It is time to develop a meal plant that you can follow. If you have diabetes, you probably have one or two things you hope to accomplish. You probably want to have a meal plan that will keep your blood glucose levels under control. If you are overweight, you may want to control your calorie and fat intake to allow you to lose some weight. Whether you have 2kg to lose or 80kg, the trick is to take it off slowly and keep it off.
You don’t want to diet, because as soon as you go “on” a diet, there is a danger that you will go “off” your diet. Instead, gradually change the way you eat so that you develop healthy habits that will be with you for the rest of your life. A successful meal plan starts with foods that ae healthy and nutritious, includes foods that taste good, keeps your blood glucose levels under control, allows for special treats, leaves you feeling satisfied and fulfilled, and helps you to lose weight, if desired.
What You Should Do
To start, schedule a visit with your dietitian. Before you visit, have a goal in mind, whether it is to lose a certain amount of weight, keep your blood glucose levels within a certain range, or lower the fat and cholesterol levels in your blood. When you come to your first visit, bring your list of goals with you.
During the week before your visit, eat as you normally would, but write down everything you eat, how much you ate, and when you ate it. Also record your blood glucose levels before each meal and 2 hours after your meals. This will give your dietitian an understanding of you, your meal patterns, the food you like, and how these foods affect your blood glucose levels. Also, if you are trying to lose weight, this will help determine your total caloric intake.
The idea is to burn off more calories than you take in. if you are eating a certain amount and staying the same weight, your dietitian can calculate how many calories you need to lose weight. A reasonable weight loss rate is 0.5kg to 1kg per week. Since each kg equals 3,500 calories, you will have to reduce your total food intake by at least 500 calories a day. So if you are used to eating 3,000 calories a day, you should eat 2,500 each day to lose 0.5kg a week, or 2,000 calories per day to lose 1kg each week. Whatever your eating pattern is, recording the exact foods you eat will give your dietitian an idea of where to start.
Once your dietitian has an idea where you are coming from, she will probably recommend a meal plan. This plan will be individualized for you. Some dietitians use plans in the form of an exchange menu. You will be given an outline of how many food exchanges you can have at each meal or snack time. You will also be given a list of different foods and how much of each food counts as each exchange. Or your dietitian may teach you how to count the carbohydrates in the foods you eat, and tell you how many carbohydrates you should eat at each meal or snack.
Make sure that the foods you like are on your meal plan. Most diets fail because they are only temporary, and because they forbid so many foods. The more you think about the foods you can’t have, the more you want them. Finally, when you get frustrated, depressed, or just plain hungry, you eat whatever you want without looking back. You can avoid this pattern, if you build some of the foods you love into your meal plan.
For example, if you know you always have a dish of ice cream after dinner, ask your dietitian how to account for this. The best way is to plan in advance. Make an allowance in your meal plan for your special treat and count up its fat and carbohydrate exchanges. This way you can still have some of your favorite foods without feeling that you have failed. With time, you may even find that you crave junk foods less and begin to find more pleasure in the foods that are more nutritious.
In addition to giving you a sample meal plan, your dietitian can also help you figure out:
Despite your best efforts, problems are bound to arise from time to time. Maybe you are traveling out of town and can’t stick to your meal plan. Your schedule gets delayed, you’re invited to a big holiday bash, or you’re afraid to refuse the boss’ homemade cheesecake. Maybe you are meeting your client for dinner at 7, even though you usually eat at 5:30. Your dietitian can help you plan for these situations. For example, if you can’t change the timing of your insulin dose, eat a piece of fruit or another carbohydrate snack at your usual mealtime. Then account for the snack in your daily tally. Always carry snacks with you. You never know when you will get stuck in traffic or in a meeting that runs overtime.
Sometimes you need to readjust your meals in advance. For example, if you are invited out to a 10:30 brunch when you usually eat breakfast at 7, eat an early-morning snack at your normal breakfast time. At brunch, eat what is left of your breakfast allotment along with part of your normal lunchtime allotment. Save the rest of your lunchtime allotment for a snack in 2 hours or so. If you’re having a late dinner, eat your bedtime snack at your normal mealtime, then eat your meal a little later. If you take insulin, you may have to adjust your short-acting doses to account for these changes.
Exactly how you do this depends on your particular meal plan. In general, you will want to take your short-acting dose of insulin before your big meal. Talk to your doctor or diabetes educator in advance about the best way to do this for your particular meal plan. Often it will mean delaying your dose of short-acting insulin to coincide with your delayed meal.
Eating more often than usual is common around holiday times. You’re around food all day and it may be too difficult to wait until dinnertime to have just a little something to eat, especially when everyone around you is eating. When this happens, try dividing your total food for the day into snack-sized meals. Then you can spread the food out a little more, even nibbling here and there without guilt, as long as you account for it. You can join in the fun without going over your allotted amounts.
You may find that you want to eat more than you usually do on certain special occasions. Sometimes just going out to a new restaurant, having friends over, or eating Thanksgiving dinner may tempt you to overeat. Ask your doctor if you can make adjustments in your insulin or exercise program to allow for the occasional larger-than-usual meal. If you know in advance that you will be eating a big dinner, for example, find out whether it would be advisable to skip a snack or reduce your lunchtime meal beforehand.
Depending on your meal plan and insulin schedule, you might be able to eat less at lunch and take a lower dose of short-acting insulin at that time, and eat a little more at dinner along with a little more insulin. Or it might be enough to add an extra work-out after dinner. Ask your doctor what is advisable for you, on occasion, and exactly how to make these adjustments.
Sources and References
The Diabetes Problem Solver—Quick Answers to Your Questions About Treatment and Self-Care by Nancy Touchette
DASH Eating Plan: An Eating Pattern for Diabetes Management by A Campbell
New Insight into Diabetes Management: From Glycemic Index to Dietary Insulin Index by Z Yari, Hamid Zand et al