Eating And Diabetes - National Institute Of Diabetes And .
What I need to know aboutEating and DiabetesU.S. Department ofHealth and HumanServicesNATIONAL INSTITUTES OF HEALTHNational Diabetes Information Clearinghouse
What I need to know aboutEating and DiabetesU.S. Department ofHealth and HumanServicesNATIONAL INSTITUTES OF HEALTHNational Diabetes Information Clearinghouse
ContentsEating and Diabetes . 1Blood Glucose Levels. 2Your Diabetes Medicines. 5Your Physical Activity Plan. 6The Diabetes Food Pyramid. 8Starches . 13Vegetables . 17Fruits . 21Milk. 25Meat and Meat Substitutes. 29Fats and Sweets . 33Alcoholic Drinks. 37Your Meal Plan . 38Measuring Your Food . 40When You’re Sick . 42Where can I get more information? . 44
Eating and DiabetesYou can take good care of yourself and your diabetesby learning what to eat how much to eat when to eatMaking wise food choices can help you feel good every day lose weight if you need to lower your risk for heart disease, stroke, and otherproblems caused by diabetesHealthful eating helps keep your blood glucose, alsocalled blood sugar, in your target range. Physical activityand, if needed, diabetes medicines also help. Thediabetes target range is the blood glucose level suggestedby diabetes experts for good health. You can helpprevent health problems by keeping your blood glucoselevels on target.1
Blood Glucose LevelsWhat should my blood glucose levels be?Target Blood Glucose Levelsfor People with DiabetesBefore meals70 to 1301 to 2 hours after thestart of a mealless than 180Talk with your health care provider about your bloodglucose target levels and write them here:My Target Blood Glucose LevelsBefore mealsto1 to 2 hours after thestart of a mealless thanAsk your doctor how often you should check your bloodglucose on your own. Also ask your doctor for an A1Ctest at least twice a year. Your A1C number gives youraverage blood glucose for the past 3 months. The resultsfrom your blood glucose checks and your A1C test willtell you whether your diabetes care plan is working.2
How can I keep my blood glucose levels on target?You can keep your blood glucose levels on target by making wise food choices being physically active taking medicines if neededFor people taking certain diabetes medicines, following aschedule for meals, snacks, and physical activity is best.However, some diabetes medicines allow for moreflexibility. You’ll work with your health care team tocreate a diabetes plan that’s best for veningsnack)Dinner3
Talk with your doctor or diabetes teacher about howmany meals and snacks to eat each day. Fill in the timesfor your meals and snacks on these clocks.4BreakfastMorning snackLunchAfternoon snackDinnerEvening snack
Your Diabetes MedicinesWhat you eat and when you eat affect how your diabetesmedicines work. Talk with your doctor or diabetesteacher about when to take your diabetes medicines.Fill in the names of your diabetes medicines, when totake them, and how much to take. Draw hands on theclocks to show when to take your medicines.Name of medicine:Time: Meal:How much:Name of medicine:Time: Meal:How much:Name of medicine:Time: Meal:How much:Name of medicine:Time: Meal:How much:5
Your Physical Activity PlanWhat you eat and when also depend on how much youexercise. Physical activity is an important part of stayinghealthy and controlling your blood glucose. Keep thesepoints in mind:6 Talk with your doctor about what types of exercise aresafe for you. Make sure your shoes fit well and your socks stayclean and dry. Check your feet for redness or soresafter exercising. Call your doctor if you have soresthat do not heal. Warm up and stretch for 5 to 10 minutes before youexercise. Then cool down for several minutes after youexercise. For example, walk slowly at first, stretch, andthen walk faster. Finish up by walking slowly again. Ask your doctor whether you should exercise if yourblood glucose level is high. Ask your doctor whether you should have a snackbefore you exercise. Know the signs of low blood glucose, also calledhypoglycemia. Always carry food or glucose tabletsto treat low blood glucose. Always wear your medical identification or other ID. Find an exercise buddy. Many people find they aremore likely to do something active if a friend joinsthem.
