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June 28, 2001

Meal Planning, Food and Diet

Question from Afton, Minnesota, USA:

I have had type 1 diabetes since I was 13 years old and have made several discoveries about diabetes. I am quite physically active, and am always trying to find ways to streamline the treatment of my diabetes, make my control more manageable, and allow my physical endurance level to be expanded. My problem seems to be largely affected by my diet rather that anything else, and I have found that reducing or eliminating the need to consume carbohydrates and fats has been a very good thing, but it remains a constant chore to find the right kinds of foods to complete my caloric requirements, and I wind up having to just eat what is available at the time. Why are some types of foods beneficial to blood sugar stability?

Answer:

You raise some important questions. The answers are not simple. I can give you my take on this. As you know, your blood sugar is determined by food intake, insulin taken, activity level, and outside stresses such as illness, etc. The goal of treatment in type 1 diabetes is to match insulin therapy with the food consumed. The emphasis on more rapid acting insulins is a favorable example of more efficient therapies. We tend to have our patients perform carbohydrate counting, as this really does get at the issue of matching insulin with food intake. This is obviously not the complete picture as protein is turned into glucose by the liver, but later. Fats also affect sugar by changing the body’s choice for fuel. For example, a large fat meal will result in the preferential use of fat and inhibit glucose metabolism.

Fad diets which rely on high protein or low carbohydrate are probably not very good. It is best to stay with American Diabetes Association recommendations and eat a diet of 50% carb, 30% fat, and 20% protein. if you need more help with this area, I would suggest seeing a dietitian at your local health care facility.

JTL