These are important considerations when drawing up a diabetic meal plan:

  • Timing of meals and snacks. In general, diabetic should take more frequent but smaller sized meals. Patients on insulin may need a bed time snack to prevent night time hypoglycaemia or an additional afternoon snack. DO NOT go for no more than 4 hours without eating
  • Remove refined carbohydrates and added sugars from your diet. This means less fast foods and more home cooked meals where you know every ingredient that goes into your meal

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  • Include healthy food types such as complex carbohydrates (whole grain), fibre (vegetables and fruits), lean protein (fish and chicken)
  • Follow ‘plate method’ to estimate portion sizes
  • Keep a food diary by either taking photos or documenting the meals eaten to discuss with your dietician

Here are few choices of meal plan strategies for diabetic patients:

Choice A: Constant Carbohydrate Meal Plan

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This meal plan is inclusive of counting grams of carbohydrate a person with diabetic needs daily. The carbohydrate is then distributed evenly at mealtimes. In the constant carbohydrate meal plan, consistency in keeping the amount of carbohydrate for each meal including snack everyday is the key. The types of carbohydrate may vary from day to day.

Choice B: Carbohydrate Counting Meal Plan

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Carbohydrate counting involves giving a matching dose of medication with the grams of carbohydrate taken daily. One carbohydrate serving is equal to 15 grams of carbohydrate. People with diabetes can get help from a dietitian to figure out the counting plan that meets the specific needs. A common plan for an adult normally consists of three to four carbohydrate choices for main meals and one to two for snacks. This meal plan is most useful for people who take multiple daily injections of insulin because it allows greater freedom and flexibility in food choices.

The formula for Insulin to carbohydrate ratio is 1:15. For example, 1 unit of rapid acting insulin would be given for each 15 grams carbohydrate eaten. If the meal consists of 60 grams of carbohydrates, 4 units of insulin would need to be given.

Choice C : Exchange Meal Plan (most commonly used)

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The Exchange System classify foods into three broad groups namely carbohydrate, meat and fat listing items which contain similar macronutrient composition. This equality allows the exchange of food on each list making it easier for patients to use as reference.  Most vegetables can be considered free foods if their energy contribution is minimal when eaten in moderation.

Carbohydrate Exchange List

  1. Cereals, grain products and starchy vegetables

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Each item contains 15g carbohydrate, 2g protein, 0.5g fat and 75kCal

1 cup is equivalent to 200 ml

1 tablespoon is equivalent to 2 teaspoons

2. Fruits

Each item contains 15g carbohydrate and 60kCal

3. Milk

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This food contains varying amount of carbohydrate, fat and protein depending on which type of milk.

Self-monitoring

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Despite being on treatment, it is estimated that over 30% patients DO NOT achieve good glucose pressure control despite being on medication. As such, healthcare practitioners also recommend lifestyle modification which includes 30-60 minutes of exercise daily (click and read article “How Much Should We Exercise Daily”) and self-monitoring. Do consult and connect with your healthcare practitioners such as your doctor, dietician or fitness trainers.

While at home, check your blood glucose regularly and take charge of your health. Do self-monitor your weight and blood sugar on TELEME TrackME Health Tracker mobile app.

References: Malaysians’ Dietitian Association. 2005. Medical nutrition therapy guidelines for Type 2 Diabetes. Nutrition Recommendations and Interventions for Diabetes”. American Diabetes Association. My Health.

Download Teleme’s mobile app and consult a health practitioner

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