The single most important factor in managing diabetes is what you put on your plate.
The Diabetes Diet.
What you eat and drink is the one thing you can control over everything else. So forget what you consider to be normal and make changes that will save your life.
The food we eat will keep us healthy or contribute to sickness. Make no mistake, if we eat highly processed and refined foods WE WILL feel the ill effects of it, but that doesn’t mean we should be overthinking it.
Despite what you may read in the media, the world is coming around to the fact that high sugar and high carbohydrate foods contribute to obesity and other modern, inflammatory diseases.
Supermarkets are being forced to bring in more varieties of foods as customers demand healthier alternatives to traditional staples like chocolate, bread, milk, flour, etc. So why do these foods matter and what do you have to do to make sure your blood glucose levels remain as stable as possible.
Walk into any supermarket and every single aisle is full of cheap, refined carbohydrates. Why? because it’s cheap to manufacture and is highly addictive. It provides large profit margins to the corporations behind them, with little to no regard for the health of people consuming it. This is not a conspiracy theory, it’s fact.
As a diabetic, we are now faced with the prospect of shopping for the same foods we’ve always eaten and injecting large amounts of insulin to cover it OR choosing lower sugar, lower carb alternatives. In our opinion, there is NO choice.
Do you want a healthier, happier life or do you want a roller coaster of glucose levels, emotions, increased stress and complications? Our bodies can no longer cope with sugar and carbohydrates, so get rid of them. You can still live a happy life. But it takes will-power and dedication.
There is no such thing as an essential carbohydrate.
* 'Normal' carbohydrate consumption as per 'Standard Western/American Diet' = 250+ grams of carbs per day.
* Low Carb High/Healthy Fat diet (LCHF) = Under 50g carbs per day.
* Ketogenic (keto) diet = Under 20g carbs per day.
* Carnivore diet = 0g carbs per day.
In short, eating low carb is removing or significantly reducing high carb foods from your diet like bread, pasta, pizza, sweets, cereals, and most fruit. The end product is likely a low carb high-fat diet (LCHF).
Currently, different countries advise on ‘daily guidelines’ for healthy eating. These guidelines offer a basic insight into what proportions of food and drink you should be having. Now, if we look at the USA; they state you should be eating between 45% and 65% of your daily calories from carbohydrate. The guidelines for women are around 2000 calories per day (2500 for men), so, this equates to roughly 900 to 1300 calories from carbohydrates or 225 to 325 grams of carbs a day.
As a diabetic, you will need to calculate how much insulin to cover this amount of carbs. So, following the above recommendations and if you’re on a ratio of 1 unit of rapid-acting insulin to 10 grams of carbs you’ll be injecting up to 32 units of insulin a day. If your ratio is higher, the insulin requirement increases.
Be careful with insulin.
Insulin is a life-saver for a type 1 diabetic, but we want low levels of it in the blood. "Insulin stimulates fatty acid synthesis in adipose tissue (fat), liver and lactating mammary glands, along with the formation of triglycerides in adipose tissue and liver. High concentrations of triglycerides in the blood indicate an elevated risk of stroke."- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1204764/
So why all the fuss about low carb?
We have normalised eating highly processed ‘fast’ food, and all of these foods are high in carbs.
What about fatty foods or foods high in salt?
We need fat in our diet. Over the past 50 years, fat has been vilified as (initially) the American Heart Association(ADA) wrongly believed it was correlated to increased cholesterol and cardiovascular disease. There has never been any evidence for this and we now know the opposite is true.
Salt is entirely natural and like fat, has been vilified in the media. The refined and processed foods which are common in our supermarkets like bread and cereal contain vast amounts of salt to make them more palatable - so we are ingesting a lot more than we need. However, if you remove these processed foods then you remove the salt as well, so you can add it to your home cooking without the need to worry. Look to get between 4 and 6 grams of salt per day.
Carbohydrates for diabetics aren’t in their whole form bad, but when you eat large amounts the body must produce larger amounts of insulin and convert them into glucose. This can lead to insulin resistance - like type 2 diabetes, and Insulin is the main fat-storing hormone in the body, and too much insulin can, therefore, lead to being overweight.
If we eat too many carbohydrates and we are not using all that energy the body turns it into fat, and fat (visceral) - around the belly - is harmful, and is correlated to increased risk of cardiovascular disease, stroke, and cancer.
Here at Believe the Hypo, we strongly suggest a low carbohydrate diet. This is backed by ever-increasing evidence and research. If you have an insatiable appetite for bread, pasta, and potatoes, then we would consider changing your way of thinking or you will be adding large amounts of sugar (in the form of carbohydrates) and insulin to your daily routine. You'll also be increasing your risk of non-fatty liver disease, obesity, insulin resistance, cardiovascular disease, stroke, and cancer.
