Living With Type 1 Diabetes
MANAGING TYPE 1: DIET
General Rules​:
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Balanced meals at regular times help control your blood sugar
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Eat meals every four to six hours
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Eat more high-fibre foods
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Limit sugars and sweets
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Limit amount of high-fat food
When you’re first diagnosed, it’s likely that several people will tell you that you’ll be able to manage your diabetes with “diet and exercise”. As a person with type 1 diabetes, this is absolute nonsense; insulin will always be required for you to maintain healthy blood glucose levels. That being said, diet and exercise can provide a major role in keeping you healthy and can also greatly impact your blood glucose levels throughout the day, so it’s important to understand how your diet and exercise regime can be managed to combine with your insulin therapy in the most effective way possible.
Carbohydrates
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Managing type 1 diabetes from a dietary perspective is all about carbohydrates. There is a popular misconception that diabetes is focused solely on regulating the consumption of sugar, and while diabetes is concerned with sugar, it’s not really focused on the sweet, powdery kind. Type 1 diabetics are in the business of managing the consumption of carbohydrates, because all carbohydrates – whether they be bread, pasta, fruit, vegetables, or sugary snacks – become sugar, or glucose, during the digestion process. Type 1 diabetes occurs when the pancreas no longer produces insulin that can extract glucose from the blood and transport it to cells.
Accordingly, as a type 1 diabetic, you’ll spend your time focusing on carbs and calculating how many grams of carbohydrates you’re consuming at any given meal so that you know how many units of insulin are required to help your body process the resulting glucose for energy.
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Unfortunately, most foods contain some carbohydrates. However, there are some that don’t, and you will almost never have to be worried about consuming these foods, because they will rarely impact your blood sugar:
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Meat
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Fish
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Poultry
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Eggs
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Cheese
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Margarine
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Oils
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Nuts
There are two ways to manage your carbohydrate intake when you’re first diagnosed.
Static Dose and Carbohydrate Portions
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When you are first diagnosed, it is likely that your doctors will have determined a static insulin dose to begin with. That means, you will have been told to take x number of units at each and every meal with the expectation that you will consume roughly 45g – 60g of carbohydrates per meal. This is a decent starting point, but it’s also inflexible and assumes that you will design your meals to ensure that you’re eating a high enough number of carbohydrates to correspond to the dosage you’ve been prescribed. It doesn’t allow you to eat the food you choose or as much or as little as you want.
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Counting Carbohydrates
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I highly recommend starting to do this as quickly as possible, because it allows you the flexibility to eat exactly what you want, and as much or as little of it as you choose. The best way to begin is to figure out your carbohydrate (grams) : insulin (unit) ratio. It will be trial and error for the first little while, but a good way to determine is to use the 500 rule.
Say that you have been prescribed a total of 50 units per day, including both day-time and night-time insulin. You would divide 500 by 50 to determine a starting working ratio of 10g : 1 unit.
Understanding your carbohydrate to insulin ratio is helpful because it allows you to adjust your dosage according to your carbohydrate intake and to eat what you want. Say, for instance, that you prepare a meal and determine after preparing it that it has 45g of carbohydrates. You can determine that 45g/10g = 4.5 units of insulin.
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Subtracting Fibre
When you’re counting carbs, it’s important to take fiber into account. Fiber is NOT counted toward your carbohydrate content, so you must subtract the amount of fiber from the total number of carbs in your meal.
For example, say that your meal has 60g of carbohydrates, but 10g of fibre. You would subtract the 10g of fibre, before determining your carbohydrate to insulin ratio.
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So, if we’re using the same ratio of 10g : 1 unit of insulin, you would do the following math:
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Meal: 60 g of carbohydrates – 10g of fiber = 50g to be considered
Based on a 10g : 1 unit ratio, 50g / 10g = 5 units of insulin
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Sugar Alcohols
If you’re eating sweets for diabetics that contain sugar alcohols instead of sugar, subtract the amount of sugar alcohol (in grams) from the total carbohydrates (in grams). You will usually find that once you do that subtraction, those sweets don’t require insulin at all.
IMPORTANT NOTE. Sugar alcohols are notorious for causing severe gastrointestinal distress, and many will contain warnings on the packaging. I STRONGLY urge you to take those warnings seriously.