Low Blood Glucose (Hypoglycemia)Low blood glucose can make you feel shaky, weak,confused, irritable, hungry, or tired. You may sweata lot or get a headache. If you have these symptoms,check your blood glucose. If it is below 70, have oneof the following right away: 3 or 4 glucose tablets 1 serving of glucose gel—the amount equal to15 grams of carbohydrate 1/2 cup (4 ounces) of any fruit juice 1/2 cup (4 ounces) of a regular (not diet)soft drink 1 cup (8 ounces) of milk 5 or 6 pieces of hard candy 1 tablespoon of sugar or honeyAfter 15 minutes, check your blood glucose again. Ifit’s still too low, have another serving. Repeat thesesteps until your blood glucose level is 70 or higher.If it will be an hour or more before your next meal,have a snack as well.7
The Diabetes Food PyramidFats and sweetsMilkMeat and meatsubstitutesVegetablesFruitsStarchesThe diabetes food pyramid can help you make wise foodchoices. It divides foods into groups, based on what theycontain. Eat more from the groups at the bottom of thepyramid, and less from the groups at the top. Foodsfrom the starches, fruits, vegetables, and milk groups arehighest in carbohydrate. They affect your blood glucoselevels the most. See pages 9, 10, and 11 to find out howmuch to eat from each food group.8
How much should I eat each day?Have about 1,200 to 1,600 calories a day if you are a small woman who exercises small or medium-sized woman who wants to loseweight medium-sized woman who does not exercise muchChoose this many servings from these food groupsto have 1,200 to 1,600 calories a day:6 starches2 milks3 vegetables4 to 6 ounces meat and meatsubstitutes2 fruitsup to 3 fatsTalk with your diabetes teacher about how to make ameal plan that fits the way you usually eat, your dailyroutine, and your diabetes medicines. Then make yourown plan.9
Have about 1,600 to 2,000 calories a day if you are a large woman who wants to lose weight small man at a healthy weight medium-sized man who does not exercise much medium-sized or large man who wants to lose weightChoose this many servings from these food groupsto have 1,600 to 2,000 calories a day:8 starches2 milks4 vegetables4 to 6 ounces meat and meatsubstitutes3 fruitsup to 4 fatsTalk with your diabetes teacher about how to make ameal plan that fits the way you usually eat, your dailyroutine, and your diabetes medicines. Then make yourown plan.10
Have about 2,000 to 2,400 calories a day if you are a medium-sized or large man who exercises a lot or hasa physically active job large man at a healthy weight medium-sized or large woman who exercises a lot orhas a physically active jobChoose this many servings from these food groupsto have 2,000 to 2,400 calories a day:10 starches2 milks4 vegetables5 to 7 ounces meat and meatsubstitutes4 fruitsup to 5 fatsTalk with your diabetes teacher about how to make ameal plan that fits the way you usually eat, your dailyroutine, and your diabetes medicines. Then make yourown plan.11
Make Your Own Diabetes Food PyramidEach day, I needservings offats and sweetsservingsof milkounces ofmeat and meatsubstitutesservings ofvegetablesservingsof fruitsservings of starchesOn pages 38 and 39, you can make your own meal plan.Write down how many servings to have at your mealsand snacks.12
StarchesStarches are bread, grains, cereal, pasta, and starchyvegetables like corn and potatoes. They providecarbohydrate, vitamins, minerals, and fiber. Whole grainstarches are healthier because they have more vitamins,minerals, and fiber.Eat some starches at each meal. Eating starches ishealthy for everyone, including people with diabetes.StarchesExamples of starches are bread potatoes pasta rice corn crackers pretzels cereal tortillasbeansyamslentils13
How much is a serving of starch?Examples of 1 serving:OROR1 smallpotato1 slice ofbreadOR1/2 cup cookedcereal or 3/4 cupdry cereal flakes1 6-inchtortillaExamples of 2 servings:OR 1 smallpotato2 slicesof bread1 small earof cornExamples of 3 servings: 1 smallrollOR 1/2 cupof peas1 smallpotato1 cupof riceIf your plan includes more than one serving at a meal,you can choose different starches or have several servingsof one starch.14
