Meal-Planning Methods for Diabetes

By

Cindy Kuzma

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The Diabetes-Depression Connection

Bowl of food

A builder would never start a house without a blueprint. A businessperson needs a strategy to start a successful company. In the same way, if you’ve set your sights on healthy eating and good diabetes management, you’ll need a plan to get you there.

Luckily, you don’t have to start from scratch. Doctors have developed several methods to help you plot out what to eat and when. Each meal-planning tool aims to keep your blood sugar in check and your disease under control. Talk with your diabetes care team to determine which will work best for you.

Making healthy lifestyle choices is key to managing type 2 diabetes, but it can be hard to stay on track. Dr. Anthony Cardillo explains that focusing on diet, exercise and stress reduction can help you maintain control of your diabetes.

Medical Reviewer: William C. Lloyd III, MD, FACS Last Review Date: Aug 13, 2015

2016 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

What is Toujeo® (insulin glargine injection) 300 Units/mL?

Prescription Toujeo® is a long-acting insulin used to control blood sugar in adults with diabetes mellitus.
• Toujeo® contains 3 times as much insulin in 1 mL as standard insulin (100 Units/mL)
• Toujeo® is not for use to treat diabetic ketoacidosis
• Toujeo® should not be used in children

Important Safety Information for Toujeo® (insulin glargine injection) 300 Units/mL

Do not take Toujeo® if you have low blood sugar or if you are allergic to insulin or any of the ingredients in Toujeo®.

Do NOT reuse needles or share insulin pens even if the needle has been changed.

Before starting Toujeo®, tell your doctor about all your medical conditions, including if you have liver or kidney problems, if you are pregnant or planning to become pregnant or if you are breastfeeding or planning to breastfeed.

Heart failure can occur if you are taking insulin together with certain medicines called TZDs (thiazolidinediones), even if you have never had heart failure or other heart problems. If you have heart failure, it may get worse while you take TZDs with Toujeo®. Your treatment with TZDs and Toujeo® may need to be changed or stopped by your doctor if you have new or worsening heart failure. Tell your doctor if you have any new or worsening symptoms of heart failure, including:
• Shortness of breath
• Swelling of your ankles or feet
• Sudden weight gain

Tell your doctor about all medications you take, including OTC medicines, vitamins, and supplements, including herbal supplements.

Toujeo® should be taken at the same time once a day. Test your blood sugar levels daily while using insulin, including Toujeo®. Do not make changes to your dose or type of insulin without talking to your doctor. Verify you have the correct insulin before each injection. Your dose for Toujeo® may be different from other insulins you have taken. Any change of insulin should be made cautiously and only under medical supervision.

Do NOT dilute or mix Toujeo® with any other insulin or solution. It will not work as intended and you may lose blood sugar control, which could be serious. Use Toujeo® only if the solution is clear and colorless with no particles visible.

Toujeo® (insulin glargine injection) 300 Units/mL

While using Toujeo®, do not drive or operate heavy machinery until you know how Toujeo® affects you. Don’t drink alcohol or use other medicines that contain alcohol.

The most common side effect of any insulin, including Toujeo®, is low blood sugar (hypoglycemia), which may be serious and can be lifethreatening. Severe hypoglycemia may cause harm to your heart or brain. Symptoms of serious low blood sugar may include shaking, sweating, fast heartbeat, and blurred vision.

Toujeo® may cause serious side effects that can lead to death, such as severe allergic reactions. Get medical help right away if you have:
• A rash over your whole body
• Shortness of breath
• Swelling of your face, tongue, or throat
• Extreme drowsiness, dizziness, or confusion
• Trouble breathing
• Fast heartbeat
• Sweating

Toujeo® may have additional side effects including swelling, weight gain, low potassium, and injection site reactions which may include change in fat tissue, skin thickening, redness, swelling, and itching.

Toujeo® SoloStar® is a disposable prefilled insulin pen. Talk to your doctor about proper injection technique and follow instructions in the Instruction Leaflet that comes with the pen.

Please see link below for Full Prescribing Information for Toujeo®

Prescribing Information | Important Safety Information
© 2002-2015 sanofi-aventis U.S. LLC. All rights reserved. | US.GLT.15.07.042

Carbohydrate Counting

Foods containing carbohydrates include breads, fruits, beans, dairy products, and starchy vegetables like potatoes and corn. Carbs in particular can have a big effect on your blood sugar. Therefore, tracking how many you consume helps you keep sugar levels within your target range.