Remember, we want control over our blood sugars, and therefore, our overall health.
The Risk vs the benefit
What is the goal for a diabetic when choosing food and drink? Well, one way to look at it is to weigh up the risk vs the benefit. e.g. eating oranges. Will the benefits of eating oranges outweigh the drawbacks?
Oranges are a good source of vitamin C which can aid in improving your immunity. However, there are plenty of other foods with significantly fewer carbs that offer higher levels of vitamin C (Strawberries / Kale), so would it not be the smarter choice to go with another food over the orange, as the orange has higher sugars which increase the risk of spiking blood sugars?
Isn’t it important to have a balanced diet I hear you say? yes, in short. But what is balanced? Where does our knowledge of nutrition come from and what is affecting our decision making?
As a diabetic, we must often choose the lesser of two evils. The citrus punch of an orange which has approx 13 grams of carbs or strawberries that have half the carb content. Plus, for hundreds of thousands of years, millions of humans situated in various parts of the globe never ate oranges as they were not accessible. These people weren’t dropping like flies because there are other foods that have similar or better nutritional profiles.
This is important and useful when identifying foods for every meal of the day. Below is an example of breakfast for a non-diabetic vs a diabetic. The breakfast example is scrambled eggs on toast with avocado. A healthy choice.
* Eggs = 0 grams Carbs
* Avocado = 2 grams Carbs (1 tbsp)
* Bread = 38 grams Carbs (2 slices bread)
* Orange Juice = 22 grams carbs / 19 grams of sugar (1 glass / 250ml)
TOTAL = 58 grams Carbohydrates.
* Eggs = 0 grams Carbs
* Avocado = 2 grams Carbs
* Low Carb Bread = 5 grams (2 slices)
* Glass of water with a slice of lemon
TOTAL – 7 grams Carbohydrates.
The above is a very simple example of making two small changes to a typical breakfast. But why is this change needed? Because when you add increased carbs into a meal, you have to increase your insulin to cover it. This, in turn, increases your chances of going too high or too low with your blood sugars. Both of which are to be avoided as much as possible.
What foods need to be avoided? As much as this question can hurt, we must remember that high carb and high sugar foods will only hinder our ability to control our blood sugars. Below are some examples of foods that are high carb;
Sweets or desserts
Crisps / Chips
Fruit / Fruit Juices
When you break down meals, you’ll see the ingredients and it is important to understand what foods are made of, which will help you gain a greater understanding of the impact of the food on your blood sugars.
A good example is bread. Bread generally consists of flour, yeast, and salt. Flour is ground up grain, typically wheat. It has approx 76 grams of carbs per 100 grams. THAT IS MASSIVE! That is also potentially catastrophic to your blood sugars. The good news is that there are now many loaves of bread that are low carb or you can learn to bake your own low carb version. In fact, you can now find almost all low sugar and low carb alternatives to the high carb foods mentioned above.
What is YOUR normal?
“A normal blood sugar should not be subjective. We are allowed the same blood glucose levels as a non-diabetic”.
No person has the right to preach to you on how you live your life. It’s all yours after all. That being said, we do make the assumption you don’t want to make your life much worse by having life-altering illnesses/complications that infringe on your quality of life, and in turn the people closest to you.
So with that being said, our end goal as a diabetic (and as a human being) has to be, how do we live our days as content as possible given what we must now manage? What makes us happy and what can we do without?
Food is something that means different things to different people. It can be the central part of a family gathering or it can simply be fuel for doing an activity. Either way, you now have to change or perhaps evolve your attitude toward it. It can still have significance in your life but you cannot allow it to dictate your health negatively (to see how your mental health can be affected by diabetes, see our page HERE)
What you have always considered to be normal must now shift to a new normal. This is not easy, but you are a lot stronger and smarter than some morally deprived executive sat in a board room at a chocolate company looking to market a new product at you. You cannot allow them to get rich and watch your health suffer as a result. Things have changed.
Start by making small changes. Remove sweets, chocolate, desserts, puddings, biscuits, etc from your home. Having these things will only act as a temptation. Re-stock your fridge with healthy alternatives. Be as organised as you can with your grocery shopping and target the areas that have your foods of choice. Wandering down the confectionary aisle will not do anyone any good (apart from the morally deprived executive).
You might say to yourself “but one chocolate bar is fine”, I’ll just give myself insulin to cover it. I’m not advocating NEVER doing this, but where will this lead?
Food acts faster in your body than insulin. That means if you have a bar of chocolate and give yourself the correct amount of insulin to cover it, you’ll still see a rise in blood sugars. We are injecting it through fat and muscle which takes time (regardless of whether its rapid-acting or not). Our fastest insulin starts to act in roughly 5 mins but in reality, it’s often longer. It’s these things that will increase your chances of complications in the long run, and for what - a bar of chocolate.
