Tips for Dining Out When You Have Type 2 Diabetes

From everydayhealth.com

Living with type 2 diabetes doesn’t mean you can’t enjoy an evening out at your favourite restaurant. Here are some dietitian-approved strategies for making healthy choices 

Eating out should be fun. But, if you’re living with type 2 diabetes, having to manage your blood sugar can take a bite out of the enjoyment of sharing a restaurant meal with family or friends.

It doesn’t have to be that way, though. By taking certain measures before you go to a restaurant, while you’re there, and afterward, you can have your dinner out without sending your blood sugar through the roof.

Before You Go

“I tell my patients, ‘What you should eat is no different than what I should eat,’” says Shiri Morgan, MPH, RD, a certified diabetes care and education specialist at the University of California in Los Angeles. Anyone who eats out or orders food regularly should try to make a conscious effort to choose healthier options — whether they have diabetes or not.

If you tend to eat out often, get into the habit of checking out the restaurant’s menu online before you go, Morgan advises. That way, you can home in on the items that won’t have a negative impact on your blood sugar, as well as those that would. With that information, you can develop a game plan for how you’ll order your meal. It will be much easier to order wisely if you have one or two selections in mind ahead of time, rather than trying to do it while a server is standing over your shoulder.

“But, if someone’s going out to eat fairly rarely, and it’s an anniversary or special occasion, I tell them to just enjoy. Eat what you want. It’s one meal, and you can get back on track at the next meal,” she says.

At the Restaurant

Making important swaps and monitoring portion size are key to enjoy eating out with type 2 diabetes.Giselle Flissak/Getty Images

Making the right dietary choices to manage type 2 diabetes is more than simply choosing the right foods. It’s also important to be mindful of your eating habits throughout the meal.

• Treat yourself in moderation. Morgan doesn’t like the word “cheat” to describe food. “It’s all about balance,” she says. “When we put negative connotations on certain foods, it can lead to guilt and, possibly, disordered eating.” She recommends making indulgences a part of your diet, but in moderation. For example, rather than eating a full order of fries yourself, split them with your dining partner. A handful of fries isn’t likely to cause your blood sugar to spike, and you’ll still get to enjoy them.
• Savour your meal. According to a review published in June 2020 in the Annals of Pediatric Endocrinology & Metabolism, eating fast may increase your risk of type 2 diabetes. One theory as to why this happens is because eating too fast triggers proteins that increase insulin resistance and blood sugar levels. So, when you’re already living with type 2 diabetes, you need to make sure you’re keeping your blood sugar levels steady. Eating slowly helps with this, while also cutting down on the chances you’ll overeat. Take your time and enjoy your meal.

What to Order

When choosing what to order at a restaurant, balance and portion control are key. “Most places, even fast food places, are going to have good choices. You just have to make special requests and substitutions,” Morgan says.

• Choose baked or grilled proteins. Opt for a lean protein, such as chicken, fish, or certain cuts of pork. They are usually a healthier option, as long as they aren’t prepared with too much oil or a sugary sauce. Pair it with steamed or grilled vegetables for a balanced meal.
• Make carbs the side, not the main attraction. When consuming carbohydrates, make them part of your meal, rather than the focus. Instead of having a bowl of pasta or rice, Morgan recommends having a salad or healthy protein with the carb as a side dish. And, when choosing carbs, it’s always better to opt for whole-grain, high-fibre versions, such as brown rice or quinoa.
• Use the plate method. Morgan suggests using the plate method to plan your meal. “Designate half of the plate to some sort of vegetable or salad, a quarter of your plate to a carbohydrate, and a quarter of your plate to protein. This is a simple way to plan your meal.”
• Control the portion size. Restaurants typically serve much larger portions than you need. Morgan suggests ordering an item that comes in an appetizer or lunch portion or opting for a soup and salad combo. Sharing meals with friends or setting aside half of your meal to box and take home are other effective portion control strategies.

What to Avoid

While Morgan doesn’t believe anything should be explicitly off limits, she does recommend exercising caution with some foods and drinks that can be deceptively unhealthy or trigger blood sugar spikes.

