MEAL PLANNING STRATEGIES FOR DIABETES

MEAL PLANNING STRATEGIES FOR DIABETES

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

DIET FOR DIABETES

DIET FOR DIABETES

Click below to watch video on Diabetic Food List

A diabetic meal plan is a healthy eating plan which consists of balance nutrition in the right amount of calorie requirement and the right amount of food types.

The aim of a diabetic meal plan is to help people with diabetes attain quality of life similar to healthy people by:

  • making it easier to achieve blood glucose control
  • reducing dependency on more diabetic medication or insulin injections
  • reducing the risk of complications or hospital admission associated with diabetes
  • achieving the same lifespan as normal individuals

Why is diabetic control important?

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Diabetic control is important to prevent the following common complications.

  • Peripheral vascular disease of the lower limbs causing ulcers and gangrene of the toes and feet
  • Peripheral neuropathy causing numbness and tingling sensation of the toes and fingers
  • Blindness due to diabetic retinopathy causing bleeding into the eye. Diabetes is most common cause of blindness in young adults
  • Kidney failure. Diabetes is the most common reason why patients are on dialysis
  • Heart disease
  • Stroke

Why is body weight important in the control of diabetes?

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Being overweight predisposes you to developing diabetes as well as making it harder for you to achieve good diabetic control because

  • Fat makes it difficult for insulin to facilitate glucose to get into the muscle efficiently and as a result the glucose remains unused in high levels in the blood stream
  • The pancreas then has to work harder to produce more insulin resulting in organ failure after 20-30 years of poor diabetic control

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Losing as little as 5-10% of your weight can reduce your risk of developing diabetes.

What is an ideal Diabetic Meal Plan?

Food is the major influence on blood sugar levels in people with diabetes and as such patients must pay attention to the food components (particularly the carbohydrates), amount eaten and timing of each meal every day. Choose foods with lower Glycemic Index (GI) as these foods do not give you a sudden surge in blood glucose after eating.

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GI is a ranking of carbohydrates on a scale from 0 to 100 according to the extent to which they raise blood sugar (glucose) levels after eating. Foods with a high GI are those which are rapidly digested and absorbed resulting in big surge in blood sugar levels immediately after a meal. Low GI carbohydrates produce smaller fluctuations and is therefore ideal for diabetic patients.

Examples of Glycemic Index of some common foods

The objective of all diabetic meal plans is to achieve better control of blood sugar levels and needs to be customised with special consideration for the Type 1 (insulin dependent diabetes) Type 2 (non-insulin dependent diabetes) and diabetes during pregnancy.

There is no one perfect meal plan and each plan has to be on trial basis and evaluated and adjusted as necessary. A good diabetic meal plan is one which can help patients manage their blood glucose at normal level AND allow them to enjoy their food.

Self-monitoring

Image Source: Diabetes Health Page

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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