Diet for blood sugar control -
Most meats and fats do not contain any carbohydrates. Carbohydrates directly affect your blood sugar level, whereas proteins and fat have little impact. Eating a consistent amount of carbohydrates at each meal can help to control your blood sugar levels, especially if you take certain oral diabetes medications or long-acting insulin.
There are different ways to make sure you eat a consistent amount of carbohydrates throughout the day, including carbohydrate counting and exchange planning. Carbohydrate counting — A dietitian can help you figure out the number of carbohydrates you need each day based on your eating habits, weight, nutritional goals, and activity level.
The way carbohydrates are divided up for each meal or snack will depend on your personal preferences, the timing and spacing of your meals, and which diabetes medications you take table 1. However, even if you do not take insulin, carb counting can help you keep your blood sugar levels from getting too low or too high.
The number of carbohydrates in a particular food can be determined by reading the nutrition label, consulting a reference book, website, or smartphone app, or using the exchange system see 'Exchange planning' below.
If you are eating out, restaurants usually have this information available upon request. See 'Where to get more information' below. For example, some prepackaged snacks contain two or more servings.
To calculate the carbohydrate content of the entire package, multiply the number of servings by the number of carbohydrates per serving.
This is because fiber slows the body's absorption of carbohydrates, so less insulin is required to manage blood sugar levels. Exchange planning — With exchange planning, all foods are categorized as either a carbohydrate, meat or meat substitute, or fat.
You can also easily determine the carbohydrate content of your meals and snacks using the exchange system. The table shows a sample daily meal plan based on this system table 2. A dietitian can give you a more complete list of foods to use for meal planning purposes.
The exchange lists also identify foods that are good sources of fiber which can help keep blood sugar levels from getting too high and foods with a lot of sodium which should be limited. A dietitian can help you determine how many servings of each group to eat at each meal and snack table 2 and the typical carbohydrate content of each meal and snack.
Meal timing — Consistently eating at the same times every day is important for some people, especially those who take long-acting insulin or oral medications that decrease blood sugar levels sulfonylureas or meglitinides.
If a meal is skipped or delayed while on these regimens, you are at risk for developing low blood glucose. If you use "intensive" insulin therapy ie, if you give yourself multiple daily injections or use an insulin pump or take certain other types of oral diabetes medications eg, metformin , you may have more flexibility around meal timing.
With these regimens, skipping or delaying a meal will not usually increase your risk of low blood sugar. While foods that are high in fat eg, pizza are OK to eat occasionally, you will need to monitor your blood sugar levels more closely. High-fat, high-protein meals are broken down more slowly than low-fat, lower-protein meals.
When using rapid-acting insulin before a meal, your blood sugar level may become low shortly after eating a high-fat meal and then rise hours later. If you eat meals that contain more protein or fat than usual, you may need to make meal-time insulin dose adjustments to manage this delayed rise in blood sugar.
Intensive insulin therapy — If you take multiple injections of insulin per day or use an insulin pump, you can adjust your pre-meal insulin based on the number of carbohydrates you plan to eat and your pre-meal blood sugar, similar to patients with type 1 diabetes. See "Patient education: Type 1 diabetes and diet Beyond the Basics ", section on 'Intensive insulin therapy'.
There is not a single optimal diet or meal plan for people with diabetes. The best diet for you depends many different things, including your health concerns, weight-loss goals, and personal preferences.
General recommendations — To help manage the ABCs A 1C, B lood pressure, and C holesterol and promote good health, experts recommend that all people with diabetes aim to maintain a healthy weight by decreasing calorie intake and increasing physical activity and monitor their carbohydrate intake.
The following guidelines for a healthy diet are similar to the recommendations for adults without diabetes see "Patient education: Diet and health Beyond the Basics " :. People with diabetes are advised to avoid sugar-sweetened beverages including fruit juice.