Your doctor or dietitian can tell you how many carbohydrates you need each day and how to spread them out to prevent blood-sugar swings. Most people with diabetes should aim for 45 to 60 grams per meal. But your diet may differ based on your weight, how much you exercise, and your diabetes medicines.

From there, plan your meals and snacks to add up to the correct number of carbs. Use food labels to determine how many carbs packaged goods contain. Pay attention to the serving size on the label. For fresh, whole foods, you can estimate based on the portion size. For instance, one half-cup of fresh fruit, one half-cup of beans, or one-quarter of a potato each has about 15 grams of carbs.

The more accurate your count, the better your blood sugar control. Track both your meals and your blood sugar, and over time you’ll improve your ability to estimate how a certain food sways your readings.

The Glycemic Index

All carbohydrates affect your blood sugar, but some send it surging more rapidly than others. These foods rank higher on the glycemic index, or GI. This scale compares a food’s effect on blood sugar to that of white bread or glucose. Whole grains, beans and lentils, and nonstarchy vegetables have a low GI, while white rice and juice sit higher on the scale.

Eating foods lower on the glycemic index, or pairing a high-GI carb with one that’s lower, can help fine-tune your blood sugar control. In most cases, the glycemic index works best when used along with carb counting. Your diabetes care team can help you decide if tracking GI would offer you significant benefits.

Exchange System

Don’t like counting? This list-based system may be best for you. You’ll use a tool called an exchange list, which groups foods together by type, based on the amount of carbohydrates, protein, and fat they contain.

For instance, one vegetable exchange may be either a cup of raw spinach, a half-cup of cooked asparagus, or a half-cup of tomato juice. One starch exchange includes a slice of bread or a half-cup of cooked pasta.

Your doctor or dietitian will give you a set number of exchanges for each meal or snack. For instance, your dinner allowance might include one starch exchange, two of vegetables, and one of meat. A snack portion can include one fruit exchange and one dairy. This way, you can incorporate variety into your diet while still striking the right balance of nutrients. Need help with exchange lists? There are many easy to use and free smartphone apps that make it easy to manage your exchange list.

Create Your Plate

Some people think best in pictures. If that describes you, try this method. It provides you with visual cues for how much of each type of food you need to keep your blood sugar on track.

First, take your typical dinner plate. Draw a line down the center from top to bottom. On one side, draw another line from the center to the edge, to make two equal sections. In the end, you’ll have three sections on your plate, one large and two small.

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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Jun 28, 2015

© 2016 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

View Sources

Medical References

  1. Carbohydrate counting accuracy and blood sugar variability in adults with type 1 diabetes. Brazeau, AS, et al. Diabetes Research & Clinical Practice. Jan. 2013;(99)1:19-23.
  2. Factors influencing medical decision-making. Ashman, E. Neurology. 2012;78(5):e34-5.
  3. Impact of intensive nutritional education with carbohydrate counting on diabetes control in type 2 diabetic patients. Zipp, C. Patient Preference and Adherence. Dec. 2010;30(5):7-12.
  4. What I need to know about Eating and Diabetes. National Diabetes Information Clearinghouse (NDIC). Nov. 27, 2012. http://diabetes.niddk.nih.gov/dm/pubs/eating_ez/index.aspx
  5. Diabetes and Nutrition. American Academy of Family Physicians. October 2010. http://familydoctor.org/familydoctor/en/diseases-conditions/diabetes/treatment/diabetes-and-nutritio...
  6. Carbohydrate Counting. American Diabetes Association. 2013. http://www.diabetes.org/food-and-fitness/food/planning-meals/carb-counting/?print=t
  7. Create Your Plate. American Diabetes Association. 2013. http://www.diabetes.org/food-and-fitness/food/planning-meals/create-your-plate/?print=t
  8. Diabetes Meal Plans and a Healthy Diet. American Diabetes Association. 2013. http://www.diabetes.org/food-and-fitness/food/planning-meals/diabetes-meal-plans-and-a-healthy-diet....
  9.  Glycemic Index and Diabetes. American Diabetes Association. 2013. http://www.diabetes.org/food-and-fitness/food/planning-meals/glycemic-index-and-diabetes.html?print=...;
  10. Eating Right with Diabetes. Academy of Nutrition and Dietetics. November 2012. http://www.eatright.org/Public/content.aspx?id=10748
  11. Diabetes and Diet. Academy of Nutrition and Dietetics. December 2012. http://www.eatright.org/Public/content.aspx?id=6813

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