1. How many servings of grains, cereals, pasta, andstarchy vegetables (starches) do you now eat eachday?I eat starch servings each day.2. Go back to page 9, 10, or 11 to check how manyservings of starches to have each day.I will eat starch servings each day.3. I will eat this many servings of starches atBreakfastSnackLunchSnackDinnerSnackA diabetes teacher can help you with your mealplan.15
What are healthy ways to eat starches? Buy whole grain breads and cereals. Eat fewer fried and high-fatstarches such as regular tortillachips and potato chips, frenchfries, pastries, or biscuits. Trypretzels, fat-free popcorn,baked tortilla chips or potato chips,baked potatoes, or low-fat muffins. Use low-fat or fat-free plainyogurt or fat-free sour creaminstead of regular sourcream on a baked potato. Use mustard instead ofmayonnaise on a sandwich. Use low-fat or fat-free substitutes such as low-fatmayonnaise or light margarine on bread, rolls,or toast. Eat cereal with fat-free(skim) or low-fat (1%) milk.16
VegetablesVegetables provide vitamins, minerals, and fiber. Theyare low in carbohydrate.VegetablesExamples of vegetables are lettuce broccoli vegetable juice spinach pepperscarrotsgreen beanstomatoes celerychiliesgreenscabbage17
How much is a serving of vegetables?Examples of 1 serving:OR1/2 cupcooked carrotsOR1/2 cupcookedgreen beans1 cup saladExamples of 2 servings: 1/2 cupvegetablejuice1 cupsalad1/2 cupcookedcarrots OR1/2 cupcookedgreen beansExamples of 3 servings: 1/2 cupcookedgreens1/2 cup cookedgreen beansand 1 smalltomato OR1/2 cupbroccoli1 cuptomatosauceIf your plan includes more than one serving at a meal,you can choose several types of vegetables or have twoor three servings of one vegetable.18
1. How many servings of vegetables do you now eateach day?I eat vegetable servings each day.2. Go back to page 9, 10, or 11 to check how manyservings of vegetables to have each day.I will eat vegetable servings each day.3. I will eat this many servings of vegetables atBreakfastSnackLunchSnackDinnerSnackA diabetes teacher can help you with your mealplan.19
What are healthy ways to eat vegetables? Eat raw and cooked vegetables withlittle or no fat, sauces, or dressings. Try low-fat or fat-free salad dressingon raw vegetables or salads. Steam vegetables using water orlow-fat broth. Mix in some chopped onionor garlic. Use a little vinegar or somelemon or lime juice. Add a small piece of lean hamor smoked turkey instead of fatto vegetables when cooking. Sprinkle with herbs and spices. If you do use a small amount offat, use canola oil, olive oil, or softmargarines (liquid or tub types)instead of fat from meat, butter,or shortening.20
FruitsFruits provide carbohydrate, vitamins, minerals, andfiber.FruitsExamples of fruits include apples bananas fruit juice raisins strawberries oranges dried fruit watermelon grapefruit peaches mangoguavapapayaberriescanned fruit21
How much is a serving of fruit?Examples of 1 serving:OR1 smallappleOR1/2 cup juice1/2 grapefruitExamples of 2 servings: OR1 banana1/2 cuporange juice11 4 cupswholestrawberriesIf your plan includes more than one serving at a meal,you can choose different types of fruit or have severalservings of one fruit.22
1. How many servings of fruit do you now eat eachday?I eat fruit servings each day.2. Go back to page 9, 10, or 11 to check how manyservings of fruit to have each day.I will eat fruit servings each day.3. I will eat this many servings of fruit atBreakfastSnackLunchSnackDinnerSnackA diabetes teacher can help you with your mealplan.23
What are healthy ways to eat fruits? Eat fruits raw or cooked, as juice with no sugaradded, canned in their own juice, or dried. Buy smaller pieces of fruit. Choose pieces of fruit more often than fruit juice.Whole fruit is more filling and has more fiber. Save high-sugar and high-fat fruit desserts such aspeach cobbler or cherry pie for special occasions.24
MilkMilk provides carbohydrate, protein, calcium, vitamins,and minerals.Milk25
How much is a serving of milk?Examples of 1 serving:OR1 cup fat-free orlow-fat yogurt1 cup fat-free (skim) orlow-fat (1%) milkNote: If you are pregnant or breastfeeding, have four tofive servings of milk each day.26
1. How many servings of milk do you now have eachday?I have milk servings each day.2. Go back to page 9, 10, or 11 to check how manyservings of milk to have each day.I will have milk servings each day.3. I will have this many servings of milk atBreakfastSnackLunchSnackDinnerSnackA diabetes teacher can help you with your mealplan.27
