Diet and type 1 diabetes

A healthy diet means having a balance of protein, carbohydrates and fat. It’s important to include plenty of vegetables and fruit. A healthy diet is recommended for everyone. However, the most important thing for diabetics to consider is whether foods have carbohydrates in or not. It’s also important to be aware how quickly the carbohydrates are absorbed by the body. Understanding these things make it easier to know when and how much insulin to inject to cover the carbohydrate in whatever you are eating.

Foods like bread, pasta, and rice are high in carbohydrates, but it’s also important to remember that many fruits also contain a lot of carbs. If you are eating a meal with a lot of carbohydrate, you will need to inject more insulin to cover it. If you are eating something with little or no carbohydrate, you may need to avoid taking any quick-acting insulin at all.

Once an insulin regime is established it is possible to include such things as chocolate or a dessert so long as it is possible to work out the extra insulin that’s needed to cover them.

Says that his diet is healthy and that the main change he had to make after diagnosis was not…

Age at interview 16

Gender Male

Age at diagnosis 11

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He says that his family always ate healthily and that the main change was to eat regular meals…

Age at interview 20

Gender Male

Age at diagnosis 10

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Type 1 diabetes and coeliac disease sometimes occur together and therefore patients with diabetes are sometimes screened for coeliac disease shortly after diagnosis. The test is done by measuring a particular type of antibodies (antiendomysium). One young woman we spoke to had been diagnosed with coeliac disease.

She is restricted in the choice of carbohydrates she can eat following a diagnosis of Coeliac…

Age at interview 17

Gender Female

Age at diagnosis 12

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In general the young people we talked to felt that they had a healthier lifestyle than other young people their own age group who weren’t diabetics. They feel that one positive outcome of their diabetes is their healthy outlook to diet and lifestyle in general. Many young people diagnosed during their teens said that they’ve made changes to their diet and life style. They hadn’t realised how unhealthy their lifestyle was until then. Many had given up smoking and cut down on ready meals, while eating more vegetables and fruit and taking more regular exercise.

A talk with the dietician made her realise that her diet was unhealthy and that some changes…

Age at interview 19

Gender Female

Age at diagnosis 17

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She dislikes vegetables and has the impression that healthy eating is expensive.

Age at interview 19

Gender Female

Age at diagnosis 3

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Food and insulin

The type of insulin regimen that you are on influences the kind of eating routine you have. Those on 2 injections a day said that they have to have fixed meal times and remember having to have their insulin injections 20 minutes before eating. People thought the main disadvantages of this regimen was the rigid meal time routine and having to eat snacks in between meals even when they’re not hungry. Those who were on this regimen since childhood describe their childhood diet as ‘very restricted’. Some remember that they were only allowed to have sugar when doing PE at school. Some young people, however, preferred this routine because it provides a structure to their day and they find that it is easier this way to remember to take their insulin.

Describes his fixed routine as a pain but at the same time recognises that it has made his life…

Age at interview 17

Gender Male

Age at diagnosis 14

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In her early teens she found it difficult to have the snacks required by her fixed insulin…

Age at interview 20

Gender Female

Age at diagnosis 2

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Most of the young people we talked to were on a combination of long-acting and short-acting insulins. They inject the long acting insulin in the morning or before they go to bed and take an appropriate dose of the short acting insulin each time they have something to eat. Young people find that this regimen gives them much more flexibility about mealtimes, suits their lifestyle better and allows them to control their diabetes better. A number of young people, however, pointed out that the sense of freedom they find with this regimen can also bring problems. For instance, some young people found that they started eating more sugary and/or fatty food. (See also ‘Finding the right insulin regimen for you‘, ‘Insulin Pumps’ and ‘Obesity and other eating problems’.)

Says that the fast-acting insulin works ‘fantastically’ well for him. And thinks that a fixed…

Age at interview 24

Gender Male

Age at diagnosis 16

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Physical activity and carbohydrates

Young people who do physical work or are engaged in exercise on a regular basis said that they tend to need a diet that is high in carbohydrates. Some young people noted that a reduction in physical activity and/or an increase in eating sugary or fatty food will affect their weight and overall control. (See also ‘Obesity and other eating problems’.

He has a diet high in carbohydrates because his job is very active and he plays football once a…

Age at interview 19

Gender Male

Age at diagnosis 14

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In his teens he was eating a lot but did not have a weight problem because he was doing lots of…

Age at interview 23

Gender Male

Age at diagnosis 7

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Carbohydrate and insulin ratio

Young people said that in addition to eating the right type of food the key to a good control is to fix the insulin dosage around what you are eating. Most of the young people we talked to know about carbohydrate counting but few felt the need to apply it rigorously to calculate the carbohydrate/insulin ratio of each meal. Many young people do ‘well-informed guesswork’ and said that they have learned through ‘trial and improvement’. (See also ‘Insulin pumps’.)

He has learned to do the carbohydrate/insulin ratio by ‘trial and improvement.

Age at interview 24

Gender Male

Age at diagnosis 16

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A few of those we interviewed consider themselves lucky because they have been able to attend training sessions to help them calculate more accurately the carbohydrate/insulin ratio. They said that participation in training courses such as DAFNE (Dose Adjustment for Normal Eating), TIFA (Torbay Insulin and Food Adjustment) and Insight has made them more confident in solving problems regarding food and insulin dosage (see also Patient education courses‘).

She found the TIFA training course most helpful because now she knows what to do when she has…

Age at interview 19

Gender Female

Age at diagnosis 3

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Glycaemic index (GI) diet and diabetes

Some of the young people mentioned the GI (glycaemic index) diet and how they and their parents became interested in finding out more about the effects that certain types of foods have on blood glucose. They learned that certain foods will make your blood glucose go straight up and then an hour later it will go straight down again and cause you to have a hypo. Other foods such as brown rice or brown bread have a very long-lasting effect but it is very gradual. Eating a mixture of rapidly absorbed with slowly absorbed carbohydrates gives you better control over your diabetes. Some young people are routinely including low GI (glycaemic index) food in their diets. One young woman indicated that she could see the benefits of a GI diet as she began to achieve a smoother control of her blood glucose level as well as losing weight over a period of time.

Explains what a GI diet is and what benefits she has had from it.

Age at interview 17

Gender Female

Age at diagnosis 2

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Illness and diet with type 1 diabetes

The young people we talked to emphasised that having regular meals does help to keep blood glucose under control. They described how that control is ‘messed up’ when you are ill and don’t feel like eating.

Talks about what he does on those occasions that he is ill and cannot eat regular meals.

Age at interview 16

Gender Male

Age at diagnosis 11

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