Type 1 Diabetes
The right diet is the key to managing many diseases and to improving general quality of life. For this condition, scientific research has found benefit in the following healthy eating tips.
High-Fiber Diet
Research indicates a high-fiber diet can help people with type 1 diabetes regulate glucose levels better and lower their risk of hypoglycemia. Eating more fiber is also associated with lower risk of all-cause mortality.High-Fiber DietPeople with type 1 diabetes benefit from eating a high-fiber diet. Research has shown eating a low-glycemic-load diet that is high in fiber can reduce blood glucose variability and prevent hypoglycemia in people with type 1 diabetes.175,176 Further, fiber comes from foods such as vegetables, fruits, legumes, nuts, seeds, and whole grains, which provide important vitamins, minerals, and phytonutrients and are associated with good overall health.
Low-Glycemic Index Diet
Low- and medium-glycemic-load foods like whole grains, beans, vegetables, and fruits are loaded with nutrients and fiber, providing valuable fuel while keeping blood sugar levels stable.Low-Glycemic Index DietEating a lower glycemic index and glycemic load diet—emphasizing foods that are more slowly digested, absorbed, and metabolized—has been associated with better glucose control in children and adolescents with type 1 diabetes.177,178 Nevertheless, those with type 1 diabetes should always discuss changes in their diet with their treating physician. For people who are using intensive insulin therapy, it’s important to be as accurate as possible when counting carbohydrates to determine a pre-meal insulin dose. For example, if the dose of insulin is calculated based on a planned meal containing 60 grams of carbohydrates, eating only 40 grams of carbohydrates will result in hypoglycemia, while eating 80 grams will lead to hyperglycemia. For this reason, experts recommend that carbohydrates be counted very accurately, and that the calculated carbohydrate grams be within 10 grams of the actual meal carbohydrate content. Glycemic load values of foods may prove to be more helpful than carbohydrate content for determining insulin doses in the future. Early research suggests monitoring glycemic load in order to calculate insulin doses may lead to slightly less glucose variability than using carbohydrate counting, but more research is needed to verify this as an effective way to calculate insulin needs.179
High-Protein Diet
As much as possible, balance your snacks and meals with carbohydrates, protein, and healthy sources of fat. Including all three macronutrients may help minimize the risk of hypoglycemic events in people who are focused on very tight blood sugar control through intensive insulin therapy.High-Protein DietWhile many people think carbohydrates alone contribute to blood glucose peaks and insulin requirements, in fact, researchers have shown high-protein and high-fat meals cause longer and higher post-meal blood glucose rises and significantly increase insulin requirements in people with type 1 diabetes.180 Because an unbalanced high-protein diet can aggravate compromised kidney function, people with type 1 diabetes should embark on a high-protein diet only under the supervision of a healthcare provider.181
Pick a Pattern
Consult a knowledgeable healthcare practitioner to identify which dietary pattern will work best for you.Pick a PatternBecause current research evidence does not show that there is one ideal eating pattern for all people with diabetes, the American Diabetes Association (ADA) recommends that the percentage of calories from carbohydrates, proteins, and fats be based on an individualized assessment of current eating patterns, preferences, and metabolic goals. Other factors, including food access and the availability of healthful foods, traditions, cultural food systems, health beliefs, knowledge of foods that promote health and prevent disease, and resources to buy health-promoting foods, should be considered as well when determining the best eating pattern to foster good glycemic control and promote health for each person with diabetes. A Mediterranean diet eating pattern, vegetarian or vegan diets, low-fat diets, low-carbohydrate diets, and the Dietary Approaches to Stop Hypertension (DASH) diet, have all been shown to be healthful choices for some people with diabetes, under some circumstances. Rather than a particular dietary pattern, the ADA recommends focusing on features these healthy diets have in common, such as being high in non-starchy vegetables and low in sugar and refined grains and emphasizing whole rather than processed foods. Working with a knowledgeable healthcare practitioner before making any major dietary changes can be help individuals identify which heating pattern is likely to be most beneficial.182