What are healthy ways to have milk? Drink fat-free (skim) or low-fat (1%) milk. Eat low-fat or fat-free fruit yogurt sweetened with alow-calorie sweetener. Use low-fat plain yogurt as a substitute forsour cream.28
Meat and Meat SubstitutesThe meat and meat substitutes group includes meat,poultry, eggs, cheese, fish, and tofu. Eat small amountsof some of these foods each day.Meat and meat substitutes provide protein, vitamins, andminerals.Meat and MeatSubstitutesExamples of meat and meat substitutes include chicken eggs beef peanut butter fish tofu canned tuna or cottage cheese other fishcheeseporklambturkey29
How much is a serving of meat and meatsubstitutes?Meat and meat substitutes are measured in ounces.Here are examples.Examples of a 1-ounce serving:OR1 egg2 tablespoons ofpeanut butterExample of a 2-ounce serving:1 slice (1 ounce) of turkey 1 slice (1 ounce) of low-fat cheeseExample of a 3-ounce serving:3 ounces of cooked leanmeat, chicken, or fish**Three ounces of meat (after cooking) is about the sizeof a deck of cards.30
1. How many ounces of meat and meat substitutesdo you now eat each day?I eat ounces of meat and meat substituteseach day.2. Go back to page 9, 10, or 11 to check how manyounces of meat and meat substitutes to haveeach day.I will eat ounces of meat and meatsubstitutes each day.3. I will eat this many ounces of meat and meatsubstitutes atBreakfastSnackLunchSnackDinnerSnackA diabetes teacher can help you with your mealplan.31
What are healthy ways to eat meat and meatsubstitutes? Buy cuts of beef, pork, ham, and lamb that have onlya little fat on them. Trim off the extra fat. Eat chicken or turkey without the skin. Cook meat and meat substitutes in low-fat ways: broil grill stir-fry roast steam microwave To add more flavor, use vinegars,lemon juice, soy sauce, salsa,ketchup, barbecue sauce, herbs,and spices. Cook eggs using cooking spray or anon-stick pan. Limit the amount of nuts, peanut butter,and fried foods you eat. They are high infat. Check food labels. Choose low-fat orfat-free cheese.32
Fats and SweetsLimit the amount of fats and sweets you eat. Fats andsweets are not as nutritious as other foods. Fats havea lot of calories. Sweets can be high in carbohydrateand fat. Some contain saturated fats, trans fats, andcholesterol that increase your risk of heart disease.Limiting these foods will help you lose weight and keepyour blood glucose and blood fats under control.Fats and SweetsExamples of fats include salad dressing butter oil margarine cream cheese mayonnaise avocado olives baconExamples of sweets include cake pie ice cream syrup cookies doughnuts33
How much is a serving of sweets?Examples of 1 serving:OR1 3-inchcookie34OR1 plain cakedoughnut1 tablespoonmaple syrup
How much is a serving of fat?Examples of 1 serving:OR1 strip of bacon1 teaspoon oilExamples of 2 servings: OR1 tablespoonregular saladdressing2 tablespoonsreduced-fatsalad dressing1 tablespoonreduced-fatmayonnaise35
How can I satisfy my sweet tooth?Try having sugar-free popsicles,diet soda, fat-free ice cream orfrozen yogurt, or sugar-free hotcocoa mix.Other tips: Share desserts in restaurants. Order small or child-size servingsof ice cream or frozen yogurt. Divide homemade desserts intosmall servings and wrap eachindividually. Freezeextra servings.Remember, fat-free and low-sugarfoods still have calories. Talk withyour diabetes teacher about how tofit sweets into your meal plan.36
Alcoholic DrinksAlcoholic drinks have calories but no nutrients. If youhave alcoholic drinks on an empty stomach, they canmake your blood glucose level go too low. Alcoholicdrinks also can raise your blood fats. If you want to havealcoholic drinks, talk with your doctor or diabetesteacher about how much to have.37
Your Meal PlanBreakfastFood GroupFoodHow MuchSnackFood GroupFoodHow MuchLunchPlan your meals and snacks for one day. Work with yourdiabetes teacher if you need help.Food GroupFoodHow Much38
SnackFood GroupFoodHow MuchDinnerFood GroupFoodHow MuchSnackFood GroupFoodHow Much39
Measuring Your FoodTo make sure your food servings are the right size, youcan use measuring cups measuring spoons a food scaleOr you can use the guide below. Also, the NutritionFacts label on food packages tells you how much of thatfood is in one serving.Guide to Sensible Serving SizesThis muchis the same as3 ounces1 serving of meat, chicken, turkey,or fish1 cup1 serving of cooked vegetables salads casseroles or stews, such as chiliwith beans milk40
