Eating to manage diabetes

The short answer: balance your plate with a mix of lean protein, fruits, and veggies, and don’t overdo it on the carbs.

• Aim to fill half your plate with non-starchy vegetables. Plus a quarter of the plate with protein and another quarter with carbs. For variety all year long, choose produce that’s in season (frozen is a great, budget-friendly option).
• Try for 25-35g of fiber a day. Fiber is linked with lower blood sugar. Fiber-rich foods include fruits, veggies, whole grains, nuts, and seeds. (See how much fiber is in each.)
• Choose zero-calorie drinks. Dehydration can cause big swings in blood sugar. Water, seltzer, and tea without sugar are all good ways to stay hydrated (and help balance out the fiber in your diet).
• Avoid skipping meals. This can create a dangerous rollercoaster. First, your blood sugar can drop too low (hypoglycemia), especially if you take certain medications. Then, extreme hunger often leads to overeating, which causes a big spike in your blood sugar later on.
• Eat smaller, more frequent meals. This strategy gives your body a slow, steady trickle of energy (unlike the sharp blood sugar spikes and crashes that happen when people with diabetes eat larger, less frequent meals).

• Pair carbs with a partner. When you eat carbs along with a protein or healthy fat—like an apple with cheese, or crackers with avocado—the sugar from the carbs takes longer to get into your bloodstream.
• Eat carbs last. Try to eat your meal in this order: vegetables first, then protein and fats, and finally carbohydrates (like bread, rice, or potatoes) at the end. The fiber and protein eaten first will slow down the digestion of the carbs, leading to a much smaller and slower blood sugar rise.
• Try vinegar before meals. Starting with a bit of vinegar—say, in water, pickled foods, or a salad with a vinegar-based dressing—can also slow digestion, leading to a smaller and more gradual rise in your blood sugar.
• Choose less ripe fruit. Certain starchy fruits, like bananas or pears, have even more starch when they’re less ripe, which makes them digest more slowly.
• Cook pasta al dente. When you eat pasta or rice that’s cooked until just firm, your body takes a longer time to break it down.
• Choose a savory breakfast. Your body is sensitive to glucose after fasting all night, so it’s best to avoid sugar and carbs in the morning.
• Cook, cool, then reheat your carbs. When you cool starchy foods like rice, pasta, or potatoes after cooking, some of their starches change and slow down digestion.

Nutrition labels can help you understand which foods are more or less nutritious before you buy them.

1. Look at the percent daily values (% DV). This is the percentage next to each nutrient on the label. It tells you how much a nutrient in one serving of that food contributes to the average person’s total daily diet.
   
   Example: If the label lists the % DV of fiber as 25%, that means one serving of that food would give 25% of the fiber you need for the day. If the % DV of total fat is 5%, one serving would give you 5% of the total fat you should have for the day.
   
2. Pay attention to the serving size.The serving size is how much most people eat at one time.
   
   Example: Let’s say the serving size listed is 1.5 cups. If you think you’d eat 3 cups at a time (twice the serving size), then the calories and nutrients you eat would be twice what’s on the label. So, if the % DV of fiber is 25% for one serving, it would be 50% for two servings. If the % DV of total fat is 5% for one serving, it would be 10% for two servings.
3. Put it all together. Take the serving size into account. Then aim to choose packaged foods that have:
   
   - A low % DV of saturated fat, sodium, and added sugar. 5% is considered low.
   - A high % DV of dietary fiber, protein, calcium, potassium, iron, and vitamin D. 20% is considered high.

When you have diabetes, it's important to be careful with alcohol because:

1. Alcohol distracts your liver
   When you drink alcohol, your liver works to process it immediately. While it’s busy doing that job, it pauses its other very important job of supplying your body with sugar for energy. So your blood sugar level can drop dangerously low, often several hours after you've had a drink.
2. Many alcoholic drinks are filled with sugar
   That’s especially true of cocktails and sweet wines. These drinks can cause your blood sugar first to spike high, before the delayed drop begins.
   
   If you want to drink alcohol, consult your care team to make sure it's safe for you. Then follow these tips:
   • Have alcohol in moderation with food
   • Choose options like dry wine or light beer over sugary cocktails
   • Always check your blood sugar before and after drinking

• Avoid foods described as: pan-fried, crispy, dipped, scalloped, breaded, cream, or alfredo.
• Go for foods described as: grilled, steamed, baked, roasted, braised, broiled, or seared.
• Skip the empty calories. Focus on your main dish instead of apps and sugary beverages.
• Ask for adjustments to your food. For example: no butter, less salt, or more veggies.
• Drink water throughout the meal. Hydration can have a big impact on blood sugar levels.

• First, ask yourself why you’re snacking. Are you bored or stressed but not actually hungry? If so, try taking a walk or phoning a friend instead.
• Keep nutrient-dense snacks on hand. They’ll give you energy and keep you feeling good throughout the day.
• Focus on whole foods with some protein or fat. For example, carrots with hummus or an apple with peanut butter will help you stay full longer.

What should I eat before and after I exercise?

1. Before a workout (If you’re hungry or your blood sugar is getting too low), choose carbs like:
   • Whole or dried fruit
   • Smoothie with fruit and yogurt
   • Whole grain cereal or bar
   • Whole grain toast
2. After a workout. Start repairing your muscles by eating protein-rich foods like:
   • Protein shake/drink
   • Hard-boiled egg
   • String cheese
   • Nuts or trail mix
   • Greek yogurt
   • Tuna pouch
   • Hummus

For many of us, the meal options that feel easiest are also the least healthy (think fast-food and frozen pizza). If you plan out the meals you’ll eat for the week, you can build healthy foods into your life.

• Start small. It might feel daunting to dive right into planning 21 meals a week. Dip your toe into the meal planning waters by planning out just a few meals or snacks for the week.
• Make lists. Choose a place to write things down (like in a notepad or on your phone). Then note the meals you’ll prepare that week and what ingredients you need to buy. It can also help to have a running grocery list that you add to as items run out.
• Plan around your schedule. Have a chunk of free time? Chop all the veggies you’ll need for the week to save time later. Or on hectic days, plan for crockpot meals you can set and forget.
• Embrace hacks. No matter your budget or schedule, finding ways to simplify meal planning and prep is a win for managing diabetes. Whether it's grocery pickup for some, or affordable hacks like batch cooking and using frozen or canned goods for others, choose strategies that fit your life.