Type 1 diabetes is a congenital autoimmune condition where the pancreas doesn’t produce enough insulin. Although type 1 is rarer than type 2, 1.4 million adults¹ over 20 in the US have type 1 diabetes and use insulin.
Medication is an important element of type 1 diabetes management, but diets can also help keep your blood sugar and cholesterol levels in check.
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Type 1 diabetes means your pancreas doesn’t make insulin or makes very little of it. This is because your own immune system attacks the insulin-secreting cells in your pancreas.
This condition makes it challenging to maintain healthy blood sugar levels since insulin is the hormone responsible for taking the glucose from the blood to the cells where it is used for energy.
Supplemental insulin helps, but neglecting your diet could cause your blood sugar levels to become too high or too low.
Your doctor has likely told you what number you should aim for with your blood sugar. This article will help you take steps to achieve your ideal levels through diet.
Diet can help people with type 1 diabetes manage blood sugar, blood pressure, and cholesterol levels.
High blood pressure (hypertension), high cholesterol, and cardiovascular problems commonly coexist with diabetes, so a healthy diet can help prevent diabetes complications.
Studies² have shown that people with diabetes who were educated about nutrition and received medical nutrition therapy³ showed positive results regarding blood sugar control and disease progression.
Meal planning for diabetes can be complicated and overwhelming, but you can always ask a doctor or dietitian for help.
Here are some approaches you can try:
Keeping track of carbohydrates in your food and drink can help keep your blood sugar levels within your target range. This is because carbohydrates are the only main food group that causes glucose levels to spike — unlike proteins and fats, which generally don’t elevate blood sugar levels.
Of the three kinds of carbohydrates — sugars, starches, and fiber — fiber is the only type that doesn’t raise your blood sugar.
One serving of carbohydrates is usually about 15g. Your doctor or dietitian can help you decide how many servings you should aim for to keep your blood sugar levels in check.
Generally, carbohydrates should account for 45–55% of your daily calorie intake. You should focus more on high-fiber, non-starchy foods.
A plating method is a visual tool that helps you plan your meals to contain enough non-starchy vegetables and lean protein. This helps minimize your consumption of carbohydrates that spike your blood sugar levels.
The plate method — using a 9-inch dinner plate — works like this:
Fill half the plate with non-starchy vegetables
Fill one quarter with lean proteins
Fill one quarter with carbohydrates
Have water or an unsweetened drink with your meal
A “portion” is the amount of food eaten at once. A “serving” is more specific. You might notice the difference when eating out, as food portions are often larger than a serving of food.
You will find it much easier to manage your blood sugar levels and weight by keeping an eye on your food portions. Make sure your portion is as close to your regular serving size as you can.
Your hands are a helpful tool when deciding what a portion of food should look like.
A portion of lean protein: about the size of the palm of your hand
A portion of dairy/cheese: about the size of your thumb from base to tip
A portion of fruit: about the size of your closed fist
A portion of nuts: one cupped handful
To prepare for your type 1 diabetes diet, you should keep your blood sugar levels in check. This is the main goal of a diabetes diet. Depending on your diet, the severity of your condition, and your insulin type and dosage, your blood sugar levels could become too high or too low.
Here are some steps you can take to maintain healthy blood sugar levels:
This is really important to keep your blood sugar in check. If you’re taking insulin but don’t eat, your blood sugar levels could drop too low. Low blood sugar levels can be just as harmful as high blood sugar levels.
A study⁴ of teens and children found those with type 1 diabetes were less likely to skip meals. However, if they did skip meals and snacked more, this negatively influenced their ability to control their blood sugar levels.
You must speak to your doctor before following a diet regimen like intermittent fasting or fasting for religious reasons. They will tell you if you can fast and help you do so safely.
This is especially important if you’re on a fixed-regimen insulin schedule, meaning you take the same amount of insulin at the same time each day.
If this is the case, your blood sugar levels are more likely to drop when delaying your meals or skipping them altogether.
The glycemic index refers to how quickly a carbohydrate-containing food can increase your blood sugar levels. Foods with a high glycemic index are broken down into sugars faster.
The glycemic index can’t tell you how high your blood sugar will get when you eat something.