This muchis the same as1 2 cup1 serving of fruit or fruit juice starchy vegetables, such aspotatoes or corn pinto beans and other dried beans rice or noodles cereal1 ounce1 serving of snack food cheese (1 slice)1 tablespoon1 serving of salad dressing cream cheese1 teaspoon1 serving of margarine or butter oil mayonnaise41
When You’re SickTake care of yourself when you’re sick. Being sick canmake your blood glucose go too high. Tips on what to doinclude the following: Check your blood glucose level every 4 hours. Writedown the results. Keep taking your diabetes medicines. You needthem even if you can’t keep food down. Drink at least one cup (8 ounces) of water or othercalorie-free, caffeine-free liquid every hour whileyou’re awake. If you can’t eat your usual food, try drinking juice oreating crackers, popsicles, or soup. If you can’t eat at all, drink clear liquids such asginger ale. Eat or drink something with sugar in itif you have trouble keeping food down, becauseyou still need calories. If you can’t eat enough,you increase your risk of low blood glucose, alsocalled hypoglycemia.42
In people with type 1 diabetes, when blood glucose ishigh, the body produces ketones. Ketones can makeyou sick. Test your urine or blood for ketones if your blood glucose is above 240 you can’t keep food or liquids down Call your health care provider right away if your blood glucose has been above 240 for longerthan a day you have ketones you feel sleepier than usual you have trouble breathing you can’t think clearly you throw up more than once you’ve had diarrhea for more than 6 hours43
Where can I get more information?Diabetes Teachers (nurses, dietitians, pharmacists, andother health professionals)To find a diabetes teacher near you,call the American Association ofDiabetes Educators toll-free at1–800–TEAMUP4 (832–6874) orsee www.diabeteseducator.org andclick on “Find an Educator.”Recognized Diabetes Education Programs (teachingprograms approved by the American DiabetesAssociation)To find a program near you, call the American DiabetesAssociation toll-free at 1–800–DIABETES (342–2383)or see www.diabetes.org/education/edustate2.asp on theInternet.DietitiansTo find a dietitian near you, call the American DieteticAssociation’s National Center for Nutrition andDietetics toll-free at 1–800–877–1600 or seewww.eatright.org and click on “Find a NutritionProfessional.”44
National DiabetesInformation Clearinghouse1 Information WayBethesda, MD 20892–3560Phone: 1–800–860–8747Fax: 703–738–4929Email: ndic@info.niddk.nih.govInternet: www.diabetes.niddk.nih.govThe National Diabetes Information Clearinghouse (NDIC) is a service ofthe National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK). The NIDDK is part of the National Institutes of Health underthe U.S. Department of Health and Human Services. Establishedin 1978, the Clearinghouse provides information about diabetes to peoplewith diabetes and to their families, health care professionals, and thepublic. The NDIC answers inquiries, develops and distributespublications, and works closely with professional and patient organi zations and Government agencies to coordinate resources about diabetes.Publications produced by the Clearinghouse are carefully reviewed by bothNIDDK scientists and outside experts. This booklet was originallyreviewed by Marion J. Franz, M.S., R.D., L.D., C.D.E., Minneapolis, andCarolyn Leontos, M.S., R.D., C.D.E., University of Nevada.This publication is not copyrighted. The Clearinghouse encouragesusers of this booklet to duplicate and distribute as many copies asdesired.This booklet is also available at www.diabetes.niddk.nih.gov.This publication may contain information about medications used totreat a health condition. When this publication was prepared, theNIDDK included the most current information available. Occasionally,new information about medication is released. For updates or forquestions about any medications, please contact the U.S. Food and DrugAdminstration at 1–888–INFO–FDA (463–6332), a toll-free call, or visittheir website at www.fda.gov. Consult your doctor for more information.