The ideal amount of carbohydrate intake is uncertain. However, it's important for people with diabetes to monitor carbohydrate intake in order to manage their blood sugar levels and adjust insulin dosing as needed. See 'Carbohydrate counting' above.
Eating a healthy diet that contains a lot of the foods you like will make it easier to stick to your plan. However, you should talk to your health care provider before starting any diet that involves extreme restriction such as a very low carb or "keto" diet.
Depending on your situation, some diets may not be recommended. Saturated fats eg, in meats, cheese, ice cream can be replaced with monounsaturated and polyunsaturated fatty acids eg, in fish, olive oil, nuts.
Trans fatty acid consumption should be kept as low as possible. Trans fats are banned from processed foods in the United States. Although very small amounts of trans fats are naturally present in meats, poultry and dairy products, the amount is too small for concern.
As diabetes increases your risk of heart disease and stroke, eating a diet low in saturated and trans fats and cholesterol can help to reduce your cholesterol levels and decrease these risks. In general, it's a good idea to get protein from lean meats, fish eggs, beans, soy, and nuts, and to limit the amount of red meat you eat.
See "Patient education: High-fiber diet Beyond the Basics ". See "Patient education: Low-sodium diet Beyond the Basics ". If you consume sugar-sweetened beverages regularly, a beverage containing artificial sweeteners such as diet soda can be a good short-term replacement strategy.
However, the best approach is to avoid both sugar-sweetened and artificially sweetened beverages, and try to drink more water. This is no longer recommended, although it's important to limit sugar intake. If you take insulin, you should calculate each pre-meal dose based upon the total number of carbohydrates in the food, which includes the sugar content.
Read all nutrition labels carefully and compare with other similar products to determine which has the best balance of serving size and number of calories, carbohydrates, fat, and fiber. Some sugar-free foods, such as sugar-free gelatin and sugar-free gum, do not have a significant number of calories or carbohydrates and are considered "free foods.
The American Diabetes Association ADA has a website called Diabetes Food Hub www. org that many people find useful. The site has tools to help you manage your diabetes, including nutrition information and customizable recipes you can use in meal planning.
It can be challenging and sometimes overwhelming to figure out how to manage your diet in order to control your diabetes.
But with time, practice, and support, most people are able to get used to it and make it a part of their daily life. Is it safe to drink alcohol? People who take oral diabetes medications do not usually need to adjust their medication doses, as long as the alcohol is consumed in moderation and with food.
Alcohol may cause a slight rise in blood sugar, followed hours later by a decrease in the blood sugar level. As a result, it is important to monitor your blood sugar response to alcohol, especially if you use insulin.
Your provider can help you to determine if any changes in insulin doses are needed. Mixers, such as fruit juice or regular cola, can increase blood glucose levels and increase the number of calories consumed in a day.
Also, calories from alcohol have little nutritional value and may contribute to weight gain or make it harder to lose weight.
Your health care provider is the best source of information for questions and concerns related to your medical problem.
This article will be updated as needed on our website www. Related topics for patients, as well as selected articles written for health care professionals, are also available.
Some of the most relevant are listed below. Patient level information — UpToDate offers two types of patient education materials. The Basics — The Basics patient education pieces answer the four or five key questions a patient might have about a given condition.
These articles are best for patients who want a general overview and who prefer short, easy-to-read materials. Patient education: Type 2 diabetes The Basics Patient education: Diabetes and diet The Basics Patient education: Diet and health The Basics Patient education: High-fiber diet The Basics Patient education: Carb counting for adults with diabetes The Basics Patient education: Treatment for type 2 diabetes The Basics Patient education: The ABCs of diabetes The Basics Patient education: Preparing for pregnancy when you have diabetes The Basics Patient education: Lowering your risk of prediabetes and type 2 diabetes The Basics.