No-one is preaching here. The end goal is to manage blood sugars and lessen the chance of complications.
So, what's the good news you may ask? well, there’s sugar-free chocolate!!
Everything that you love doesn’t have to go out of the window, Coke has a no-sugar alternative, there’s low carb bread, no sugar chocolate, low carb pasta, almond milk, even low carb no sugar ice cream.
Why are carbohydrates dangerous for a diabetic?
Carbohydrates aren't necessarily the bad guy, but it's their effect on insulin that is causing the problems.
Carbs are split into 2 main groups: Sugars and Starches.
Sugars are things like fructose, glucose, and lactose (fruit, honey, and milk). Starch is essentially plant tissue. Foods that contain starch are some vegetables, and grains like bread and rice.
Fun fact: Carbohydrates are made up of Carbon, Hydrogen, and Oxygen – hence the name.
So when we look at all the foods that contain carbs, what is it about them that is so bad for a diabetic?
Carbohydrates, when digested get converted into glucose by the body and glucose raises your blood glucose levels (BGL). In a person who does not have diabetes, their pancreas will produce insulin at the same time as the increase in glucose to provide energy and essentially keep the body in balance. Short periods of blood sugar spikes in non-diabetics are not seen as dangerous but overtime this can lead to insulin resistance, and this is now considered one of the most serious modern inflammatory diseases. Type 1 Diabetics don’t have that luxury of a fully functioning pancreas, so the damage is quick in comparison. That is why even with exogenous insulin we cannot afford to eat like an unhealthy non-diabetic. We're simply placing our body under too much undue stress.
We must be very conscious of what affects our glucose levels. When our blood glucose levels rise it is essentially poisoning our body, and it is this that leads to complications over time.
Currently, medical science does not know to what extent you can raise your BGL and how this will affect your body. But we do know that continued exposure to high BGL’s (chronic hyperglycemia) increases your chances of complications by turning the blood toxic and damaging blood vessels and organs. A good indicator is the infogram below from the diabetes council:
Where does this leave us?
Before Insulin was manufactured to treat diabetes, diabetics were told to eat a very low carb diet with a prolonged period of fasting as it helped extend their life. Now that we have exogenous insulin, this is still the same truth. By eating high carb foods and injecting insulin to cover the inevitable spike in BGL we simply reduce our chances of maintaining good glycemic control.
Insulin now gives us the chance to live. Don’t pretend that having cake or pasta will keep your quality of life because it wasn’t that long ago that diabetes was a death sentence, and high carb foods simply speed the process up.
Think about where your food is made and comes from. Humans have been around for a while now. We haven’t always made bread and pasta and cake and burgers and crisps and chips and chocolate and ice cream and pies and cereals. We have simply foraged or killed our food, and for a lot longer than we have been making the other stuff.
Remove processed and refined foods, and you will see a huge difference in your weight, skin, energy, mood, mental clarity, and sleep.
Diabetics have a simple choice; buy into the cheap and highly processed ‘food’ coming out of a factory which will play havoc with your BGL’s or revert to more organic and fresh produce. Why can’t you do both? Simply, because your pancreas doesn’t work anymore, sorry.
There are now many T1D’s that follow a low carb diet, but where are they getting their information from? (other than here). The most famous person/advocate/expert/Dr, who is also a type 1 diabetic is Dr. Bernstein. He has numerous books and videos that can be bought or are free on youtube.
So why would you listen to Dr. Bernstein?
Firstly, and very importantly, he is 85 years old. This is old by anyone’s standards, so by listening to someone who has been a T1D since he was 12, you are taking decades of experience and wisdom.
Secondly, When he was younger he had many diabetic complications until he was in his late 30’s. He followed guidance from his Dr’s and Endocrinologists, as well as the American Diabetes Association on diet. Despite this, his health deteriorated. When he began to follow a very low carb diet, the complications began to lessen and even disappear.
Thirdly, Dr. Bernstein became a doctor in his 40’s after he became disillusioned with the advice he was being given by his medical team. He took himself to medical school, became an expert in the field of diabetes and was then able to ensure he could have full control and management of his condition. This gave him invaluable insight from both doctor and patient perspective.
Finally, He has dedicated his life to improving the outcomes for his diabetic patients. He doesn’t just explain what to eat, but he breaks apart the theory behind it all. By listening to him, you’re not just following the information that can dramatically improve your quality of life but you’re also being educated in all things diabetes-related.
As with above, having an understanding of the ingredients and carb content of any drink is vitally important. This knowledge won’t come overnight but will be accumulated over many years. You will never stop learning once you have diabetes, and that isn’t a bad thing.
Start by breaking down your daily routine and identifying drinks that contain high levels of carbs and sugar. You’ll be surprised!