U.S. DEPARTMENT OF HEALTHAND HUMAN SERVICESNational Institutes of HealthNIH Publication No. 08–5043October 2007
Use low-fat or fat-free plain yogurt or fat-free sour cream instead of regular sour cream on a baked potato. Use mustard instead of mayonnaise on a sandwich. Use low-fat or fat-free substitutes such as low-fat mayonnaise or light margarine on bread, rolls, or toa
6. Detection of Eating Disorders 63 7. Diagnosis of Eating Disorders 73 8. Interventions at the Different Levels of Care in the Management of Eating Disorders 81 9. Treatment of Eating Disorders 91 10. Assessment of Eating Disorders 179 11. Prognosis of Eating Disorders 191 12. Legal Aspects Concerning Individuals with Eating Disorders in Spain 195
Bruce W. Bode, MD, FACE Atlanta Diabetes Associates Atlanta, Georgia American Diabetes Association. Facts and Figures. Available at: http://www.diabetes.org/ada/facts.asp. Accessed January 18, 2000. Diagnosed Type 1 Diabetes 0.5 - 1.0 Million Diagnosed Type 2 Diabetes 10.3 Million Undiagnosed Diabetes 5.4 Million Prevalence of Diabetes in the US 3
National Center for Chronic Disease Prevention and Health Promotion Division of Diabetes Translation. CS220221. National Diabetes Fact Sheet, 2011. Data Sources, Methods, and References for Estimates of Diabetes and Prediabetes. Attention: In the. National Diabetes Fact Sheet, 2011, we defined undiagnosed diabetes and prediabetes based on both
eating and may not be able to stop even if they want to. Eating habits is used as a way to cope with challenging emotions. A person with Binge Eating Disorder will often have a range of identifiable eating habits. These can include eating very quickly, eating when they are not physically hungry and continuing to eat even when they are full,
Binge Eating Disorder: Basic Criteria continued B. The binge-eating episodes are associated with 3 (or more) of the following: 1. Eating much more rapidly than normal 2. Eating until feeling uncomfortably full 3. Eating large amounts of food when not feeling physically hungry 4. Eating alone because of feeling embarrassed by how much one is .
9. True or false: Eating a lot of sugar causes diabetes. (Either the body stops making insulin or isn't able to use it properly.) 10. True or false: Diabetes can't be prevented. (While type 1 diabetes can't be prevented, type 2 diabetes can sometimes be prevented by maintaining a healthy weight, eating a healthy diet, and being active .
Clinical Diabetes. 2017 Jan; 35(1)51-54. Speight J, Conn J, Dunning T, Skinner TC, Diabetes Australia. Diabetes Australia position statement. A new language for diabetes: improving communications with and about people with diabetes. Diabetes Res Clin Pract 2012 Sep; 97(3): 425- 31.
Type 2 Diabetes Type 2 diabetes, which used to be called adult-onset diabetes, can affect people at any age, even children. However, type 2 diabetes develops most often in middle-aged and older people. People who are overweight and inactive are also more likely to develop type 2 diabetes. Type 2 diabetes usually begins with insulin resistance—a
