Understanding diabetes and the impact of food on your glucose levels is an important part of diabetes management. There is no specific diet one should follow when living with diabetes; however, different foods can impact glucose levels in different ways. Food planning, understanding carbohydrate intake and regularly monitoring blood glucose levels are all important when managing diabetes.
Carbohydrate counting is an approach to meal planning. When mastered, it allows you to closely match insulin needs and gives enhanced freedom in food choices.
When I was diagnosed, my HbA1c was 11% (97 mmol/L). I started with MDI and I was not counting carbs, so I had to eat the same quantity of carbs and vegetables every day, which was pretty boring. When I began carbohydrate counting, my daily life improved. Then, when I started on an insulin pump it was obvious to me that my control was better than with MDI. After 3 months my HbA1c dropped from 8% to 5.6%! Now, I eat normal meals like everyone else, and when I go to a restaurant I order what I like. When my dish arrives, I just add the necessary bolus without having to inject myself. Being on a pump definitely gives me better control over my diabetes!
All food falls into three main nutrient categories: protein, fat or carbohydrate. Out of the three, the main nutrient which affects blood glucose (sugar) levels is carbohydrate. When carbohydrate is digested it is turned into glucose. Glucose enters the bloodstream and causes blood sugar levels to rise, usually 15 minutes after eating, depending on the type of food. Insulin is then required to allow sugar in the form of glucose to move from the bloodstream into cells for energy.
Knowing how to calculate the amount of carbohydrate in food makes it easier to match the amount of insulin needed. This is known as carb counting.
What foods contain carbohydrates?
- Starches: Breads, cereals, crackers, rice, pasta and grain
- Starchy vegetables: Potatoes, peas, beans and corn
- Fruit and fruit juices
- Milk and yoghurt
- Sweets: Honey, table sugar, syrup, jelly, sweets, sport drinks, cookies, cakes, pastries, ice cream and pudding
Two methods of counting carbohydrates:
- Carbohydrate Exchange System
This is a system based on counting servings of food that contain 10 grams of carbohydrate. Each 10 gram serving is equal to one exchange/carbohydrate choice/carbohydrate portion.
- Carbohydrate Gram Counting
This is a system based on weighing and calculating the exact number of grams of carbohydrate in each meal. Weighing scales, food labels, food lists and meal planning books are good tools for carbohydrate gram counting.
A slice of bread is very different in France than in the US or in Nepal. Thanks to my pump, I can adjust my bolus which makes it easier. - DELPHINE
KEEPING BLOOD GLUCOSE LEVELS UNDER CONTROL
After eating, food is broken down into glucose which is needed to give the body energy for all daily activities. Our bodies also need insulin, normally produced by the pancreas, to help transfer glucose from the bloodstream to the cells. When the pancreas does not produce insulin the glucose will remain in the blood, leaving cells without any energy. These high glucose levels in the blood cause the more acute clinical signs and symptoms of diabetes. To treat diabetes it is important to take into consideration many factors in its management, including blood glucose monitoring, carbohydrate intake, physical activities and insulin requirements to ensure good blood glucose control and to reduce the risk of complications.
Alcohol can alter blood glucose levels, or potentially increase the risk of hypoglycaemia. It is important to understand the amount of carbohydrates in each drink, as this can vary depending on alcohol type and mix. It is important to monitor glucose levels before, during and after drinking alcohol.
Hypoglycaemia (“hypos”) refers to when blood glucose levels fall below 3.5 mmol/L, although the exact figure can vary between individuals. In the case of mild hypoglycaemia, symptoms are felt, and action can be taken to prevent it becoming worse by eating or drinking something containing carbohydrates. Severe hypoglycaemia requires assistance from another person and may need hospital treatment.
It can be a challenge to reach and maintain the HbA1C goal whilst minimising the risk of hypoglycaemia. However, by understanding the body’s needs and learning how to keep blood glucose within recommended levels, it is possible to manage diabetes effectively.
HbA1c: an important measure of how effectively diabetes is being managed using a measure of the amount of glucose that has attached itself to each red blood cell over the preceding 2 to 3 months to assess the level of diabetes control.
