condition permits one should drink plenty of fluids.

If dehydrated, drink:

  • Water
  • Caffeine-free drinks
  • Tomato juice
  • Chicken broth

If Blood Sugar is less than 100 mg/dL, drink

  • 100% juices
  • Tea with honey
  • Ginger – ale or lemon-lime soda

Again a physician or your diabetologist should be consulted before altering your diet or medication on a given day as different diseases have to be dealt with in a different way.

Carbohydrate Choices

Choose Instead of
Whole grain bread White breads
Brown rice White rice
Fruits & vegetables Fruit & vegetable juice
Popcorn, nuts, seeds Chips & candy
Low fat /nonfat milk & yogurt Full fat/Whole milk &yogurt
Unsweetened beverages Sugar- sweetened beverages

Fat Choices

Choose Instead of
Chicken breast Poultry wings, drum sticks, legs
Lower fat margarines Butter, Desi Ghee,
Olive, canola oil, Rice Bran Oil Tropical oils
Low fat /nonfat dairy foods Full fat/whole dairy foods
Nuts, seeds Nuts w/added fat, salt, sugar
Fruit desserts, low sugar Candy, chocolate, chips
Lower fat condiments Full fat condiments

Dietary Fiber Choices

Good Source of Dietary Fiber
Whole grains and 100% whole wheat breads
Fruits
Vegetables
Legumes: dried peas, beans
Nuts, seeds

 

Food with No Carbohydrate

  • Meat, fish, poultry
  • Eggs
  • Cheese
  • Fats, oils, butters
  • Water

Glycemic Index and Glycemic Load

Glycemic Index (GI) : Glycemic index is a rating system based on a scale of 0-100 with 100 being the highest and equivalent to 50 grams of pure glucose. It is used to compare glycemic response of food items i.e. change in the blood sugar upon eating various food items.

GI of food is determined experimentally upon consumption of food with ~50 grams of carbohydrates. Blood glucose response is monitored and that determines the glycemic index of food.

  • High-GI foods: Food items with high Glycemic responses similar to that of pure glucose (GI ≥ 70)
  • Low-GI foods: Food items with low Glycemic response or more gradual rise in glucose (GI ≤ 55)

For a diabetic person it is good to include food items with Low-GI in the diet. High GI foods lead to shooting up of Glucose levels in the blood and lead to fluctuations in the blood sugar levels. Marketers use this to their advantage and try to popularize food items with Low GI as Diabetic Food items. Even variety of Rice which is low GI in comparison to others is sold as Diabetic Food nowadays.

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