Advice after your nerve block for surgery
On this page…
What is Diabetes?
Diabetes is a condition in which the body is unable to control the level of glucose (a type of sugar) in the blood. Everyone needs a certain level of glucose in their blood. This is produced when we eat carbohydrate containing foods (sugars and starches). An organ called the pancreas produces a hormone called insulin. Insulin helps to regulate the level of glucose in the blood by transferring glucose to cells to be used for energy.
In Type 1 diabetes and Latent Autoimmune Diabetes in Adults (LADA) the pancreas has stopped producing insulin. This means that blood glucose levels rise and if left untreated can cause damage to your body. In Type 1 diabetes and LADA insulin is replaced either by daily injections, or with insulin pump therapy.
Although diabetes is a serious condition, keeping your blood glucose levels
under control can limit the risk of diabetes related complications.
What can you eat?
People with Type 1 diabetes or LADA should eat a healthy balanced diet the same as someone without diabetes. This information booklet will guide you on how to eat a well-balanced diet.
How does food affect your blood glucose level?
Food and drinks containing carbohydrate are digested by the body to produce glucose (a type of sugar), which is then released into the blood stream. Insulin acts like a key to open the door to the cell, allowing the glucose to move inside where it is used to fuel our bodies
Which foods contain carbohydrate?
Carbohydrate containing foods can be divided into several groups:
- Starchy foods, which include bread, rice, pasta, cereal, potatoes
- Foods with added sugar such as cakes, sweets, biscuits, chocolate, jams and sugary drinks
- Natural sugars found in fruit, milk and yoghurt
Most types of carbohydrate will increase your blood glucose level. The degree of change depends on several factors including:
- The amount and type of carbohydrate in the food you eat or drink
- Your insulin doses, the type of insulin you use and how close to a meal/snack you take it
- The glycaemic index of the foods (how quickly it is absorbed)
- Your usual daily activity levels, as well as any exercise or sport you do
There is no ‘right’ amount of carbohydrate to eat each day, and this will vary depending on factors such as your weight and activity level.
If you have taken an injection of quick acting insulin for a meal, you need to include some carbohydrate with that meal, or your blood glucose level could drop too low.
Carbohydrate counting
To help keep your blood glucose levels stable you will need to balance the amount of insulin you take with the carbohydrate you eat.
You can either do this by:
- Eating similar amounts of carbohydrate every day alongside the same doses of quick acting insulin
- Learning to adjust your insulin dose to match the amount of carbohydrate you wish to eat
Your dietitian will be able to help you with this, and you will be offered carbohydrate counting education.
Balancing Your Diet
Everyone needs to eat a balanced diet to keep healthy. This is especially important if you have diabetes.
| One portion is equivalent to: | |
|
Starchy Carbohydrate Foods 5-14 portions per day If you are trying to lose weight, aim You would only need to consume |
|
|
Fruit and Vegetables
|
|
|
Dairy Products 2-3 portions of dairy products per Dairy products contain calcium |
|
|
Meat, Fish, Eggs and Pulses
|
|
These plate models show what a healthy meal should look like. Check your plate at your next meal and see if you have a healthy balance.
How can I eat more Fibre?
Fibre from foods such as wholemeal/wholegrain bread and cereals help to keep your digestive system healthy, prevent constipation and satisfy appetite.
In addition, ‘soluble’ fibre, which is found in fruit, vegetables, pulses and oats, helps to reduce cholesterol and the risk of heart disease.
When you eat more fibre, you will need to drink more fluid to prevent constipation. Try to include at least 8-10 cups a day. Being physically active will also reduce constipation.
What are the Benefits of Weight Loss?
If you are overweight, weight loss can improve diabetes control and reduce the risk of developing heart disease. Gradually losing 10% of your body weight can have a positive impact on your health by reducing blood pressure, lowering certain fats in the blood and improving insulin sensitivity.
A safe and achievable target for a long-term healthier weight is to lose 1-2lbs (0.5–1kg) a week. To achieve this, you will need to consume about 600 fewer calories per day than your body needs to maintain its weight. Increasing your physical activity will help you to burn off more calories and
lose weight more quickly.
There are many different dietary approaches to losing weight. Evidence shows that the best approach is the one that you are most likely to stick to. So for successful long-term weight loss small and realistic changes are crucial. The key is to make a plan that you will enjoy and that will fit in
with your lifestyle. Research shows that people who write down their goals are more likely to achieve them.
If you reduce the amount of carbohydrate in your meals/snacks, you are likely to need smaller doses of quick acting insulin with your food. Ask your dietitian to assist if you would like to make this sort of change.
It is common to regain weight lost once treatment starts
AIM for a healthy BMI -
Calculate your body mass index (BMI) for adults - NHS
Why do I Need to Eat Less Sugar?