So, as someone living with diabetes,
how can I better manage my glucose control when eating?
Diabetes, eating and insulin pumps
Food plays a central role in diabetes management and keeping blood glucose levels under control. With Multiple Daily Injections (MDI) it can be more difficult to manage delayed meals, skipped meals or diverse diets. With an insulin pump, eating can be easier and meal types and timing more flexible.
An insulin pump is a small device, about the size of a mobile phone, that can be easily carried on a belt, inside a pocket, or even attached to a bra. An insulin pump can help you and your healthcare team to more closely mimic the way a healthy pancreas delivers the basal insulin to the body by providing small amounts of rapid acting insulin during the day and night. It can help to better manage the need for insulin dose adjustments, particularly after meals and overnight, and can thus help to achieve better glucose control.
Clinical studies* confirm that many Type 1 patients of various ages who switch from MDI to insulin pump therapy report improvements in their quality of life and increased satisfaction with their treatment.
"When I started MDI, I had 2 injections of long-acting insulin at fixed times so I had to get up early even during weekends. For my meals, as I was not carb counting, I had to eat the same quantity of food and vegetables every day. It was pretty boring. To be honest, now that I’m doing carb counting and that I use the Bolus Wizard™ on my pump, I can’t even imagine how I did it before!" - FABIENNE
HOW DOES THE MINIMED™ 640G INSULIN PUMP HELP CONTROL GLUCOSE LEVELS?
The MiniMed™ 640G insulin pump allows for better glucose control due to the ability to adjust insulin delivery, reducing the risks of hypers and hypos. With insulin pump therapy users can benefit from:
Calculating insulin requirement can be a complex task with many different aspects to be considered. As part of the MiniMed™ 640G insulin pump, the built-in Bolus Wizard™ feature helps to ensure more accurate dosing by taking into account the insulin already in the body, current glucose levels, carbohydrate intake and personal insulin settings.
Precise amounts of rapid acting insulin are delivered throughout the day by the infusion set which is easily removed and replaced every 2 to 3 days.
The MiniMed™ 640G insulin pump can be instantly adjusted to allow for exercise, during illness or to deliver small boluses to cover snacks. This can be easily done with a touch of a button, rather than with another injection. There is even a temporary basal rate option to proportionally reduce the basal insulin rate, an option that can be used during exercise, for example.
The MiniMed™ 640G insulin pump offers the additional convenience of a wirelessly connected blood glucose meter. This meter automatically sends blood glucose values to the pump, allowing more accurate Bolus Wizard™ calculations. It also stores this information in a digital diary along with your insulin doses.
IS AN INSULIN PUMP RIGHT FOR ME?
Many people with Type 1 diabetes may benefit from an insulin pump without even knowing it. In general if you experience any of the following, you could get better control with an insulin pump:
- Concerns about long-term complications
- The first symptoms of long term complications
- Fear of needles
- Difficulty in managing highs and lows
- Fear of hypoglycaemia, especially at night and after sports
- Outside targeted HbA1c levels
- Reduced hypoglycaemia awareness
- Seeking more flexibility in everyday life
The best way to stay within a healthy glucose range is to self-monitor blood glucose (SMBG) at least 4 times per day and make adjustments to the therapy as needed. The MiniMed™ 640G insulin pump with the use of the Bolus Wizard™ can make these calculations and adjustments to help improve glucose control.
ADDITIONAL OPTIONS AVAILABLE WITH THE MINIMED™ 640G INSULIN PUMP
When coupled with CGM, the MiniMed™ 640G insulin pump is currently the only insulin pump with the SmartGuard™ feature which may help reduce the impact of hypoglycaemia* if glucose levels fall dangerously low, SmartGuard™ can predict when you are approaching lows 30 minutes in advance and automatically stop insulin delivery. When your glucose levels recover, it will automatically resume insulin delivery. This could be a big advantage over SMBG because the MiniMed™ Integrated System alerts you prior to crossing pre-set threshold limits, as well as showing current glucose trends.