Diet and Diabetes: Information for People New to Insulin

How many meals should I eat?

You should try to eat 4 meals per day. Avoid skipping meals and space out your breakfast, lunch, evening meal and supper across the day. This will help control of your appetite and your blood glucose (sugar) levels, especially if you are on twice-daily insulin.

What should a meal contain?

Ideally a meal should be a portion of protein (e.g. meal, fish, eggs, cheese, Quorn, soya products, and pulses), a portion of vegetables or salad and a portion of carbohydrates.

You should try to include starchy carbohydrate foods in each meal.

These foods include:

Carbohydrates are broken down into glucose in your body. We need these foods for energy but the amount we eat is important. The actual amount you need will vary from person to person. You should spread these foods out throughout the day. If you have a low carbohydrate meal while taking insulin, you are at risk of hypo (low blood glucose).

Starchy carbohydrates with a lower glycaemic index are more slowly absorbed and will not affect your blood glucose levels as much. Try to include these, for example, high fibre and wholegrian varieties of breads (granary, rye), high fibre breakfast cereals, porridge oats, new potatoes, basmati rice, sweet potato and yam.

Can I have sugar or sugary foods?

Yes, but you should:

• Try to avoid adding sugar to drink or cereals. An artificial sweetener can be used if needed.
• Replace sugary, fizzy drinks/squashes with water or sugar-free alternatives like no added sugar or diet fizzy drinks/squashes. Nourishment, supermalt and sweet (fruit) lassi are high in sugar too so be cautious with these.
• Try to limit adding condensed milk to drinks.
• Limit the quantity and number of times you eat chocolate, sweets, cakes, biscuits and desserts. Treats such as barfi, gulab jamun, ladoo, daheen, kunafa and baklava in particular often have syrup added and can be included in a healthy balanced diet. A piece of fruit (a banana, apple, orange or a handful of grapes) can be eaten as a snack instead of biscuits or cake.
• Limit fresh fruit to a small glass (125ml) once per day and avoid having it on an empty stomach.
• Use a small carton of fresh fruit juice, 150ml full sugar coke, 4 to 5 jelly babies or druit pastilles/wine gums or 2 to 3 glucose tablets as a treatment for hypoglycaemia (blood glucose level less than 4mmol/l).

Should I buy diabetic food or drinks?

They offer no benefit to people with diabetes. They will still affect your blood glucose levels, contain just as much fat and calories as the ordinary version and can have a laxative effect and are expensive.

Can I have alcohol?

Yes, in moderation. You should have no more than a maximum of 2 to 3 units of alcohol per day.

It is recommended you have 2 to 3 alcohol free days per week.

A single pub measure (25ml) of spirit is about 1 unit, half a pint of lager, ale, bitter or cider has 1 to 1.5 units. A small glass of wine (175ml) typically contains 2 units.

Alcohol can make hypoglycaemia more likely to occur. You should not drink on an empty stomach and you should have a snack containing starchy carbohydrate before going to bed when you have had alcohol.

Remember, alcohol contains calories so think about cutting back further if you are trying to lose weight.

How should food be cooked?

• Try to grill, steam, boil and poach foods rather than frying.
• If frying, try to limit the amount of oil, ghee, coconut oil and butter used. Fat is extra calories which can contribute to weight gain.

Meal ideas:

Breakfast

• Wholegrain breakfast cereal or low sugar muesli with skimmed or semi-skimmed milk and a small glass of fruit juice or piece of fruit.
• Bread or toast (granary or multigrain) with a thin scraping of spread (olive or rapeseed oil).
• Baked beans on wholegrain/granary bread with grilled tomato and mushrooms.
• Flatbread with olives, cheese and yoghurt.
• Paranthe (paratha) with plain yoghurt.
• Pakora/samosa or spring roll.
• Lontong Sayur (rice with vegetable curry and meat).
• Porridge made with oatmeal/cornmeal/millet/maizemeal/quinoa/rice (congee) with skimmed or semi-skimmed milk and a small glass of fruit or piece of fruit.