• Avoid excessive alcohol and sugary drinks. High-calorie, sugary drinks can cause significant blood sugar spikes. “Alcohol itself, like tequila or vodka, does not affect blood sugar. It’s actually metabolized more like a fat. It’s typically the mixers that raise blood sugar,” Morgan explains. Excessive alcohol should be avoided with type 2 diabetes, but if you are going to have a drink, choose a glass of wine or liquor with a diet mixer, as opposed to a sugary cocktail or carb-heavy beer.
• Watch your sauces and soups. Honey mustard, BBQ, and teriyaki sauces can be laden with sugar. Request them on the side, or choose an alternative. Morgan also advises avoiding anything cream based. “The calories in cream-based foods are going to be in the fats, so things like aioli, butter, and cheese are going to give you a lot of calories.” She recommends soups that are broth based and sauces that are made from tomato or vinegar, such as marinara or vinaigrette.
• Limit fried or breaded food. Fried or breaded dishes are usually heavy in both unhealthy fats and carbs.

After the Meal

Once you’ve finished your meal, check in with your body and engage in activities that help regulate your blood sugar.

• Monitor your blood sugar levels. If you actively monitor your blood sugar, checking your levels about two hours after eating can provide valuable insights into how different meals affect your body. According to Morgan, the goal is to have your post-meal blood sugar below 180. Any higher, and it’s time to reassess what you ate and determine what’s triggering it. “If you are watching your carbohydrates closely and being really diligent about following your plan, but your blood sugar is still high, you need to talk to your doctor,” she says.
• Move your body. After a particularly heavy meal, Morgan recommends engaging in a low-impact activity, such as walking or stretching. “If someone is very insulin resistant, going for a walk immediately [after eating] reduces some of that insulin resistance and helps [you] uptake some of the glucose in [your] bloodstream,” Morgan explains.
• Remember to drink water. Research has found that staying hydrated can help stabilize blood sugar levels in people with type 2 diabetes.

While there are guidelines many dietitians follow when it comes to managing nutrition in people with type 2 diabetes, Morgan acknowledges that there’s a fair share of trial and error. Try to cook for yourself as much as possible, and make healthy choices when you dine out.

If your blood sugar is still not properly controlled, Morgan suggests experimenting. “Eat really simple foods at home to see what the culprit is, and determine if your blood sugar is high because of what you’re eating or if there’s a medication issue,” she says. And, as always, speak to your doctor if you have any new or worsening symptoms.

https://www.everydayhealth.com/type-2-diabetes/tips-for-dining-out-when-you-have-type-2-diabetes/

What Are the Different Stages of Type 1 Diabetes?

From beyondtype1.org

While type 1 diabetes (T1D) makes up only between 5-10 percent of all diabetes cases, the diagnosis of the condition is actually easier to make for doctors than other types of diabetes, which can often go symptomless and develop more slowly—over months or even years. 

T1D is usually diagnosed due to the presence of classic symptoms of the condition—excessive thirst, frequent urination, weight loss and exhaustion. But did you know that once someone presents with symptoms of T1D, they’re already in stage three of the development of it? 

Here are the different stages of T1D and the benefits of detecting the condition sooner—for individuals and their families. 

THE DIFFERENT STAGES OF T1D 

T1D actually exists on a staged continuum, but by the time most people receive a diagnosis they are in stage three. 

The stages someone goes through before they are properly diagnosed can vary, but they are predictable.

Stage one 

Stage one is the first stage in the development of T1D and it is marked by the presence of β- cell autoimmunity and the detection of two or more islet autoantibodies. 

Islet autoantibodies are proteins developed by the immune system that are associated with T1D but not any other form of diabetes. These autoantibodies show an immune response to the islet cells of the body. 

Getting tested for these islet autoantibodies can easily be done by a simple blood test. 

