My Eating Plan for Living With Type 1 Diabetes and RA

Patient Expert
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When you have rheumatoid arthritis (RA) and diabetes, food can be the common pleasure and sometimes enemy of both conditions. We all must eat to survive, and yet those of us with chronic conditions may find that food is as much of an issue as the disease(s) we manage.

The human body needs carbohydrates for energy. People with diabetes all share the same basic issues, how to survive when our bodies do not process carbohydrates, but use different diets and methods to live healthy lives. Some use ultra-low carbohydrate diets, usually referred to as a Bernstein diet. But no two people likely do the same thing because our body’s method of processing carbohydrates is different.

Using insulin is an imprecise activity at best. That means that with type 1 diabetes, I constantly have access to both insulin (in case my blood sugar goes high) and quick acting glucose in case it goes low. Both conditions can be deadly. For that reason, I always have my pump with insulin and quick acting glucose. The plan is for me to treat these conditions before others have to assist.

My quick acting glucose of choice is a white powder that tastes like cherry. My other two choices are orange cream and chocolate marshmallow tablets. While some are better than others, none of these taste very good. I also make sure I have syringes and a vial of insulin within two hours of anywhere I go. I use this in case of a pump or calculation failure.

As my diet has to be suitable for both RA and diabetes, I tend to eat foods that are close to a Mediterranean diet, and look for foods to minimize inflammation and manage protein, fat, and carbohydrates. We normally cook with olive oil as it is low in fast acting carbohydrates.

Eating in this way means that I do not add sugar, and I limit rice and starchy food like potatoes and pasta.

While many people with chronic illnesses respond to different food differently, here’s a quick peek at what my daily food intake looks like.

Breakfast

I use short-acting insulin in a pump. That allows for fewer food restrictions than other treatments. For me, the most challenging meal is breakfast. The typical North American breakfast is high in carbohydrates and fat. High-fat foods slow digestion, thus making how and when I use fast acting insulin difficult. I also love oatmeal, a high carbohydrate, slow-digesting food. My current go-to breakfast is one serving of instant oatmeal, which is low in carbohydrates and fat.

Food geared toward weight loss can help you get out of the door quickly with a minimal amount of carbohydrates (I look for less than 20 grams in the morning). Make sure you look at the fat content, as many products contain higher levels of fat, which make the digestion of the carbohydrates I need to get the day going a bit uneven. In an ideal world, my body would process carbohydrates evenly or at least in a predictable manner so I could give insulin appropriately. This almost never happens.

Lunch

For lunch, we like to eat light, so we typically chose a homemade egg salad on low carbohydrate bread, with fresh vegetables. If there is one overarching thing we try to accomplish in our diet, it is to add fresh vegetables and fruits. When we go shopping, between 25 and 30 percent of our grocery budget is spent on fresh produce. I love roasted vegetables, and it is easy to add small bit of olive oil and seasonings. Roasted vegetables at our house often includes cauliflower, onion, carrots, asparagus, and Brussels sprouts.

People often ask if having items such as bananas or other sweets around the house tempts me to stray from my diet. It does not. If I must have a sweet dessert, I satisfy that urge with a bite. I learned long ago that the first taste of any food for me is usually the best. Over the years, my desire for highly sweetened foods has changed to the point that if food is very sweet, it no longer tastes appealing to me. Even foods others say are bland is often too sweet for my taste.

Dinner

Like most American families, we dine out often for dinner, often at our favorite BBQ place. Smoked turkey is a great satisfying meal paired with green beans and a side salad.

You can still pick healthy options while eating out: keep to lower fat content and reduced sugar foods when selecting from the menu. Get that side salad instead of French fries. Pick a dish sautéed in olive oil instead of cream or butter.

We should always keep in mind that food is more than a matter of nutrition. It involves cultural and communal choices. So the tastes and preferences of my partner is as much a part of my food plan as what I might choose to eat individually. After 40 years of marriage, my food choices are really our food choices, and we choose food together based on our desire to continue to live a healthy life.