Beyond the Basics — Beyond the Basics patient education pieces are longer, more sophisticated, and more detailed. These articles are best for patients who want in-depth information and are comfortable with some medical jargon. Patient education: High blood pressure, diet, and weight Beyond the Basics Patient education: High cholesterol and lipids Beyond the Basics Patient education: Type 2 diabetes: Overview Beyond the Basics Patient education: Type 2 diabetes: Insulin treatment Beyond the Basics Patient education: Glucose monitoring in diabetes Beyond the Basics Patient education: Hypoglycemia low blood glucose in people with diabetes Beyond the Basics Patient education: Exercise and medical care for people with type 2 diabetes Beyond the Basics Patient education: Preventing complications from diabetes Beyond the Basics Patient education: Losing weight Beyond the Basics Patient education: Exercise Beyond the Basics Patient education: Chronic kidney disease Beyond the Basics Patient education: High-fiber diet Beyond the Basics Patient education: Low-sodium diet Beyond the Basics.
Professional level information — Professional level articles are designed to keep doctors and other health professionals up-to-date on the latest medical findings. These articles are thorough, long, and complex, and they contain multiple references to the research on which they are based.
Professional level articles are best for people who are comfortable with a lot of medical terminology and who want to read the same materials their doctors are reading.
Alpha-glucosidase inhibitors for treatment of diabetes mellitus Exercise guidance in adults with diabetes mellitus Measurements of chronic glycemia in diabetes mellitus Glycemic control and vascular complications in type 2 diabetes mellitus Initial management of hyperglycemia in adults with type 2 diabetes mellitus Insulin therapy in type 2 diabetes mellitus Management of persistent hyperglycemia in type 2 diabetes mellitus Metformin in the treatment of adults with type 2 diabetes mellitus Nutritional considerations in type 2 diabetes mellitus Overview of general medical care in nonpregnant adults with diabetes mellitus Sulfonylureas and meglitinides in the treatment of type 2 diabetes mellitus Thiazolidinediones in the treatment of type 2 diabetes mellitus.
org , available in English and Spanish. The following reference books are a good source of information regarding diabetes and diet and carbohydrate counting. Contributor disclosures are reviewed for conflicts of interest by the editorial group.
When found, these are addressed by vetting through a multi-level review process, and through requirements for references to be provided to support the content. Appropriately referenced content is required of all authors and must conform to UpToDate standards of evidence.
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Patient education: Type 2 diabetes and diet Beyond the Basics. Formulary drug information for this topic. No drug references linked in this topic. Find in topic Formulary Print Share. Official reprint from UpToDate ® www. com © UpToDate, Inc. All Rights Reserved. Author: Linda M Delahanty, MS, RD Section Editor: David M Nathan, MD Deputy Editor: Katya Rubinow, MD.
All topics are updated as new evidence becomes available and our peer review process is complete. Don't store it in the freezer or in direct sunlight. Tell your healthcare professional about any medicine problems. If your diabetes medicines cause your blood sugar level to drop too low, the dosage or timing may need to be changed.
Your healthcare professional also might adjust your medicine if your blood sugar stays too high. Be cautious with new medicines. Talk with your healthcare team or pharmacist before you try new medicines.
That includes medicines sold without a prescription and those prescribed for other medical conditions. Ask how the new medicine might affect your blood sugar levels and any diabetes medicines you take.
Sometimes a different medicine may be used to prevent dangerous side effects. Or a different medicine might be used to prevent your current medicine from mixing poorly with a new one.
With diabetes, it's important to be prepared for times of illness. When you're sick, your body makes stress-related hormones that help fight the illness.
But those hormones also can raise your blood sugar. Changes in your appetite and usual activity also may affect your blood sugar level. Plan ahead. Work with your healthcare team to make a plan for sick days. Include instructions on what medicines to take and how to adjust your medicines if needed.
Also note how often to measure your blood sugar. Ask your healthcare professional if you need to measure levels of acids in the urine called ketones. Your plan also should include what foods and drinks to have, and what cold or flu medicines you can take. Know when to call your healthcare professional too.
For example, it's important to call if you run a fever over degrees Fahrenheit Keep taking your diabetes medicine. But call your healthcare professional if you can't eat because of an upset stomach or vomiting.