The presence of two or more of the following islet autoantibodies is associated with T1D: 

• Islet Cell Cytoplasmic Autoantibodies (ICA)
• Glutamic Acid Decarboxylase Autoantibodies (GADA)
• Insulinoma-Associated-2 Autoantibodies (IA-2A)
• Insulin Autoantibodies (IAA)
• Zinc Transporter-8 Autoantibodies (ZnT8A)

In this stage, there are no symptoms and people have completely normal blood sugar levels. 

Some people who develop T1D never develop detectable amounts of these autoantibodies, but this is a rare occurrence. Over 95 percent of people with new-onset T1D will have at least one islet autoantibody. 

The five-year and ten-year risks of developing T1D at this stage are 44 percent and 70 percent, respectively—the lifetime risk is near 100 percent. 

Stage two 

In stage two, people will experience slight glucose intolerance and higher blood sugar levels due to loss of functional β-cells—although most are still not experiencing symptoms at this stage. 

This is because blood sugar levels will still vary. The pancreas is still working, although not at 100 percent, and blood sugar levels are usually only slightly higher than normal. 

However, the five-year risk of developing T1D if you reach stage two is around 75 percent certainty, and the likelihood of developing T1D in your lifetime if you reach stage two is nearly 100 percent. 

Stage three 

This is the classic stage where most people receive their diagnosis. At this stage, people experience loss of β-cell functionality, resulting in both complete glucose intolerance and high blood sugar levels, often resulting in the classic symptoms of T1D, which include:

• Frequent urination
• Excessive thirst 
• Exhaustion
• Unexplained weight loss 

If diagnosis is not made promptly and treatment is delayed, stage three of T1D can quickly lead to diabetic ketoacidosis (DKA)—which can be fatal if not treated quickly. 

Shockingly, between 30-46 percent of all children diagnosed with T1D in the United States are in DKA at diagnosis, making it critical to see the signs early. 

THE CAUSES OF T1D 

The exact cause of type 1 diabetes is still unknown. However, researchers believe it to be a combination of genetics, family history, and environmental triggers—like a virus. 

Likely the development of T1D is a combination of inherent risk factors from parents, genetic risk factors as well as an environmental trigger. 

When someone catches a virus, their immune system produces antibodies that fight off the infection. T-cells are in charge of releasing antibodies to fight off the virus. When someone develops T1D, the T-cells of their immune system mistakenly attack the body’s own β-cells instead of the viral particles, destroying their insulin-producing β-cells. 

One study showed that children exposed to enteroviruses are more likely to develop T1D, but it is not a guarantee that they will. 

Other factors may also increase the risk of T1D development, including: 

• Gender: Males are more susceptible to T1D development
• Race/ethnicity: Non-Hispanic Caucasians develop T1D the most often 
• If you have other autoimmune diseases like Celiac disease, multiple sclerosis, Rheumatoid arthritis, or Lupus
• Introduction of babies to cereals before four months old, early exposure to cow’s milk or cow’s milk formula
• Where you live: T1D is more common north of the equator 
• If you have chronic low vitamin D levels

THE IMPORTANCE OF EARLY DETECTION 

If you are at high risk for developing T1D or have a family history of the condition, it is worth asking your doctor about autoantibody testing to see if you have the markers for the condition. 

This can be beneficial as the diagnosis can be made much more quickly if you test positive for autoantibodies, and you’re more likely to be diagnosed before you reach dangerously high blood sugar levels and life-threatening DKA. 

Additionally, new preventive medications are being released that have the potential to delay the onset of T1D. You may be able to postpone diagnosis altogether—at least for a few years. 

https://beyondtype1.org/different-stages-type-1-diabetes/

7-Day Easy Diabetes Meal Plan for Fall, Created by a Dietitian

From eatingwell.com

By Emily Lachtrupp, M.S., RD

Improve your blood sugar levels while enjoying the best flavours and meals of fall in this delicious, easy meal plan for diabetes 

As the seasons change and summer transitions into fall, we often dust off our slow-cookers and welcome the comforting flavours of the season. Though summer is certainly the season of fun, by the time September rolls around, many of us are itching for a more regular routine. In this easy diabetes meal plan for fall, we include many of our seasonal favourites while aiming to keep the meals quick and easy.

