A healthy diet is one which consists of an appropriate balance of protein, carbohydrates and fat. Recent research has highlighted the importance of including plenty of vegetables and fruit in one's diet. Such a healthy diet is recommended by experts for everyone, whether they have diabetes or not. Therefore the diet eaten by someone with diabetes need be no different from a healthy diet for anyone else and can be shared with the rest of the family. What however is particularly important in the diabetic diet is that meals are regular, that they include starchy foods (e.g. potatoes, bread pasta etc) that they avoid sugar (in drinks, sweets cakes etc) and that they are low in animal fats. 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 calculate the extra insulin that is needed to cover them at the time. 

Says that his diet is healthy and that the main change he had to make after diagnosis was not what to eat but when to eat.

He says that his family always ate healthily and that the main change was to eat regular meals and include carbohydrates in all of them.

One young woman was diagnosed with coeliac disease after being screened for the condition. Type 1 diabetes and coeliac disease sometimes occur together and therefore patients with diabetes are usually screened shortly after diagnosis, for coeliac disease by measuring a particular type of antibodies (antiendomysium).

She is restricted in the choice of carbohydrates she can eat following a diagnosis of Coeliac disease (needs a gluten free diet). Despite this her diet is healthy.

In general the young people we talked to feel that they have a healthier lifestyle than other young people their own age group who are not 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 indicated that they have made changes to their diet and life style, indicating that until then they hadn't realised how unhealthy their lifestyle was. Many reported having given up smoking, and cut down on ready to eat meals, while eating more vegetables and fruit and taking more regular exercise. 

A talk with the dietician made her realised that her diet was unhealthy and that some changes were needed.

Not everyone who talked to us felt happy about eating just health food. Many young people insisted that you can eat everything but in moderation. Having a pizza, chips or a burger is something that young people wanted to be able to do in the company of friends. Moreover, one young woman pointed out that a healthy diet can be expensive and that not everyone has the money to buy from health food shops.

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

Food and insulin

The type of insulin regimen that you are on influences the kind of eating routine you have. Those on two injections a day indicated that they have to have fixed mealtimes and remember having to wait 20 minutes or so after an insulin injection before eating. But the main disadvantages mentioned are the rigid meal time routine and the snacks in between meals that have to be eaten even when you are 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, prefer this routine because it provides a well organised 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 easier. Before he was forgetting to do his injection every time he ate.

In her early teens she found it difficult to have the snacks required by her fixed insulin regimen. She felt that she was always having to eat and developed an eating problem.

Most of the young people we talked to are currently 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' and 'Obesity and other eating problems'.) 

Says that the fast-acting insulin works 'fantastically' well for him. And thinks that a fixed insulin regimen is most inconvenient if you are at university.

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 week. Says that he recently let his diet slip a little bit.

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

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 'Finding the right insulin regimen for you.')

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

A few respondents 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.

She found the TIFA training course most helpful because now she knows what to do when she has problems regarding food and insulin dosage.

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 have 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 GI (glycaemic index) food in their diets (see Diabetes UK website). 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.

Illness and diet

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.

There are five illness 'rules' that every type 1 diabetics needs to follow in order to cope with an illness:

• First, you should never stop taking your insulin.
• Secondly, you should check your blood glucose every 2 to 4 hours and if you cannot do it yourself ask a relative or friend to help.
• Third, use Ketostix to test your urine. If you have ketones it is likely that you are lacking in insulin. Please do not ignore this because ketoacidosis may develop. Diabetes ketoacidosis is serious and needs immediate treatment.
• Fourth, take at least five pints of sugar free liquids specially water and particularly if you have a temperature or diarrhoea or vomiting because you can easily become dehydrated.
• Fifth, try to eat your normal diet but if you are unable to do this, replace your meals with sugary fluids such as milk, fruit juice, flat lucozade or cola.

For more information see Diabetes UK website.

Last reviewed April 2010.

Last updated April 2010.