Diabetes type 1

Diet and diabetes

A healthy diet means having a balance of protein, carbohydrates and fat. It's important to include plenty of vegetables and fruit. A healthy diet is recommended for everyone. However, the most important thing for diabetics to consider is whether foods have carbohydrates in or not. It’s also important to be aware how quickly the carbohydrates are absorbed by the body. Understanding these things make it easier to know when and how much insulin to inject to cover the carbohydrate in whatever you are eating.

Foods like bread, pasta, and rice are high in carbohydrates, but it’s also important to remember that many fruits also contain a lot of carbs. If you are eating a meal with a lot of carbohydrate, you will need to inject more insulin to cover it. If you are eating something with little or no carbohydrate, you may need to avoid taking any quick-acting insulin at all.

Once an insulin regime is established it is possible to include such things as chocolate or a dessert so long as it is possible to work out the extra insulin that's needed to cover them. 

Type 1 diabetes and coeliac disease sometimes occur together and therefore patients with diabetes are sometimes screened for coeliac disease shortly after diagnosis. The test is done by measuring a particular type of antibodies (antiendomysium). One young woman we spoke to had been diagnosed with coeliac disease.

In general the young people we talked to felt that they had a healthier lifestyle than other young people their own age group who weren't diabetics. They feel that one positive outcome of their diabetes is their healthy outlook to diet and lifestyle in general. Many young people diagnosed during their teens said that they've made changes to their diet and life style. They hadn't realised how unhealthy their lifestyle was until then. Many had given up smoking and cut down on ready meals, while eating more vegetables and fruit and taking more regular exercise. 

Food and insulin
The type of insulin regimen that you are on influences the kind of eating routine you have. Those on two injections a day said that they have to have fixed meal times and remember having to have their insulin injections 20 minutes before eating. People thought the main disadvantages of this regimen was the rigid meal time routine and having to eat snacks in between meals even when they're not hungry. Those who were on this regimen since childhood describe their childhood diet as 'very restricted'. Some remember that they were only allowed to have sugar when doing PE at school. Some young people, however, preferred this routine because it provides a structure to their day and they find that it is easier this way to remember to take their insulin. 

Most of the young people we talked to were on a combination of long acting and short acting insulins. They inject the long acting insulin in the morning or before they go to bed and take an appropriate dose of the short acting insulin each time they have something to eat. Young people find that this regimen gives them much more flexibility about mealtimes, suits their lifestyle better and allows them to control their diabetes better.  A number of young people, however, pointed out that the sense of freedom they find with this regimen can also bring problems. For instance, some young people found that they started eating more sugary and/or fatty food. (See also 'Finding the right insulin regimen for you' and 'Obesity and other eating problems'.) 

Physical activity and carbohydrates
Young people who do physical work or are engaged in exercise on a regular basis said that they tend to need a diet that is high in carbohydrates. Some young people noted that a reduction in physical activity and/or an increase in eating sugary or fatty food will affect their weight and overall control. (See also 'Obesity and other eating problems'.)

Carbohydrate and insulin ratio
Young people said that in addition to eating the right type of food the key to a good control is to fix the insulin dosage around what you are eating. Most of the young people we talked to know about carbohydrate counting but few felt the need to apply it rigorously to calculate the carbohydrate/insulin ratio of each meal. Many young people do 'well-informed guesswork' and said that they have learned through 'trial and improvement'. (See also 'Finding the right insulin regimen for you.')

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A few respondents consider themselves lucky because they have been able to attend training sessions to help them calculate more accurately the carbohydrate/insulin ratio. They said that participation in training courses such as DAFNE (Dose Adjustment for Normal Eating), TIFA (Torbay Insulin and Food Adjustment) and Insight has made them more confident in solving problems regarding food and insulin dosage.

GI diet and diabetes
Some of the young people mentioned the GI (glycaemic index) diet and how they and their parents became interested in finding out more about the effects that certain types of foods have on blood glucose. They learned that certain foods will make your blood glucose go straight up and then an hour later it will go straight down again and cause you to have a hypo. Other foods such as brown rice or brown bread have a very long-lasting effect but it is very gradual. Eating a mixture of rapidly absorbed with slowly absorbed carbohydrates gives you better control over your diabetes. Some young people are routinely including low GI (glycaemic index) food in their diets. One young woman indicated that she could see the benefits of a GI diet as she began to achieve a smoother control of her blood glucose level as well as losing weight over a period of time. 

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Illness and diet
The young people we talked to emphasised that having regular meals does help to keep blood glucose under control. They described how that control is 'messed up' when you are ill and don't feel like eating. 

There are five illness 'rules' that every type 1 diabetics needs to follow in order to cope with an illness:

  • 1. Never stop taking your basal (background) insulin.
  • 2. Check your blood glucose every 2 to 4 hours and if you cannot do it yourself ask a relative or friend to help.
  • 3. Use Ketostix to test your urine. If you have ketones it is likely that you are lacking in insulin. Please do not ignore this because ketoacidosis may develop. Diabetes ketoacidosis is serious and needs immediate treatment.
  • 4. Drink at least five pints of sugar free liquids especially water and particularly if you have a temperature or diarrhoea or vomiting because you can easily become dehydrated.
  • 5. Try to eat your normal diet but if you are unable to do this, replace your meals with sugary fluids such as milk, fruit juice, flat lucozade or cola.

For more information see our resources section.

Last reviewed November 2014.

Last updated November 2014.

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