To keep it simple, you'll see leftovers used often, short ingredient lists, meal-prep, repeated breakfast options and easy snacks. Plus, each night's dinner is on the table in 25 minutes or less. To keep this plan diabetes-friendly, we map out a week of meals and snacks with a steady carbohydrate intake at each meal, which helps promote stable blood sugars. Plus, we aim for high-fibre foods and a protein source at each meal—both of which help reduce blood sugar spikes and promote satiety.

Because the American Diabetes Association (ADA) recommends weight loss as one strategy to help improve blood sugars for people who are overweight, we set this plan at 1,500 calories per day, which is a level where most people will lose weight. For those with other calorie needs, we also included modifications for 1,200 and 2,000 calories per day. Though this is a diabetes-friendly meal plan, it is also a great option for anyone looking to simplify their routine—whether they have diabetes or not.

Strategies for Healthy Blood Sugar Levels:

There are several ways to promote healthy blood sugars. Here are a few of our favourite strategies:

• Exercise: any increase in movement tends to be helpful in improving blood sugar levels. Walking is a great place to start, though strength training has its benefits, too! Moving your body in whatever way you enjoy is beneficial, but don't discount starting small. Research links walking for just 2 to 5 minutes after meals with lower blood sugar levels.
• Drink Water: save added sugar and carbohydrates for meals or the occasional treat and opt to drink water, instead. Because sweetened drinks are so high in added sugar, it's tricky to enjoy them regularly and promote healthy blood sugars for people with diabetes. Opt for water, seltzer and other zero-carbohydrate drinks for hydration whenever possible. Plus, make sure to drink enough water. Staying properly hydrated has several benefits—including better blood sugar levels.
• Get Enough Sleep: getting the recommended 7 to 9 hours of sleep per night has several benefits, including improved insulin sensitivity and lower blood sugar levels.
• Aim for Whole Grains: fibre-rich whole-grains—such has bulgur, quinoa, oats, whole-wheat products and brown rice—have tons of health benefits. In fact, people who regularly include whole grains in their diets have a lower risk of developing type 2 diabetes.
• Pair Protein with Carbs: pairing carbohydrate-rich foods with foods rich in protein (or fat) helps to reduce blood sugar spikes, resulting in a more steady blood sugar levels and energy. Because carbohydrates, especially refined-grain carbohydrates, are broken down more quickly than protein or fat, they tend to raise blood sugars quickly. When carb-rich foods are consumed with a protein or fat source, they are broken down slower and the blood sugar response is improved. Consider pairing whole-grain toast with an egg or peanut butter or opting for nuts with fruit to reap the benefits.

Foods to Focus on for Diabetes:

• Non-starchy vegetables, especially leafy greens, broccoli, cauliflower, cucumbers, Brussels sprouts and more
• Starchy vegetables, such as winter squash, sweet potato and potato
• Fruit, especially fruit high in fibre such as apples, pears, berries and more
• Whole grains (examples include quinoa, freekeh, bulgur, oats, whole-wheat)
• Legumes
• Nuts and seeds, including nut butters
• Lean proteins and unprocessed meats (chicken, turkey and leaner cuts of pork and beef)
• Fish
• Eggs
• Dairy, especially fermented dairy like kefir and yogurt
• Unsaturated fats (such as olive oil, avocado and avocado oil)
• Water and unsweetened beverages

How to Meal-Prep Your Week of Meals:

1. Make One-Pot Turkey & Vegetable Soup to have for lunch on days 2 through 5
2. Whip up a double batch of Lemon-Garlic Vinaigrette to have with side salads at dinner throughout the week

Day 1

JACOB FOX

Breakfast (314 calories)

• 1 cup non-fat plain strained yogurt, such as Greek-style
• ¼ cup sliced almonds
• ½ cup cherries (fresh or frozen)

A.M. Snack (176 calories)

• ¼ cup dry-roasted unsalted pistachios (shelled)

Lunch (311 calories

• 1 serving Cucumber & Roasted Red Pepper Hummus Wrap
• 1 medium orange

P.M. Snack (200 calories)