Naturally occurring sources of sugar, such as those found in fruit and milk should be included as part of a healthy diet as these foods are nutritious.
Added sugar e.g. table sugar, is found in foods such as confectionery, cakes and biscuits. Reducing the amount of these foods in your diet is sensible for several reasons:
- These foods are a poor source of essential nutrients and are frequently high in calories and fat.
- Some very sugary foods, especially sugary drinks and sweets, can cause sudden rises in blood glucose levels which are harder to be matched with quick acting insulin.
- They can contribute to tooth decay.
Hypoglycaemia treatment
Some sugary foods are recommended as treatment for hypoglycaemia (blood glucose level <4mmo/l), as they are very quickly digested and absorbed by the body. This means the blood glucose level increases soon after they are eaten or drunk.
Examples of good hypo treatments are:
- 150-200mls of fruit juice or full sugar cola
- 4-5 large Jelly babies
- 5-6 dextrose tablets
After taking the hypo treatment wait 15 minutes. Re-check your blood glucose level. If still less than 4.0 mmol/L then repeat the initial step until your blood glucose level is greater than 4.0 mmol/L* Once it is above this have some slower release carbohydrate such as a couple of biscuits or a
small piece of toast or a piece of fruit
Low Calorie Sweeteners
If you need to sweeten your food, there are many artificial sweeteners and alternatives to sugar available that will not affect your blood glucose. Some examples of artificial sweeteners that do not contain carbohydrate and will not affect your blood glucose are saccharin, aspartame, sucralose and
stevia. They are available in three forms:
- Tablet for use in drinks
- Liquid for use in custards and sauces
- Powder for use on cereals
Many are affected by heat, so add them after liquids have been boiled, e.g. custard, or once a dish has gone cold. Some sweeteners do contain carbohydrate, but they tend to have very little effect on blood glucose levels, these include fructose and polyols such as sorbitol and xylitol. Polyols can have a strong laxative effect if eaten in large quantities and can still contribute to weight gain as they are a source of calories.
You do not need special diabetic foods. They can be high in fat and expensive.
How Can I Eat Less Fat?
It is important to cut down on the fat you eat, particularly saturated (animal) and trans-fatty acids, as these are associated with heart disease. All fats are high in calories and should be restricted if you
need to lose weight.
- Choose monounsaturated e.g. olive or rapeseed oil and spreads, or polyunsaturated fats e.g. sunflower, corn or soya oil and spreads as an alternative.
- Grill, bake, poach, casserole, steam or microwave food instead of frying.
- Choose lean cuts of meat and trim the fat off. Remove skin from poultry. Cut down on pâté, beefburgers and sausages. In casseroles and stews replace some meat with extra vegetables, and plant sources of protein, e.g. beans and pulses.
- Use semi-skimmed or skimmed milk instead of full cream milk.
- Watch out for hidden sources of fat. Pies, pastries, chips, mayonnaise, crisps and cream all add extra fat to your diet. Oven chips are lower in fat and can be used occasionally.
- Cheese contains a lot of fat so choose lower fat varieties and use small amounts. Try grating and sprinkling to use less. Use as part of your meal rather than as a between meal snack.
- Nuts contain unsaturated fat but are high in calories, so limit to one portion a day (a small, cupped handful).
- Oily fish such as mackerel, sardines, herrings, kippers, pilchards, salmon and trout contain Omega 3 fatty acids which are beneficial to health. Aim to have at least two portions of fish per week, with at least one of these portions being oily fish.
How Can I Use Less Salt?
A high intake of salt may raise your blood pressure and increase your risk of heart disease, so it is sensible to use less. It is very important to control blood pressure when you have diabetes.
- Avoid adding salt to meals
- Use sparingly in cooking. If you steam or microwave vegetables, you will probably find you do not need to add salt
- Cut down on processed foods e.g. salty meats, crisps, salted nuts and ‘ready meals’
- Cut down salt gradually so that you can get used to the taste change.
- Adding herbs and spices instead can add flavour
- Avoid salt substitutes as they may contain too much potassium for some people
Alcohol
Most people with diabetes can have alcoholic drinks but check with your doctor first. The recommended limit for men and women is 14 units per week.
| Alcohol | Serving size | Units |
| Beer, lager, cider (standard strength) | 1/2 pint | 1 |
| Strong lager, beer, cider | 1/2 pint | 2 |
| Spirits | 1 pub measure (25ml) | 1 |
| Wine (12% ABV) | 1 small glass (90ml) | 1 |
This should only be used as a rough guide as the alcoholic content of drink varies greatly.
- Spread your units of alcohol throughout the week, allowing some alcohol-free days and avoid ‘binges’.
- Avoid ‘diabetic’ and strong beers and lagers, e.g. Pils, as they are higher in alcohol and calories.
