On the Menu: the right kind of sweet for type 1 diabetes
Sugar intake does not cause type 1 diabetes but artificial sweeteners are more gentle on blood glucose levels
Apple sauce cinnamon muffins. Photograph: Aidan Crawley
Spicy Indian fish bake. Photograph: Aidan Crawley
Children hate to be different. The diagnosis of type 1 diabetes may leave them wondering: “Why me – did I eat too much sugar?” In fact, entire families can feel shaken and flummoxed initially. “Will the child be able to eat what the rest of the family is eating? What can they not eat? What about their favourite foods? Are there special diabetic foods to buy?”
Eating sugar is not the cause of type 1 diabetes. It’s an autoimmune condition. However, people with type 1 diabetes need to be more careful about their intake of sweet foods because different foods affect the blood sugars in distinct ways.
The big challenge is to understand how sharply different foods affect your blood glucose level, and how to balance the amount of carbohydrate with the right amount of insulin. This takes time, practice and patience.
Blood glucose testing can help you understand the dynamics of how what you eat affects your blood sugar levels. Testing your blood sugar before a meal and at intervals of two to four hours after eating is a great way to see how your blood sugar responds.
Some people may want to reduce their carbohydrate intake to help minimise swings in blood glucose levels. Your diabetic nurse can help you do this safely, by adjusting your insulin to match your reduced carbohydrate intake.
Changes can result in hypoglycaemia if doses are not matched correctly, so it’s important to discuss significant dietary changes with your hospital dietitian.
Learning to count your carbohydrates plays a key role in helping you balance your insulin with the food you eat. There are excellent courses such as DAFNE (dose adjustment for normal eating) available. Ask your specialist dietitian for details. Another excellent resource is the book and phone app called Carbs and Cals. Buy the UK edition if you order on Amazon. This is a fantastic visual illustration of how many carbohydrates there are in a wide variety of meals and portion sizes.
Fresh is best
Limiting processed foods is important, and trying to include home-prepared or freshly prepared food wherever possible is of huge benefit. People with types 1 and 2 diabetes may want to use alternative sweeteners in home baking to help curb their cravings for sweet treats. That may tick the taste box, but it’s important to remember that many foods containing artificial sweeteners still have calories and carbohydrates.
Stevia, also referred to as rebaudioside A, is getting a lot of attention recently. It’s a new type of “natural” sweetener derived from the stevia leaf, a plant native to Central and South America.
It is 200-300 times sweeter than sugar, although some of its extracts may have a bitter or liquorice-like aftertaste. The fact that it differs from artificial sweeteners, as it is made from a natural plant source, makes it an attractive alternative for diabetics and parents. I hesitate to use the word “unprocessed”, though, as obviously the sweetener has been processed into a powder or liquid form.