Type 1 Diabetes Diet: How to Control Your Blood Sugar Levels
Lifestyle issues are the foundation of living with any kind of diabetes, including type 1 diabetes. That puts nutrition, along with exercise and managing stress, at the top of the list of ways to successfully manage type 1 diabetes.
The aim is not to restrict food but to make sure blood sugar levels are controlled, and food plays a role. "Diet may help in managing type 1 diabetes because it allows better control over blood sugars," Deena Adimoolam, MD, a specialist in endocrinology and preventative medicine in New Jersey, tells Health.
What is type 1 diabetes?
At the most basic level, diabetes—both type 1 and type 2—involve abnormally high levels of blood sugar. Over time, this can lead to serious complications including neuropathy, blindness, as well as heart and kidney diseases.
The causes, though, are different for each diabetes type. Type 2 is driven primarily by environmental factors, such as being overweight or obese and following a high-fat, high-sugar diet. This form of diabetes mostly affects adults.
Type 1 diabetes, formerly called juvenile-onset diabetes, is an autoimmune disease. The body's own immune system mistakenly destroys the insulin-producing islet cells in your pancreas. Lack of insulin leads to dangerously high blood sugar levels.
Is there a specific diet for type 1 diabetes?
The goal of managing type 1 diabetes is to keep blood sugar at normal levels to ward off future problems. "Taking control of your blood sugar is the only way that you're going to save yourself from a lot of trouble later on," Sandra J. Arevalo, RDN, national spokesperson for the Academy of Nutrition and Dietetics, tells Health.
All people with type 1 diabetes will need to take insulin for the rest of their lives, but diabetes is a highly individual disease. Every person will need different amounts of insulin at different times, and the insulin must be carefully calibrated with not just food but also exercise, stress, sickness, your body size, and metabolism—all of which can affect blood sugar. In the beginning, there's a trial-and-error period to find the right combinations of insulin and diet (as well as exercise and other factors). "It takes time to find that magic number," says Arevalo. Type 1 diabetes is also not static, she adds. It will change as time goes on. For this reason and others, there is no one "diabetes diet."
One way to start a dietary plan is with the Diabetes Food Pyramid, based on the well-known Food Pyramid from the US Department of Agriculture. Depending on how many calories you need, the plan recommends:
- 6 or more starches a day, such as beans, yams, potatoes, and whole-wheat bread
- 3 or more vegetables. Go for dark green and orange. "The more colors the better," says Arevalo.
- 2 or more fruits
- 2 or more milks. This could also be low-fat or non-fat yogurt or cheese
- 4 to 6 ounces of meat or another protein
- Up to 3 fats
Alcohol, sweets, and fatty foods should only be taken in moderation.
The plate method can simplify things. Half of your plate should be non-starchy vegetables. Meat or another protein occupies one-fourth, and the final one-fourth is a grain or starch.
Related factors that might affect blood sugar include timing of your meals and how much you exercise. Consulting with a registered dietitian or diabetes educator will help you come up with a plan that suits your personal needs.
What foods can you eat with type 1 diabetes?
That healthy diet for someone with type 1 diabetes is not too different from the one we should all be following, namely a focus on the grains, vegetables, fruits, lean proteins, and low-fat dairy. Remember that almost three-quarters of Americans are overweight or obese, which means they may already have type 2 diabetes or are at risk for it.
"When it comes to maintaining diabetes control, certain carbohydrates may be better than others," says Dr. Adimoolam. "For example, complex carbohydrates are typically better than simple carbohydrates."
Examples of complex carbohydrates include lentils or beans, and whole-grain bread or pasta. These foods have a lower glycemic index than their simple carbohydrate counterparts, which means they don't raise blood sugar as much. Meats and fats have few or no carbs and have a minimal effect on blood sugar. Opt for lean meats and "healthy" fats, such as avocados, nuts and seeds. Cook with oil rather than solid products like butter or margarine.
What foods should you avoid with type 1 diabetes?
If you have type 1 diabetes, you should stay away from refined carbohydrates including white rice, chips, candy, and cake as well as fried foods, energy drinks, juice, and flavored milks. People with type 1 diabetes may need certain high-sugar foods if their blood sugar dips too low but, otherwise, these items will spike your blood sugar levels to unhealthy highs.
Your best bets for beverages are water, milk, and non-sugar-sweetened beverages like diet soda or Crystal Light, which won't raise your blood sugar as much as regular sodas or energy drinks.
Stay away from vegetables with added sauces and choose fruits over fruit juice. As for dairy like milk and yogurt, low- and non-fat versions are the best, especially those without added sugar.
Type 1 diabetes and low-carb diet
Carbohydrates are often made out to be the bad guy in managing type 1 diabetes, but it would be a mistake to think you should avoid them entirely. "That's a misconception because the main source of energy for humans is carbohydrates," says Arevalo.
Carbohydrates provide most of the sugar in your bloodstream, which is why the quantity and quality of the carbs you take in matter.
"We advise our patients with type 1 diabetes to carb count, which means learning to calculate the total number of carbohydrates in their meal and providing themselves insulin based on this carb amount," says Dr. Adimoolam.
"The less simple sugars a person living with type 1 diabetes has in their meal, the more stable their blood sugar values will be," she adds. "In general, we encourage our patients with type 1 diabetes to not restrict or limit carbohydrates, but to follow a healthy, balanced diet."
Type 1 diabetes and the keto diet
There has been considerable interest in using the high-fat, very-low-carb ketogenic ("keto") diet to control diabetes, including type 1 diabetes. Normally, our bodies get energy from sugar, which comes from carbohydrate-rich foods. By restricting carbs and loading up on fat, the keto diet makes your body rely on ketones, which your liver produces from stored fat.
The subject is still a controversial one. One very small study found that adults with type 1 diabetes who followed a keto diet had well-controlled blood-sugar levels, but that the diet may have increased cholesterol levels as well as episodes of low blood sugar, which can be serious. Experts still don't know much about how the keto diet affects our bodies, so don't make any major changes in your eating without consulting a specialist.
Can type 1 diabetes be controlled by diet alone?
The simple answer is no. What you eat plays an important role in how well you manage your diabetes, but a healthy lifestyle also includes exercise, adequate sleep, and as little stress as possible. All of these factors need to be balanced with how much insulin you take. As someone with type 1 diabetes, you will have to consider insulin, diet, exercises, stress, and more for the rest of your life.
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