- All alcohol is high in calories, so if you are trying to lose weight reducing the quantity you drink will also reduce your calorie intake.
- Choose low calorie, sugar-free or slimline ‘mixers’ with spirits e.g. diet cola, low calorie tonic.
Be aware!
Alcohol can increase the risk of hypoglycaemia, or low blood sugar for up to 24 hours after drinking as it slows down the normal release of glucose from the liver. Don’t drink on an empty stomach and if you are drinking in the evening have a snack containing carbohydrate before bed. You can learn
more about how to manage the effects of alcohol by attending DAFNE (Dose Adjustment for Normal Eating), a structured education programme for managing Diabetes
Snacking
If you snack between meals, initially you may find it easier to stick to snacks that contain 10g of carbohydrate or less. These snacks won’t require any additional injections of quick acting insulin. Snacks that fall in to this category include a small piece of fruit, raw vegetable sticks with hummus, small portion of nuts/seeds (25g), a small pot of Greek style yoghurt (125g) or 20g
of popcorn.
Speak to your dietitian for more snack suggestions and guidance on managing snacks
Drinks
Tea and coffee without sugar, sugar free drinks or water can be taken freely throughout the day
Reading Food Labels
Understanding food labelling can help you to make informed choices about your diet and following a healthy lifestyle.
| Per 100g | |
| A lot (means these amounts or more) | A little (means these amounts or less) |
| 22.5 of total sugars | 5g of total sugars |
| 17.5g of fat | 3g of fat |
| 5g of saturates | 1.5g of saturates |
| 3g of fibre | 0.5g of fibre |
| 0.6g of sodium | 0.1g of sodium |
| 1.5g of salt | 0.3g of salt |
- Use the ‘per 100g column’ to compare foods of similar composition e.g. yoghurts.
- Use the ‘per serving’ column if you are comparing quite different foods e.g. a lasagne with a fisherman’s pie.
- Think of how much of a food you will be eating. The more you eat of a product, the more fat, sugar and energy you will be taking in.
- Limit your intake of foods that are high in sugar to 0-2 servings per day.
- Moderate the amounts of foods that contain a lot of fat.
- Foods that make claims like ‘reduced fat’ and ‘reduced sugar’ should be at least 30% lower than the standard version by law.
However, these claims are often seen in products that are high in fat or sugar like crisps, cheeses and cakes. It is important to remember that the reduced version may still be high in fat, sugar or salt and should only be eaten occasionally.
* Using food labelling to support carbohydrate counting will be covered in another of our leaflets. Ask your dietitian for more details.
Steps to Healthy Living with Diabetes
- Aim to reach or maintain a healthy weight.
- Activity can help with weight maintenance and improve the way insulin works. Aim to exercise for 30 minutes five times a week (or 150 minutes per week) e.g. walking/cycling/swimming/golf/gardening; this can be spread throughout the day. Resistance (muscle strengthening) training twice a week is also beneficial. Activity can have varying effects on your blood glucose level and can place you at risk of hypoglycaemia during and after. Ask your dietitian for more information about how to manage this.
- As often as possible choose wholegrain varieties of breads and cereals as these contain more fibre. This helps to maintain a healthy bowel.
- Reduce the fat in your diet and where possible swap saturated fat for unsaturated fat.
- Reduce your intake of foods and drinks with a high sugar content.
- Eat more fruit and vegetables or salad. Aim for at least five portions a day.
- Use less salt.
- Drink alcohol in moderation only.
- Stop smoking.
- Use medication as prescribed and attend the regular check-ups that you will be offered.
Referral to a Dietitian
When you are first diagnosed with diabetes you should be referred to a diabetes specialist dietitian who will contact you within two weeks of being diagnosed.
If you are not newly diagnosed but would like to speak to a dietitian, you can ask your diabetes nurse, consultant or GP to refer you.
Structured education for people with Type 1 diabetes
If you have Type 1 diabetes or LADA you can be referred for the structured education programme DAFNE (Dose Adjustment for Normal Eating). This is a five-day course covering all aspects of managing type 1 diabetes. For more information on DAFNE go to: https:/
If you would like to attend a DAFNE course, please ask you diabetes nurse, dietitian, consultant or GP to refer you
Contact us
If you have any queries relating to this information, please contact the Dietetics service.
About this information
Service:
Dietetics
Reference:
DT/023
Approval date:
1 July 2023
Review date:
30 June 2026
Click ‘show accessibility tools’ at the bottom of the page
Then click ‘select language’
Alternative formats
You can use the accessibility toolbar at the bottom of your screen to:
-
Change the text size
-
Adjust the font
-
Modify the colour contrast
-
Use the translate function
If you would like this information in another format, such as Braille, audio, or easy read, please speak to a member of staff.
You can also print as well as download as PDF using the “Print this page” button at the end of the page.
Staff will print a copy for you on request
Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.