Square Meals vs. Mini Meals
I've been thinking lately about the advantages and drawbacks to eating three "square" meals per day versus six "mini" meals for my diabetes management.
As a diabetic, and particularly during my pregnancy, I cemented an eating pattern of several mini meals each day. I found that it kept the morning sickness at bay, plus helped me achieve the blood glucose control I desired. Also, it kept me from getting overly hungry.
A few weeks ago, at my first appointment with a new endocrinologist, the doctor pointed out a disadvantage of the mini meal approach. He mentioned that I could better gauge the accurateness of my meal boluses if I ate three times per day. I countered with some of the advantageous aspects of mini meals. Apparently, some of his patients are not diligent about bolusing for their snacks, thus he generally encourages diabetics to avoid eating between meals. He acknowledged that since I do bolus appropriately each time I eat, then the mini meal plan is great.
So, I'm continuing to eat roughly six meals of 300-350 calories each. The advantages to this system are many:
First of all, it's easier to avoid overeating because I never allow myself to get too hungry. Since I'm not ravenous when it's time to eat, I can eat a modest portion without requiring a lot of self-control. Last weekend, my husband and I stopped in at a local Mexican food place that's famous for its fish tacos. Rather than ordering the combo plate (which used to be my standard order) I just got one fish taco, which is exactly 300 calories. It fit perfectly into my meal plan!
I actually need less insulin when I eat more often. The concept of stacking insulin can be used to your advantage, if you're aware of it. By bolusing about every three hours, I still have bolus insulin-on-board from my previous mini meal. Thus, I don't need as much insulin to cover whatever I'm eating next. For example, if I had a banana with peanut butter (my favorite!) and then had half a tuna sandwich 2 ½ hours later, I'd need less than one unit of insulin to cover the sandwich. However, if the gap between meals was closer to 4 or 5 hours, I'd likely require 1 ½ units of insulin. Less insulin is always a good thing.
On the other hand, my endocrinologist did point out a legitimate drawback of eating several times per day. It can be difficult to gauge which food item, bolus rate, or basal rate is the offending variable when my blood sugar goes out of range. If I ate larger meals, separated by several hours, I could carefully observe how my blood sugar reacted to that particular meal. In between meals, one could witness the effectiveness, or lack thereof, of their basal rate.
This seems to be a minor issue, since typically my blood sugar runs lower when I stick to my mini meal approach. Also, basal rate checks can be employed by fasting for several hours, thus more accurately assessing my basal rates.
What do you think? Do you eat square meals or mini meals? What other disadvantages or advantages do you notice?