Many companies add sugar to things that it simply shouldn’t be in. Semi-skimmed milk has added sugar - more than full fat. Some brands of almond/soy/macadamia milk often have added sugar. pre-made coffee from the supermarket has a ton of the stuff.
Get into the habit of checking the nutritional information on the back of EVERYTHING.
Your eyes need to go straight to carbohydrates and sugar. If it’s packed full of it then leave it alone.
Fruit juices are for medicinal purposes only. It doesn’t matter how it’s packaged, it is full of sugar and therefore, carbs. Have some in the fridge in case you are running on low blood sugars but NEVER drink it as you would water. It will send you sky-high.
Alcohol is a different set of rules altogether. It’s important to understand how alcohol is metabolised in your body. This is because, despite its often high sugar content, it will result in your blood sugars lowering over several hours. So it can be dangerous for this fact. If enjoyed in balance there is no reason you can't have it.
A quick lesson: In the months following my diagnosis, I became an expert at knowing what food to eat to offset my alcohol intake. I would often have a burger and fries as I knew I would be having a few (or more) drinks of an evening. This meant I was not running too high or low.
Please don’t follow my lead as this was not a clever thing to do and looking back I was not as ‘balanced’ as I often thought I was.
In the end, all we are trying to achieve is balance. We are rapidly learning that what we consume dramatically dictates our health, regardless if you’re a diabetic or not. The consequences of eating badly for us diabetics can be quite a bit more sinister.
My Experience with Diet
I guess you could have called me a ‘binge’ eater. Generally speaking (before T1D), I ate healthy meals consisting of mostly protein with little carbs, particularly after university where I learned a lot about health and nutrition.
I definitely did not hold back though and would have regular sweets and desserts, as well as high carb ‘junk’ food. It was quite normal for me to grab a kebab or chips after a night out.
I wasn’t overweight but I wasn’t skinny either (5’11 and 84kgs).
Since being diagnosed and having educated myself with many years of research into diet and nutrition - including revisiting my university literature; I have adopted a very low carb diet. All my nutrition comes from meat, fat, and vegetables. I have swapped various ‘treats’ for low sugar / low carb alternatives. Like Coke No Sugar, Low carb alcohol, low carb bread, and no sugar / low carb chocolate.
I don’t eat a lot of it but if I want it, I’m having it. My weight now is 74 kgs and does not move up or down more than a few hundred grams. Couple this with exercise and I look and feel better now than I ever did before diabetes.
Here’s an example of my daily meal plan;
2 x slices of low carb bread = 5 grams carbs
3 x large eggs (scrambled / fried or poached) = 0 grams carbs
1/4 Avocado (spread like butter) = 2 grams carbs
1 x large glass of water = 0 grams carbs
1 x coffee (made with almond milk) = 0 grams carbs
Almonds with herbs such as rosemary, chili, salt, and pepper = 10 grams carbs (1/4 cup) = 2 grams carbs
Protein bar = 3 grams carbs
Salad with grilled chicken or chicken sandwich with low carb bread = 5 grams carbs
Protein Shake = 2 grams carbs
Grilled Fillet of Salmon (200g) = 0 grams carbs
Kale (roasted) = 5 grams carbs
Cauliflower Rice = 1.5 grams carbs
Pay the farmer now or pay big pharma later
There is no greater investment than in your health.
You shouldn't have to feel the ill effects of poor dietary choices before you make a change.
If You Change the Shape Of The Bricks, The Whole Building Falls Down.
Smoothies are all the rage at the moment. It seems that everyone has a blending device in their kitchen and there has been plenty of media attention and documentaries filmed watching someone live off blended fruit and veggies, and looking and feeling great.
But how much of this is true?
Not much. When you change the structural integrity of food, it changes how your body digests it. Your body releases much more insulin for foods that have been broken down into a liquid. Plus, you need to blend far more to get a single glass, meaning you'll be ingesting three or four apples, oranges or pears in one sitting. The sugar content skyrockets and so does your blood sugar.
A low-fat blueberry boost juice has the equivalent of 22 tsp of sugar.
When you eat food in its natural whole form, it also contains fiber. The fiber by itself is not required by the body but it helps greatly in the digestion process helping to pass the food through your gastrointestinal tract.
Research has also shown that if you must choose carbohydrates with your food, then to eat it last. This will slow the rise in blood sugars.
The moral of the story is to try and not change the structural integrity of your food as much as possible. It will help your blood sugars and your overall health.
Tips to enhance your diet and balance your blood sugars
These include: Grain, Fruit, Cereal, Starchy Vegetables, Sweets & Deserts.
Dietary fat is good for you. Eat more animal fat, butter, olive oil, fish oil (omega 3).
Packed with essential amino acids and high in protein. Eat red, white & fish.
Keep the structural integrity of your food as much as possible. Don't use a blender.