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Lifestyle Changes to Manage Type 1 Diabetes
What and how much you eat, when and how much insulin you take, and how much you exercise are major factors in diabetes management that you can control. It is important for you to learn how to eat a healthy diet and to incorporate regular exercise into your daily life.
The dietary guidelines for managing diabetes can seem complicated. However, you will see that the recommendations are the same as those for general good health, and you can eat the same foods as everyone else. A nutritionist can help you make sense of these guidelines and help you develop healthy eating patterns that will work for you. Ask your doctor for a referral to a certified diabetes educator (CDE) registered nutritionist.
The basic eating guidelines for people with type 1 diabetes are:
Follow a Routine
Eat 3 balanced meals per day and do not skip meals. Try to eat meals at the same time each day, with about the same amount of carbohydrate, protein, and fat as the same meal the day before. In case a meal is delayed, keep snacks with you at all times.
Your blood sugar rises and falls in response to your eating patterns. Therefore, by eating about the same amount and types of food at the same times each day, you can easily predict when your blood sugar level will rise. This makes it easier to match your insulin dose with these rises in blood sugar.
Fill Your Plate with Healthy Choices
To make sure that you are getting the nutrients that you need, follow the US Department of Agriculture’s ChooseMyPlate guidelines. ChooseMyPlate encourages you to:
- Fill half of your plate with fruits and vegetables .
- Eat whole grains , lean protein , and fat-free or low-fat dairy products.
- Avoid overeating by monitoring portion sizes.
- Choose low-sodium foods.
- Opt for water instead of sugary drinks.
In addition, the American Diabetes Association (ADA) offers these tips for creating a healthy plate:
- Give yourself a larger amount of nonstarchy vegetables. There are many kinds to choose from, such as spinach, carrots, broccoli, cucumbers, mushrooms, or peppers.
- Add a serving of starchy foods. Some examples include: whole grain bread, whole grain rice, cooked beans, peas, corn, and potatoes.
- Add a serving of meat or meat substitute, such as chicken, fish, shrimp, or tofu.
- Drink a glass of fat-free or low-fat milk with your meal.
- For desert, eat a piece of fruit.
Both sugar and starch are carbohydrates. Your body reacts to any type of carbohydrate in the same way, so the total amount of carbohydrate you eat is more important for blood sugar control than the source.
A dietitian can help you determine how many grams you should eat per day. This amount should be dispersed evenly throughout your meals and snacks. Many foods contain carbohydrates. White grain products, citrus fruits, and milk products contain the highest amounts.
Keep a Record
Keep a record of your meals, include the time you ate, what you ate, and how much. Include this information with your blood sugar levels and insulin dosages. This information is very helpful for your doctor and registered dietitian.
Methods of Dietary Planning
There are 2 main methods for planning your meals: the exchange system and carbohydrate counting. Meet with a registered dietitian to determine which of these systems will work for you and to learn the details of using it.
This system divides all food into 6 groups—starch, fruit, milk, vegetable, meat, and fat. Within each of these groups are defined servings, or exchanges of food items. Each exchange within a given group has the same calories and grams of fat, protein, and carbohydrate as every other exchange in that category.
For example, each of the following counts as one starch exchange:
- ½ cup of cooked pasta
- 1 slice of bread
- 1 small (3 oz.) baked potato
- 1 ounce of dry cereal
You can use these (and other starch exchanges) interchangeably when your meal plan calls for one starch.
In the exchange meal planning system, your dietitian will determine the number of calories you need each day and translate them into exchanges from each of the six food categories. Then, he or she will work with you to distribute these exchanges across your meals and snacks for the day.
Carbohydrate counting is based on the fact that carbohydrate has the strongest effect on blood sugar level, as compared with fat and protein. Your doctor and/or dietitian will determine how many grams of carbohydrate you need each day. Your doctor will determine the amount of insulin you need for each gram of carbohydrate you eat. Then, these grams are distributed evenly across your meals and snacks. You can choose foods based on the amount of carbohydrate they contain.
Carbohydrates differ in the degree and rapidity with which they raise blood sugar. Whole grains and certain other complex carbohydrates raise blood sugar less than simple carbohydrates, such as sugar, white rice, or potatoes. These complex carbohydrates are said to have a low glycemic index, and their consumption has been shown in some studies to improve control of diabetes without increasing risk for hypoglycemia.
Regular exercise is essential for everyone to ensure better health. For people with diabetes, it offers extra benefits, including:
- Lowering blood sugar and improving the body's ability to use glucose—in some cases, regular exercise can decrease the amount of insulin necessary for blood glucose control
- Lowering risk factors for heart disease, a common complication of diabetes
Talk with your doctor about your exercise program. Since exercise causes your blood sugar to drop, you may need to make some modifications in your insulin dose and schedule and your eating plan. For some people, and in some situations, exercise can increase blood sugar levels. Moreover, have your doctor screen you for any diabetic complication(s), especially heart disease, which may be made worse by exercise.
Smoking may negatively affect your ability to control your diabetes. Quitting smoking can also reduce your risk of numerous conditions, like heart disease, lung disease, and many types of cancers. Talk to your doctor about strategies to quit.
A good night’s sleep is not only important for having energy and alertness, but is also essential in managing weight and controlling the blood sugar. You should try to get a minimum of 7-8 hours sleep per night.
When to Contact Your Doctor
- If you have any questions about your eating plan.
- If you feel that your eating plan is too difficult to follow.
- When you want to start up an exercise program or make significant changes in your present program.
- If you have any symptoms of hypoglycemia after exercising. Symptoms include shakiness, lightheadedness, extreme sweating, hunger, headache, and pale skin color.
Causes of diabetes. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://www.niddk.nih.gov/health-information/health-topics/Diabetes/causes-diabetes/Pages/index.aspx. Updated July 31, 2013. Accessed September 4, 2013.
Create your plate. American Diabetes Association website. Available at: http://www.diabetes.org/food-and-fitness/food/planning-meals/create-your-plate. Accessed September 4, 2013.
Diabetes mellitus type 1. EBSCO DynaMed website. Available at: EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 9, 2013. Accessed September 4, 2013.
Type 1 diabetes. American Diabetes Association website. Available at: http://www.diabetes.org/diabetes-basics/type-1/?loc=DropDownDB-type1. Accessed September 4, 2013.
3/12/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Hofer SE, Rosenbauer J, Grulich-Henn J, et al. Smoking and metabolic control in adolescents with type 1 diabetes. J Pediatr. 2009;154(1):20-23.
- Reviewer: Kim A. Carmichael, MD
- Review Date: 09/2015
- Update Date: 09/17/2014