Eating plans for diabetes and prediabetes management

The number of people diagnosed with diabetes and prediabetes increases each year in the U.S. The disease affects how your body turns food into energy and can result in uncontrolled high blood sugar levels.

What is diabetes?

Diabetes occurs because of the body's inability to make or use enough insulin. Insulin is a hormone produced by the pancreas's islet cells that helps regulate blood glucose (sugar) levels. When insulin levels are low, blood sugar builds up.

There are three main types of diabetes: Type 1, Type 2, and gestational diabetes (diabetes while pregnant). Type 1 diabetes is primarily diagnosed in children and is genetically linked. However, more adults are being diagnosed with Type 1 diabetes later. Type 2 occurs most often in middle-aged and older people and is mainly related to lifestyle factors and genetic predisposition.

Diabetes can affect many body parts, including your brain, heart, skin, kidneys, nerves and ears.

What you eat and when you eat have a significant impact on diabetes and prediabetes.

Keeping a schedule

When you have diabetes, registered dietitians recommend establishing routine times to eat meals and snacks. For example, you could plan for 8:00 AM, 12:00 PM and 6:00 PM for your three main meals, with an even distribution of healthy snacks between the three meals.

New research suggests that establishing a cut-off time for eating at the end of the day can help control blood sugar levels by giving your pancreas, which produces insulin, time to rest.

Time-restricted eating and diabetes

Here’s how it works. Eat healthy meals and snacks between 8 AM and 6 PM or any given eight-to-10-hour timeframe. Then, hold off eating for the next 12 to 16 hours. So, in this case, stop eating after dinner around 6 AM. Have your next meal at 8 AM the following day.

Note: It is important to speak with your healthcare provider before starting a time-restricted eating pattern, as certain medications and insulins may put you at risk for hypoglycemia (low blood glucose) while following this eating pattern.

Health benefits from time-restricted eating include:

• Better insulin sensitivity: The body uses insulin released from the pancreas more efficiently, so less insulin is required to control glucose.
• Lower insulin levels: This helps lead to fewer insulin spikes or surges
• Reduced inflammation: Ultimately, lower circulating insulin could result in less inflammation.

Inflammation in the body can be systemic, possibly impacting heart disease, cancer risk and Alzheimer's disease. When you do not eat, you avoid insulin release from the pancreas, protecting it and reducing its workload.

Meal patterns for diabetes management

Every five years, a group of experts with the American Diabetes Association (ADA) examines nutrition guidelines for patients with diabetes and prediabetes in depth. They currently recommend seven key meal patterns that can help manage diabetes.

These plans are not “diets” in that they are not temporary or designed to “cut out” types of food entirely. Instead, they focus on a long-term, healthier approach to eating.

You should talk with your healthcare provider or a registered dietitian before choosing a meal pattern that best suits your needs and health goals.

• Mediterranean-style meal pattern: This plan emphasizes plant-based foods, fish and other seafood. It recommends olive oil as the primary source of dietary fat and limits dairy and red meat intake.
• Vegetarian or vegan meal pattern: This is a plant-based approach excludes animal-based products (for vegans), and meats, seafood and poultry. It includes eggs and/or dairy products for those who take a vegetarian approach.
• Low-fat meal pattern: This meal plan focuses on vegetables, fruits and carbohydrates that include high amounts of fiber, lean protein sources (including beans) and low-fat dairy products.
• Very low-fat meal pattern: Similar to above, but this pattern comprises 70-77% carbohydrates and less than 10% total calories from fat.
• Low carbohydrate meal pattern: This pattern reduces carbohydrates to 26-45% of the total calories per day. This is accomplished by focusing on non-starchy vegetables, healthy fats and protein in the form of meat, poultry, fish, shellfish, effs, cheese, nuts and seeds.
• Very low carbohydrate meal pattern: This meal pattern is similar to the low-carbohydrate pattern but with more limits on carbohydrate-containing foods.
• Dietary approaches to stop hypertension (DASH) meal pattern: This pattern highlights eating vegetables, fruits, low-fat dairy products, whole grains, poultry, fish and nuts. It also focuses on reduced saturated fat, red meats, sweets and sugar-containing beverages.

Sentara diabetes services

• The Sentara diabetes prevention program is for individuals at risk of developing Type 2 diabetes or who have prediabetes.
• Sentara offers diabetes and nutrition support with our registered dietitians to help you make thoughtful dietary decisions, keep your blood sugar within a healthy range and effectively manage diabetes.
• The Sentara diabetes fitness program at Sentara therapy centers provides personal evaluations and prescribed exercise programs to people diagnosed with diabetes or prediabetes.