Diet and Type 1 Diabetes

By Richard Morell

When a person receives a diagnosis of Diabetes mellitus, he or she must begin to make some fundamental changes to their lives.  This is true regardless of which type of DM has been diagnosed, but there are some elements that are significantly more important for those having Type 1 Diabetes.  For instance, eating consistently on a structured schedule lessens risk of dangerous levels of blood sugar.  One can set different mealtimes based on personal needs and preferences, but spacing out consumption of carbohydrates is recommended.  If one is using long-acting NPH Insulin, it is more critical that they maintain consistent eating times from day to day.  In contrast, those using an insulin pump or who inject themselves multiple times a day have a bit more flexibility as regards to mealtimes.

Those with high risk of hypoglycemia or low blood-sugar events oftentimes will need to eat smaller meals more frequently.  It is not uncommon for someone with T1D to have 5 meals a day, though each meal will be less substantial than that for a typical three-meal-a-day consumer.  Physical activity and blood pressure levels also must be recognized for their role in the planning of meals and the health of the circulation.

Regarding meal-planning, special attention must be paid to carbohydrate counting in order to maintain a healthy level of blood sugar in their system.

The amount of fiber diminishes the glycemic index, and higher-fiber foods are most encouraged for those on diabetes maintenance.  In fact, when calculating the carbohydrate level of a food, the fiber content must be subtracted to obtain the accurate glycemic figure.

When calculating pre-meal insulin dosage to conduct orderly exchange of glucose into energy, the rule of thumb is 1 unit of insulin is needed to digest 10 grams of carbohydrate.  A food with a carb index of 90 would require 9 units of insulin.

Many charts and tables are available to discern the carb index for any given meal, and the insulin required to sufficiently metabolize the same.

Where fat-intake is concerned, the types of insulin being administered also rate as important factors to consider when planning daily nutrition.  Those receiving rapid-acting insulin can tolerate the occasional high-fat meal, but it must be noted that the body is limited in its ability to quickly break fat down and ingestion of, say, a slice of pizza might create wider fluctuations in blood sugar levels.  Again, those with more intensive insulin therapies can tolerate a bit more frequency, but please note that better dietary choices do exist.  Since Diabetes can lead to greater risk of heart disease, low-fat-intake diets are recommended because they reduce blood pressure and cholesterol.

There are many recipes on-line, from sources such as www.diabetesdaily.com and the American Diabetes Association.  Below is a recipe to consider:

“Squapple Pudding”
1 large butternut squash
1/4 c. sugar-free maple syrup
Pumpkin Pie Spice
1 cup applesauce

Preheat oven to 400.  Slice the butternut squash in half and seed it.  Apply maple syrup and spice to the two halves of the squash.  Place squash halves face down in suitable bakeware with 1/4 in. water. Bake for 40-60 minutes until squash is tender.  Remove from oven and remove skin.  Mash squash with applesauce and stir.  Serves 4.

(May substitute baked apples for applesauce, other winter squash for butternut squash.)

By Richard