The glycemic load shows how fast carbohydrates are broken down to release sugars and how much carbohydrate the food contains. This way, the glycemic load can give you an idea of how much carbohydrate-containing food might increase your blood sugar.
Knowing a food’s glycemic index and load can help prevent blood sugar levels from getting too high too quickly. Generally, processed foods containing more sugar have a higher glycemic index and load. Foods with more fiber, healthy proteins, and fats have a lower glycemic index and load.
The nutritional labels on the back of packaged foods can help you count carbs. They’ll also tell you how much fat, protein, and fiber the food contains.
These labels can guide you when deciding whether or not you should be buying or eating something at all.
These nutritional recommendations for people with type 1 diabetes are important for overall health, not just for controlling your blood sugar levels.
The American Heart Association⁵ recommends limiting your consumption of saturated and trans-saturated fats. Try to consume unsaturated fats instead.
Studies⁶ report that replacing some carbohydrates with healthy fats, particularly polyunsaturated fatty acids, can improve blood glucose levels and insulin secretion capacity. That being said, people with type 1 diabetes are advised to keep their overall fat consumption low — at about 30–35%⁷ of their total daily calorie intake.
Fiber is the only carbohydrate that won’t cause your blood sugar levels to rise. It can also slow the rate at which other foods and carbs break down into glucose and absorb it into your bloodstream.
Moderate fiber consumption has been associated with benefits such as reduced overall inflammation and improved glycemia and CVD risk markers. It was also linked⁸ to reduced mortality⁸ in people with diabetes, while high glycemic load and carb and sugar intake were associated with increased mortality risk.
Healthy proteins include lean animals or plant proteins, like tofu, legumes, nuts, and seeds. Remember, these should not form the basis of your entire meal.
Ensure your protein intake is moderate. This is important because kidney disease is linked⁹ to diabetes, and high protein intake can damage your kidneys.
Starches are a type of carbohydrate that elevates blood glucose levels. Some vegetables, such as potatoes, sweet potatoes, beets, and squash, contain lots of starch.
Keep your consumption of starchy vegetables to a minimum and eat more non-starchy vegetables, which tend to be more nutritious.
Hydration is very important for your health. It’s especially important for people with diabetes as your kidneys can flush out excess sugar if there is enough water. This function can also lead to dehydration.
People with type 1 diabetes should avoid or limit some foods, including:
Sugary foods and drinks (like energy drinks, flavored milk, regular soda, and sports drinks) can negatively affect fat placement, metabolism, blood pressure, and insulin sensitivity.
Try to limit these foods and drinks as much as possible as they can worsen your diabetes symptoms and cause more complications.
Processed, refined, or simple carbohydrates will rapidly increase your blood sugar levels without much other benefit. Complex carbohydrates, such as vegetables and wholegrain sources, can provide more protein and fiber.
Processed carbohydrates have been found to cause increased fluctuations in glucose levels, plasma insulin, and postprandial reactive hypoglycemia. They are also linked to weight gain, increasing your risk of other diabetes complications.
Being as mindful as possible about your diet is important if you have type 1 diabetes. Your main goal will be to keep your blood sugar levels within the target range your doctor has recommended.
Your doctor or dietician will advise you on managing your type 1 diabetes through diet, but you can try carb counting and eating the right balance of food with the plate method.
With type 1 diabetes, you should follow general nutritional guidelines like staying hydrated, eating enough fiber and healthy proteins, and limiting starchy vegetables and unhealthy fats. You should also try to reduce your consumption of sugary foods and drinks and processed and simple carbs.
National diabetes statistics report 2020. Estimates of diabetes and its burden in the United States | Centers for Disease Control and Prevention
Monounsaturated fat | Heart Attack and Stroke Symptoms
Effects of saturated fat, polyunsaturated fat, monounsaturated fat, and carbohydrate on glucose-insulin homeostasis: A systematic review and meta-analysis of randomised controlled feeding trials (2016)
Diabetes and chronic kidney disease | Centers for Disease Control and Prevention
The lowdown on glycemic index and glycemic load | Harvard Health Publishing
Nutrition and early kidney disease (Stages 1–4) | National Kidney Foundation
Water and diabetes | Diabetes.co.uk