10 Diet Commandments for Better Diabetes Management


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The question—“What diet should I follow?”—has perhaps never been more confusing, more controversial, or more stressful. There are more diets, diet books, diet opinions and news headlines than ever before. In reality, no single “diet” trumps them all, especially for people with diabetes—all approaches have their pros and cons, whether you’re talking about health effects (e.g., blood sugar, blood pressure, cholesterol), cost, convenience, or taste. So instead of a “diet,” I prefer to think about eating in terms of general strategies, or what this article is calling my “commandments.”

After experimenting with many different eating approaches over the years, I’ve honed in on 10 eating commandments that I strive to follow every day—these strategies seem to keep my blood sugars in range, give me plenty of energy, are transportable to different eating environments, are relatively convenient and fit within my budget. Of course, eating preferences are highly personal (especially in diabetes), and my own principles may not apply for everyone.

A Starting Point: Brainstorming Your Eating Commandments

When you see higher blood sugars (over 11.1 mmol/L200 mg/dL) 90 minutes after a meal, what did you eat? How did you eat? When and where did you eat? How did you manage your diabetes around these times? As you look at your answers, can you pull out some themes? Can you write some rules or guidelines for making better mealtime choices?

If you are struggling to identify patterns, I recommend taking a few days to record what you’re eating, along with doing blood glucose tests before and 90 minutes after your meals. I find this is easiest using an app, such as mySugr or Meal Memory (both available on Apple and Android). The ultimate goal is to come up with a list of eating principles that helps keep your blood glucose in check, gives you enough energy, and is realistic in day-to-day life. Here is the result of my brainstorm:

The 10 Diet Commandments I Strive to Follow Every Day

1. Try to limit carbohydrates to no more than 30 grams in one sitting. (Note: I know this is controversial in the nutrition and diabetes communities, that research is conflicting on this topic, and this approach may not be realistic for everyone. But for managing my own blood sugar, I’ve found this to be a complete and total gamechanger.)

2. Eat more vegetables.

3. Choose whole foods as often as possible; less than five ingredients is ideal, and more than 10 ingredients is a red flag.

4. Cook my own food.

5. Avoid sugar, white bread/potatoes/rice/pasta, crackers, chips, candy and anything fried.

6. Snack on nuts, seeds, vegetables, fruits and lean sources of protein.

7. Drink water or unsweetened tea.

8. Eat a filling breakfast (protein, fiber) and ideally nothing within 90 minutes of bedtime.

9. Eat fruit for dessert, when desired.

10. Check my blood sugar 90-120 minutes after eating or wear continuous glucose monitor (CGM) or Flash Glucose Monitoring if possible financially.


Everyday Challenges and How to Overcome Them

Eating out
• Choosing salads or chicken/fish with a side of vegetables
• Reading nutrition facts/labels, when available
• Substituting salad or vegetables in place of potatoes (including French fries or chips)/rice/pasta
• Avoiding the bread
• Getting sauce/dressing on the side
• Drinking lots of water
• Remembering I don’t have to clean my plate (and probably can’t if I want to follow my own commandments, given portion sizes in most restaurants)
• Asking for a bowl of berries for dessert
• Having predictable go-to snacks when on the run: almonds, peanuts, pumpkin seeds
KEY OBSTACLE: Resisting bad food choices when they are readily accessible • Keeping junk food out of the house
• Eating at home before attending an event where unhealthy food will be served
• Filling up on the healthy stuff first
• Mentally linking enough pain to eating the bad food (“I will regret eating this”) and pleasure to making the better choice (“This is making me healthier”)
• Remembering what the unhealthy food tastes like (“Yes, I know what mint chocolate chip ice cream tastes like”) and appreciating that I don’t have to eat it just to experience the taste again. For some, doing this may make you more likely to eat the food, so you’ll have to experiment to see if it works for you.
KEY OBSTACLE: Avoiding boredom or feelings of restriction. Using cookbooks, recipe websites, or food blogs to find tasty, healthy food options that fit with my commandments
• Using almond flour for making baked goods
• Using zucchini or spaghetti squash as a pasta substitute
• Roasting delicata squash as a potato/French fries substitute
• Using almond flour + eggs as a pizza crust substitute
• Making reasonable exceptions once in a while (see #5)
KEY OBSTACLE: Time investment • Making healthy eating a major priority alongside all the other time demands in my life
• Having a repertoire of fast, go-to recipes— mine are steaming frozen vegetables, smoothies with frozen fruit, scrambled eggs, ground turkey with vegetables, sautéed salmon or chicken
• Making a grocery run for everything I need for a week
• Buying frozen: vegetables, fruit, fish and chicken
KEY OBSTACLE: Making Exceptions Setting ground rules for my exceptions ahead of time—otherwise, it’s easy to fall into the trap, “Just this one time.” For example:
• I break the sugar/carb commandments when I’m doing long bike rides (usually once per week)
• I break the white rice 30 g carb commandments when eating sushi, one of my favorite foods (typically every other week)

Concluding Thoughts

One tough thing about eating is that very small errors in judgment, repeated consistently, add up to big health risks over time. It can be hard to see these in the moment, and often, we don’t even realize that we’re making a bad choice. Add to that an ever confusing nutritional landscape, crazy fad diets and unrealistic expectations, and it’s pretty stressful out there! I’ve found that making my own list of commandments is like my secret playbook—I just look at it and know what to do in many cases. The result has been more predictable blood sugars in the short-run and better health (hopefully!) in the long run. I hope you can develop a list that works for you. Let me know how it goes by email or on twitter.


This article originally appeared on diaTribe.org

Copyright © 2015, The diaTribe Foundation. This article has been reprinted with permission. Find the original article here. Read more from diaTribe and subscribe to their email updates!


Adam Brown joined diaTribe in 2010 as a summer associate, became managing editor in 2011, and now serves as senior editor. Adam brings nearly 15 years of experience with type 1 diabetes to all of his work at diaTribe, especially in testing out new technology like glucose meters, CGMs, insulin pumps, automated insulin delivery and mobile apps. Adam also writes an acclaimed column for diaTribe, Adams Corner, which focuses on actionable tips for living well with diabetes. Through his work at Close Concerns and diaTribe, Adam has brought a patient perspective to numerous venues, including FDA meetings, scientific and industry conferences and patient events. Adam graduated summa cum laude from the Wharton School of the University of Pennsylvania in 2011 pursuing concentrations in marketing and health care management and policy. He is passionate about exercise, nutrition, psychology and wellness, and spends his free time cycling in San Francisco.