Light Meal

• Wholegrain or granary bread, rolls or pitta bread, with either lean beef, pork, chicken, boiled egg, tuna in brine, sardines, low fat hummus, baked beans or a small amount of cheese and salad vegetables.
• Tuna pasta salad with peppers, tomatoes and sweetcorn.
• Soup with fufu or pounded yam or bread.
• Stuffed vine leaves and salad.
• Houmous and flatbread (pizza/khubz).
• Falafel with couscous and salad.
• Soup noodles with vegetables (Pho).
• Chicken Satay.

Between meal snacks, if needed

• Crackers or crispbreads.
• Low sugar/low fat yoghurt.
• Small handful nuts.
• Piece of fruit.
• Small portion of popcorn.
• Samosa or pakora or bhajia.
• Small patty (meat or vegetable).
• Spring rolls.
• Bombay mix or sev.
• Namak paray (small pastry biscuit).
• Lemper (rice cake with seasoned shredded chicken).

Cooked Main Meals

• Lean meat, skinless poultry with boiled potatoes and 2 to 3 portions of vegetables.
• Grilled, microwaved or baked white or oily fish with boiled potatoes or rice and 2 to 3 portions of vegetables.
• Tuna risotto or pasta bake with salad.
• Chilli con carne with kidney beans and basmati rice and 2 to 3 portions of vegetables.
• Shepherd’s pie with added beans and 2 to 3 portions of vegetables.
• Spaghetti bolognaise with added beans and 2 to 3 portions of vegetables.
• Curry with meat/fish/chickpeas or lentils and basmati rice or chapatti/roti.
• Vegetable curry eg aloo gobi (potato and cauliflower) or saag (spinach) or chili paneer (cheese) with basmati rice/roti/chapati.
• Rice and peas.
• Beans, plantain and vegetable soup with eba or fufu.
• Soup (peanut or spinach or meat or fish with fufu/pounded yam or gari).
• Stew (with meat and/or vegetables) with rice.
• Fish with banku (corn and cassava dough) with salad or vegetables.
• Tagine with couscous.
• Tarka dal and rice or chapatti.
• Lontong Sayur (rice with vegetable curry and meat).

Desserts

• Low fat/low sugar yoghurt.
• Sugar free jelly.
• Fresh fruit or fruit tinned in juice.
• 1 scoop of ice cream.
• Low fat/low sugar rice pudding or kheer.
• Small banana and low fat/low sugar custard.

Bedtime Snacks

• Small bowl of porridge or high fibre (wholegrain) cereal with milk.
• Whole grain or granary toast.
• Piece of fruit.

Foods to be eaten with care

• Kheer (sweet rice pudding with nuts and spices).
• Ladoo (sweet made with sugar).
• Gulab jamun (made with sugar syrup).
• Barfi (made with condensed milk and sugar).
• Jalebi (made with sugar syrup).
• Halwa.
• Cake or cornmeal pudding.
• Kunafa (pastry with syrup).
• Baklawa.
• Glucose sweets.
• Chocolate.
• Biscuits.

This information is for use until your appointment with a Diabetes Specialist Dietician.

Contact Numbers

If you require further help or advice, please contact:

North Tees and Hartlepool NHS Foundation Trust

Specialist Services Admin Hub

Telephone: 01429 522471

Monday to Friday, 8:30am to 4:30pm (excluding Bank holidays)

Further information is available from:

Diabetes UK Central Office

Wells Lawrence House

126 Back Church Lane

London

E1 1FH

Telephone: 0345 123 2399

Or visit the website at: [email protected]/www.diabetes.org.uk

British Dietetic Association

3rd Floor Interchange Place

151 – 165 Edmund Street

Birmingham

B3 2TA

United Kingdom

Or visit the website at: www.bda.uk.com/foodfacts

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