In these situations, you may need to change your insulin dose. If you take rapid-acting or short-acting insulin or other diabetes medicine, you may need to lower the dose or stop taking it for a time.
These medicines need to be carefully balanced with food to prevent low blood sugar. But if you use long-acting insulin, do not stop taking it.
During times of illness, it's also important to check your blood sugar often. Stick to your diabetes meal plan if you can. Eating as usual helps you control your blood sugar.
Keep a supply of foods that are easy on your stomach. These include gelatin, crackers, soups, instant pudding and applesauce. Drink lots of water or other fluids that don't add calories, such as tea, to make sure you stay hydrated.
If you take insulin, you may need to sip sugary drinks such as juice or sports drinks. These drinks can help keep your blood sugar from dropping too low. It's risky for some people with diabetes to drink alcohol.
Alcohol can lead to low blood sugar shortly after you drink it and for hours afterward. The liver usually releases stored sugar to offset falling blood sugar levels.
But if your liver is processing alcohol, it may not give your blood sugar the needed boost. Get your healthcare professional's OK to drink alcohol. With diabetes, drinking too much alcohol sometimes can lead to health conditions such as nerve damage. But if your diabetes is under control and your healthcare professional agrees, an occasional alcoholic drink is fine.
Women should have no more than one drink a day. Men should have no more than two drinks a day. One drink equals a ounce beer, 5 ounces of wine or 1. Don't drink alcohol on an empty stomach. If you take insulin or other diabetes medicines, eat before you drink alcohol.
This helps prevent low blood sugar. Or drink alcohol with a meal. Choose your drinks carefully. Light beer and dry wines have fewer calories and carbohydrates than do other alcoholic drinks. If you prefer mixed drinks, sugar-free mixers won't raise your blood sugar. Some examples of sugar-free mixers are diet soda, diet tonic, club soda and seltzer.
Add up calories from alcohol. If you count calories, include the calories from any alcohol you drink in your daily count.
Ask your healthcare professional or a registered dietitian how to make calories and carbohydrates from alcoholic drinks part of your diet plan. Check your blood sugar level before bed. Alcohol can lower blood sugar levels long after you've had your last drink.
So check your blood sugar level before you go to sleep. The snack can counter a drop in your blood sugar. Changes in hormone levels the week before and during periods can lead to swings in blood sugar levels. Look for patterns. Keep careful track of your blood sugar readings from month to month.
You may be able to predict blood sugar changes related to your menstrual cycle. Your healthcare professional may recommend changes in your meal plan, activity level or diabetes medicines.
These changes can make up for blood sugar swings. Check blood sugar more often. If you're likely nearing menopause or if you're in menopause, talk with your healthcare professional.
Ask whether you need to check your blood sugar more often. Also, be aware that menopause and low blood sugar have some symptoms in common, such as sweating and mood changes. So whenever you can, check your blood sugar before you treat your symptoms. That way you can confirm whether your blood sugar is low.
Most types of birth control are safe to use when you have diabetes. But combination birth control pills may raise blood sugar levels in some people. It's very important to take charge of stress when you have diabetes.
The hormones your body makes in response to prolonged stress may cause your blood sugar to rise. It also may be harder to closely follow your usual routine to manage diabetes if you're under a lot of extra pressure.
Take control. Once you know how stress affects your blood sugar level, make healthy changes. Learn relaxation techniques, rank tasks in order of importance and set limits. Whenever you can, stay away from things that cause stress for you.
Exercise often to help relieve stress and lower your blood sugar. Get help. Learn new ways to manage stress. You may find that working with a psychologist or clinical social worker can help. These professionals can help you notice stressors, solve stressful problems and learn coping skills.
The more you know about factors that have an effect on your blood sugar level, the better you can prepare to manage diabetes. If you have trouble keeping your blood sugar in your target range, ask your diabetes healthcare team for help.
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