Diabetes Outreach Network
QUICK REFERENCE GUIDE TO DIABETES FOR HEALTH CARE PROVIDERS

3. Nutrition and Diabetes

Meal Plans for people with diabetes can vary dramatically based on lipid levels, glucose control, weight loss goals, insulin use, activity habits and other health concerns. The majority of people with diabetes are overweight, and it has been discovered that even a small amount of weight loss (10-20 pounds or 5-9 kg) can greatly assist with glycemic control, even if the person does not attain a desirable body weight.

In General, People with Diabetes ...

• Do not need any special diet foods (Some of the reduced calorie items can be useful).
• Benefit from eating high fiber foods such as dried beans, fruits, vegetables and whole grains everyday.
• Should use less added fat, salt and sugar.
• Can eat foods which are good for the whole family.
• Should decrease portion sizes, if weight is a concern.
• Benefit from limiting alcohol and if drinking, only drinking with meals.
• Benefit from eating a wide variety of foods.
• Need to limit the amount of saturated fat and hydrogenated fat consumed - found in animal products such as cheese, hamburger, bacon, butter and other fats which are solid at room temperature.
• Benefit from eating on a regular basis (every 4-5 hours).
• Need to eat consistent amounts of carbohydrates (from fruit, milk, bread/starch, and sweets) at meals. 

  Regular meetings with a registered dietitian are recommended to help people with diabetes develop a meal plan that works for them.

Sugar and Diabetes

Most people with diabetes can also include some sugar in their meal plan. The sugar containing food must be substituted for some of the other carbohydrate (bread and starches, fruits, vegetables or milk) at a meal. Also, if the product is high in fat, less fat should be added to the rest of the meal.

High Fat Meal Plan and Diabetes

Some people with diabetes have better glucose control on a high monounsaturated fat meal plan (40-45% of the calories from fat). Monounsaturated fats (found in most nuts, olive oil, canola oil, peanut butter and avocados) are substituted for part of the carbohydrate calories (found in bread and starches, vegetables, fruits and milk). One concern is that the person may get too much saturated fat as many of the monounsaturated fat sources contain saturated fat. Another concern is fiber intake may be inadequate, which may easily result in the consumption of too many calories with a high fat, low fiber diet.

Sugar-free Products

Sugar-free products are not all reduced calorie items. If it contains aspartame, saccharin, acesulfame K, or sucralose, the calorie and carbohydrate content will be lower than the regular product, and it may be useful for the person with diabetes. If the item is sweetened with fruit juice, honey, fructose, sorbitol, molasses or any other sugar replacement product, it is not a calorie-reduced product! There is no real benefit to using these products in place of sugar sweetened products.

Additional Help for the Overweight Client

1. Determine if your patient is truly ready to lose weight. Ask: are you intending to make changes within the next six months to lose weight? If no, patient may need to explore in more detail the benefits of weight loss.
2. Set reasonable goals. A 10-15% weight loss is generally achievable.
3. Does your patient have a problem with binge eating or bulimia? An eating disorder clinic or specially trained counselor may be needed.
4. A good understanding of nutrition is necessary--a registered dietitian can help.
5. Mild caloric restrictions are easier to adapt to (250-500 calorie deficit.)
6. Surgical intervention or medication may be options for some seriously overweight patients.
7. Regular physical activity is key in helping maintain weight loss.

Many nutrition handouts are available through the Diabetes Outreach Networks.