Diabetes and Mindful Eating

How can I eat what I love when I have diabetes?

By Michelle May, M.D.
Co-Author of Eat What You Love, Love What You Eat with Diabetes

"I love sweets! How can I eat what I love when I have diabetes?" This common question underscores a common misconception about diabetes. The old myth that eating sugar causes diabetes and must be avoided when you have diabetes is a misunderstanding about the nature of the problem.

To help you understand the importance of learning to eat what you love, consider this interesting report published in the Archives of Internal Medicine called "Association Between More Frequent Chocolate Consumption and Lower Body Mass Index" (Golomb et al). They speculated that maybe chocolate had some physiological effect on weight but I have a different theory:

People who eat what they love (in this case, chocolate) don't feel deprived. Therefore, they enjoy their favorite foods in moderation and therefore maintain a healthier weight. And, if they have diabetes, they should also be better able to maintain their glucose in the target range.

So the short answer is, yes, you can eat sweets even if you have diabetes. The full answer requires a little more information which I'll summarize here (of course, there's a lot more detail in Eat What You Love, Love What You Eat with Diabetes):

• Carbohydrates have the greatest effect on blood glucose levels
• The total amount of carbohydrate you consume at each meal or mini-meal is important when you have pre-diabetes or diabetes
• A typical range to begin with is between 45-60 grams of carbohydrate per meal for women, 60-75 grams for men, with 15-30 grams for a snack. Follow your health professional's recommendations and monitor your blood glucose to determine the optimal range for you.
• Sugar is a carbohydrate
• Grains and grain products, starchy vegetables, fruit, and dairy are also carbohydrates
• Restriction can lead to feelings of deprivation, cravings, overeating, guilt, and more overeating
• Therefore, if you love sweets, it is wise to determine how to include them in your total carbohydrate intake rather than restricting, then overeating, them!

Why Do Blood Glucose Levels Continue to Rise?

By Megrette Fletcher M.Ed, RD, CDE 
Co-Author of Eat What You Love, Love What You Eat with Diabetes

It happens when the seasons change. One after another, my clients say, “Well, I expected my blood sugars to be higher in the winter, but now that it is spring, I just thought they would go down.” 

We talk about how to problem-solve changes in blood glucose readings in Chapter 18 of Eat What You Love, Love What You Eat with Diabetes . Elevated blood glucose typically has seven causes: 

• Changes in eating 
• Changes in physical activity
• Changes in medications
• Over-treatment of a low blood sugar
• Side effects in medications 
• Illness
• Progression of diabetes

In this blog post, I will explore the progression of diabetes. Many people assume that once their blood glucose levels have stabilized, their diabetes is all set – forever. Type 2 diabetes is a problem of both insulin resistance and a decrease in insulin production.  Unfortunately, diabetes always changes, and one of these changes includes a decline in the body’s ability to make insulin. 

Insulin, which is produced in the pancreas, can be thought of as a key that allows energy in the form of glucose to enter the cells. As diabetes progresses, the body’s ability to produce insulin decreases.    

How Mindful Eating Helps

When individuals with prediabetes or diabetes stop chronically overeating, they are not asking the pancreas to make as much insulin. This helps preserve the insulin production and ultimately slows the progression of the disease. 

Yet moderation can be a challenge. A great place to start is by asking, “Am I hungry?” If you realize you are hungry, ask, “How much food do I need to eat for this level of hunger?” When you establish a clear intent to satisfy, but not overshoot your level of hunger, you break the Overeating Cycle described in Chapter 1 of Eat What You Love, Love What You Eat with Diabetes.  

Mindful eating brings freedom to food and eating choices. For example, say Susan realizes she is at a hunger level of 2, which we describe as “starving.” Susan admits that there is “no way!” that 45 grams of carbohydrates, which is about 1 cup of tortellini, will satisfy her level of hunger. Remembering that mindful eating isn’t about restriction, she explores other choices to satisfy her hunger. (How do you use MyPlate when you have diabetes?) She decides to have the tortellini as part of a larger salad, adding diced chicken, tomatoes, carrots, broccoli and peppers to the meal. These other choices do not contain a significant amount of carbohydrates so they do not require the body to use more insulin.

Looking at her plate, Susan notices that by adding a greater variety of foods to the meal, she had plenty to eat, while still managing her carbohydrate intake. Recognizing hunger and fullness is an invaluable tool and the first step to breaking free of the Overeating Cycle.