Type 1 Diabetes

  • Lifestyle Changes


    Good nutrition and regular exercise can help prevent or manage medical complications of diabetes (such as heart disease and stroke), and help patients live longer and healthier lives.

    Diet

    There is no single diabetes diet. Patients should meet with a professional dietitian to plan an individualized diet within the general guidelines that takes into consideration their own health needs.

    Healthy eating habits, along with good control of blood glucose, are the basic goals, and several good dietary methods are available to meet them. General dietary guidelines for diabetes recommend:

    • Carbohydrates should provide 45 - 65% of total daily calories. The type and amount of carbohydrate are both important. Best choices are vegetables, fruits, beans, and whole grains. These foods are also high in fiber. Patients with diabetes should monitor their carbohydrate intake either through carbohydrate counting or meal planning exchange lists.
    • Fats should provide 25 - 35% of daily calories. Monounsaturated (olive, peanut, and canola oils; avocados; and nuts) and omega-3 polyunsaturated (fish, flaxseed oil, and walnuts) fats are the best types. Limit saturated fat (red meat, butter) to less than 7% of daily calories. Choose nonfat or low-fat dairy instead of whole milk products. Limit trans-fats (hydrogenated fat found in snack foods, fried foods, and commercially baked goods) to less than 1% of total calories.
    • Protein should provide 12 - 20% of daily calories, although this may vary depending on a patient’s individual health requirements. Patients with kidney disease should limit protein intake to less than 10% of calories. Fish, soy, and poultry are better protein choices than red meat.
    • Sodium (salt) intake should be limited to 1,500 mg/day or less. Reducing sodium can help lower blood pressure and decrease the risk of heart disease.

    [For more information, see In-Depth Report #42: Diabetes diet.]

    Healthy Weight Control

    Weight gain is a potential side effect of intense diabetic control with insulin. Being overweight can increase the risk for health problems. On the other hand, studies suggest that more than one-third of women with diabetes omit or underuse insulin in order to lose weight. Eating disorders are especially dangerous in patients with diabetes and can increase the risk for diabetic ketoacidosis. Ketoacidosis is a significant complication of insulin depletion and can be life threatening.

    Exercise

    Aerobic exercise has significant and particular benefits for people with type 1 diabetes. It increases sensitivity to insulin, lowers blood pressure, improves cholesterol levels, and decreases body fat. Because glucose levels swing dramatically during workouts, people with type 1 diabetes need to take certain precautions:

    • Monitor glucose levels carefully before, during, and after workouts.
    • Avoid exercise if glucose levels are above 300 mg/dL or under 100 mg/dL.
    • To avoid hypoglycemia, patients should inject insulin in sites away from the muscles they use the most during exercise.
    • Before exercising, avoid alcohol and if possible certain drugs, including beta blockers, which make it difficult to recognize symptoms of hypoglycemia.
    • Insulin-dependent athletes may need to decrease insulin doses or take in more carbohydrates, especially in the form of pre-exercise snacks. Skim milk is particularly helpful. They should also drink plenty of fluids.
    • Good, protective footwear is essential to help avoid injuries and wounds to the feet.

    Avoid resistance or high impact exercises. They can strain weakened blood vessels in the eyes of patients with retinopathy. High-impact exercise may also injure blood vessels in the feet. Because patients with diabetes may have silent heart disease, they should always check with their doctors before undertaking vigorous exercise.

    Warning on Dietary Supplements

    Various fraudulent products are often sold on the Internet as “cures” or treatments for diabetes. These dietary supplements have not been studied or approved. The US Food and Drug Administration (FDA) and Federal Trade Commission (FTC) warn patients with diabetes not to be duped by bogus and unproven remedies.