• 1 medium apple
• 1 Tbsp. natural peanut butter

Dinner (488 calories)

• 1 serving Skillet Lemon-Garlic Salmon
• 1 serving Roasted Brussels Sprout & Butternut Squash Salad

Daily Totals: 1,489 calories, 82g protein, 69g fat, 147g carbohydrate, 29g fiber, 1,090mg sodium

Make it 1,200 Calories: reduce to 2 Tbsp. sliced almonds at breakfast, change A.M. snack to 1 small pear and omit peanut butter at P.M. snack

Make it 2,000 Calories: add 1 slice sprouted whole-wheat toast with 1 Tbsp. natural peanut butter to breakfast, 1 cup low-fat plain kefir to lunch and 1/4 cup dry-roasted unsalted almonds to evening snack

Day 2

Breakfast (374 calories)

• 1 slice sprouted wheat bread, toasted
• 1 Tbsp. almond butter or natural peanut butter
• 1 medium apple
• 1 cup low-fat plain kefir

A.M. Snack (62 calories)

• 1 medium orange

Lunch (365 calories)

• 1 serving One-Pot Turkey & Vegetable Soup
• 1 medium pear

P.M. Snack (206 calories)

• ¼ cup dry-roasted unsalted almonds

Dinner (491 calories)

• 1 serving Slow-Cooker Chicken Chili
• 2 cups mixed greens
• 1 serving Lemon-Garlic Vinaigrette

Meal-Prep Tip: reserve leftover Slow-Cooker Chicken Chili to have for dinner tomorrow night

Daily Totals: 1,498 calories, 86g protein, 68g fat, 150g carbohydrate, 41g fiber, 1,366mg sodium

Make it 1,200 Calories: omit kefir at breakfast and change P.M. snack to 1 clementine

Make it 2,000 Calories: add 1/4 cup unsalted pistachios, shelled, to A.M. snack and add 1 avocado, sliced, to the side salad at dinner

Day 3

PHOTOGRAPHY / ANTONIS ACHILLEOS, STYLING / CHRISTINE KEELY, ALI RAMEE

Breakfast (314 calories)

• 1 cup non-fat plain strained yogurt, such as Greek-style
• ¼ cup sliced almonds
• ½ cup cherries (fresh or frozen)

A.M. Snack (200 calories)

• 1 medium apple
• 1 Tbsp. natural peanut butter

Lunch (365 calories)

• 1 serving One-Pot Turkey & Vegetable Soup
• 1 medium pear

P.M. Snack (154 calories)

• 20 dry-roasted unsalted almonds

Dinner (491 calories)

• 1 serving Slow-Cooker Chicken Chili
• 2 cups mixed greens
• 1 serving Lemon-Garlic Vinaigrette

Daily Totals: 1,524 calories, 97g protein, 72g fat, 133g carbohydrate, 38g fibre, 1,176mg sodium

Make it 1,200 Calories: change A.M. snack to 1 clementine and change P.M. snack to 1/2 cup sliced cucumber

Make it 2,000 Calories: add 1 slice sprouted wheat toast with 1 Tbsp. natural peanut butter to breakfast and 1 avocado, sliced, to dinner

Day 4

Breakfast (374 calories)

• 1 slice sprouted wheat bread, toasted
• 1 Tbsp. almond butter or natural peanut butter
• 1 medium apple
• 1 cup low-fat plain kefir

A.M. Snack (206 calories)

• ¼ cup dry-roasted unsalted almonds

Lunch (365 calories)

• 1 serving One-Pot Turkey & Vegetable Soup
• 1 medium pear

P.M. Snack (139 calories)

• 1 medium orange
• 1 large hard-boiled egg

Dinner (390 calories)

• 1 serving Chickpea, Artichoke & Avocado Salad with Apple-Cider Dressing

Daily Totals: 1,475 calories, 76g protein, 71g fat, 148g carbohydrate, 36g fiber, 1,416g sodium

Make it 1,200 Calories: omit kefir at breakfast and change A.M. snack to 1 clementine