Milk
The relationship between dairy foods (made from cow’s milk) and type 1 diabetes remains unclear, although there is some evidence that these foods may increase the risk of developing type 1 diabetes.MilkShould children avoid dairy foods, especially early in life, to prevent type 1 diabetes? The relationship between dairy foods and type 1 diabetes risk remains unclear, although there is some evidence that milk consumption might increase the risk of developing type 1 diabetes in children who are genetically susceptible to developing the disease. Researchers noted some time ago that worldwide, in places with higher dairy consumption, children have a significantly higher chance of developing type 1 diabetes compared with areas where less dairy is consumed.183 Some research indicates that drinking milk may cause susceptible children to make antibodies that attack the pancreas (autoantibodies), causing type 1 diabetes to develop.184,185 One long-running double-blind, randomized controlled study has been following infants with a higher than average risk of developing type 1 diabetes due to the presence of genetic factors for the disease.186 Infants who were unable to consume breast milk for the first six to eight months of life were assigned to receive either regular cow’s milk infant formula or a casein hydrolysate formula. While casein is found in milk, this second formula is considered more digestible and may be less likely to elicit an immune response, because the casein proteins are hydrolyzed or broken down in this product. Although initial findings from this study were promising, the hydrolyzed infant formula was ultimately not been found to reduce the risk of type 1 diabetes autoantibodies after an 11.5 years of follow up.187 Newer research examining whether a cow’s milk formula that is free of bovine insulin is less likely to trigger autoantibody production in children has reported encouraging findings after three years, but longer observation is needed before conclusions can be reached.188
Because the evidence is conflicting, there are no official guidelines recommending the avoidance of dairy foods (made from cow’s milk) for children at higher than average risk of developing type 1 diabetes. However, if you have concerns about type 1 diabetes, or have a family history of the disease or other autoimmune conditions, such as rheumatoid arthritis or celiac disease, ask your pediatrician about the pros and cons of keeping dairy foods out of your child’s diet for the first few years of life. Dairy can provide valuable nutrients to a child’s diet, including protein, calcium, and vitamin D, so if you decide to avoid it, work with a registered dietitian who can guide you on how best to replace important nutrients with non-dairy options.
Olive Oil
Extra virgin olive oil is a good source of monounsaturated fat. Increasing monounsaturated fats relative to other dietary fats is associated with better blood sugar control and cholesterol levels.Olive OilChanging the overall percentage of calories from fat and carbohydrates in the diets of people with type 1 diabetes can be challenging. However, it is possible to improve the quality of the dietary fat. Increasing monounsaturated fats has been associated with better control of blood sugar and reductions in triglyceride and cholesterol levels in subjects with type 1 diabetes.189,190,191 The best way to incorporate monounsaturated fats into the diet is to use olive oil, especially extra virgin olive oil, which has the highest antioxidant values in addition to monounsaturated fat. Studies have noted that, in people with type 1 diabetes, including olive oil in a meal reduces the after-meal blood glucose spike more than butter.192,193
Low-Sugar
Most doctors recommend that people with diabetes eat less sugary foods like snacks and processed foods and replace these foods with high-fiber, whole foods.Low-SugarCurrently, the American Diabetes Association guidelines do not set specific limits for sucrose—white table sugar—in the diet, because substituting sucrose-containing foods for equal caloric amounts of other carbohydrates may have similar blood glucose effects. However, consumption of sucrose, which is mostly found in less healthy, processed foods, should be minimized to avoid displacing nutrient-dense food choices, such as vegetables, legumes, fruits, and whole grains.194 All people, including those with diabetes, should follow the American Heart Association guidelines that men eat no more than 150 calories, or approximately nine teaspoons, of added sugar per day, and that women eat no more than 100 calories, or approximately 6 teaspoons, of added sugar per day.195