Make it 2,000 Calories: add 1 medium banana to A.M. snack, increase to 2 large hard-boiled eggs at P.M. snack, add 1 serving Everything Bagel Avocado Toast to dinner and 1/4 cup dry-roasted unsalted pistachios, shelled, to evening snack

Day 5

Breakfast (314 calories)

• 1 cup nonfat plain strained yogurt, such as Greek-style
• ¼ cup sliced almonds
• ½ cup cherries (fresh or frozen)

A.M. Snack (95 calories)

• 1 medium apple

Lunch (365 calories)

• 1 serving One-Pot Turkey & Vegetable Soup
• 1 medium pear

P.M. Snack (217 calories)

• 2 large hard-boiled eggs
• 1 medium orange

Dinner (491 calories)

• 1 serving Chicken Enchilada Skillet Casserole
• 2 cups mixed greens
• 1 serving Lemon-Garlic Vinaigrette

Meal-Prep Tip: reserve two servings Chicken Enchilada Skillet Casserole to have for lunch on days 6 & 7

Daily Totals: 1,482 calories, 104g protein, 63g fat, 136g carbohydrate, 31g fiber, 1,406mg sodium

Make it 1,200 Calories: reduce to 1 Tbsp. sliced almonds at breakfast and change P.M. snack to 1 clementine

Make it 2,000 Calories: add 1 slice sprouted wheat toast with 1 Tbsp. natural peanut butter to breakfast, 2 Tbsp. natural peanut butter to the apple at A.M. snack and 3 Tbsp. chopped walnuts, toasted if desired, to the salad at dinner

Day 6

PHOTOGRAPHY: KELSEY HANSEN; FOOD STYLING: GREG LUNA

Breakfast (374 calories)

• 1 slice sprouted wheat bread, toasted
• 1 Tbsp. almond butter or natural peanut butter
• 1 medium apple
• 1 cup low-fat plain kefir

A.M. Snack (101 calories)

• 1 medium pear

Lunch (342 calories)

• 1 serving Chicken Enchilada Skillet Casserole

P.M. Snack (216 calories)

• 20 dry-roasted unsalted almonds
• 1 medium orange

Dinner (486 calories)

• 1 serving One-Pot Garlicky Shrimp & Broccoli
• 2 cups mixed greens
• 1 serving Lemon-Garlic Vinaigrette

Daily Totals: 1,520 calories, 85g protein, 66g fat, 161g carbohydrate, 29g fiber, 1,603mg sodium

Make it 1,200 Calories: omit kefir at breakfast, change A.M. snack to 1 clementine and omit almonds at P.M. snack

Make it 2,000 Calories: add 1/4 cup dry-roasted unsalted pistachios, shelled, to A.M. snack and 1 avocado, sliced, to dinner

Day 7

Breakfast (314 calories)

• 1 cup non-fat plain strained yogurt, such as Greek-style
• ¼ cup sliced almonds
• ½ cup cherries (fresh or frozen)

A.M. Snack (268 calories)

• ¼ cup dry-roasted unsalted almonds
• 1 medium orange

Lunch (342 calories)

• 1 serving Chicken Enchilada Skillet Casserole

P.M. Snack (200 calories)

• 1 medium apple
• 1 Tbsp. natural peanut butter

Dinner (399 calories)

• 1 serving Sheet-Pan Balsamic-Parmesan Roasted Chickpeas & Vegetables

Daily Totals: 1,523 calories, 83g protein, 77g fat, 135g carbohydrate, 30g fiber, 1,179mg sodium

Make it 1,200 Calories: reduce to 1 Tbsp. almonds at breakfast and omit almonds at A.M. snack

Make it 2,000 Calories: increase to 1 1/2 Tbsp. natural peanut butter to P.M. snack, add 1 serving Guacamole Chopped Salad to dinner and 1/4 cup dry-roasted unsalted pistachios, shelled, to evening snack.

https://www.eatingwell.com/article/8074992/7-day-easy-diabetes-meal-plan-for-fall/