Mealtimes Matter - Managing Blood Sugar

 Chef and diabetes education advocate Siva Swaminathan

Chef and diabetes education advocate Siva Swaminathan

Managing blood sugar levels after meals can be a challenge  for people living with type 1 or type 2 diabetes. Chef and diabetes education advocate Siva Swaminathan lives with type 1 diabetes and teaches healthy cooking techniques that help those living with diabetes to manage their blood sugar levels. She and Dr. Maureen Clement, a Vernon, British Columbia-based family physician and diabetes specialist,  share insights to help others overcome mealtime challenges and better manage their diabetes.

Adjusting to life with diabetes

When Swaminathan was diagnosed with type 1 diabetes at age 40, she struggled to cope. “I was depressed. It’s a major chronic disease, and I was concerned about juggling a cooking career and living with diabetes.”

Six months later, Swaminathan experienced a revelation when she realized she could control her blood sugar levels not just with medication, but also through diet. “Diet gives you a lot of control because you are what you eat.” She put her professional skills to work by preparing lower carbohydrate meals, which help limit the rise in blood glucose after meals. “I started looking at food in a whole different way and started exploring how to cook and eat with lower carbohydrates and high fibre for a low glycemic diet.”

Today, her cuisine features more vegetables, legumes. and well-seasoned low-carbohydrate foods to enhance their appeal and flavour. When she makes pastas and risottos, she prepares them “al dente” (firm in the middle), and chooses whole wheat pasta and barley for risottos. Both the cooking method and the different basic ingredients for pasta and risotto contribute to the final cooked product having a lower glycemic index, which is ideal for people living with diabetes.

With type 1 and type 2 diabetes, taking medications at the correct time  is key

Even with a well-managed diet, Dr. Clement emphasizes that taking some medications before mealtimes, such as mealtime or bolus insulin and oral medications that produce insulin is key for diabetes management.

“I helpmy patients understand that taking their mealtime  insulin ahead of a meal will improve their blood glucose values post meal.Insulin takes some time to be effective once placed under the skin, although very recently, newer insulins may work faster and potentially could be taken with the meal or even just after. Dr. Clement adds that  large observational studies  of populations show that there is a connection between the  risk for heart disease and high post-mealtime blood glucose test results.

Check  after meals too

While Swaminathan routinely considers how many carbohydrates she will eat at a meal, she always takes her medication beforehand. She also stresses the importance of testing her blood to monitor her blood sugar levels two hours after each meal to ensure she has taken the right level of insulin. If her levels are too high, she can “top up” her dose to correct the situation.

“Checking blood sugar after a meal is especially important since some foods, particularly Chinese and Indian food, may have hidden carbohydrates,” says Swaminathan.

Carbohydrate counting in advance of a meal doesn’t have to be challenging. Swaminathan uses a programmable food scale that allows her to enter specific foods and their related carbohydrate levels, so they can be easily recalled whenever she measures that food. The scale also assists with portion control, which is crucial for people living with diabetes.

Mealtimes – a balancing act of medication, monitoring and ongoing management

Dr. Clement says, “Watch the type and amount of carbohydrates, avoid processed foods, and add a little protein and fat to carbohydrates to slow down the blood glucose post-meal bump.”

Managing medication properly and checking post-meal blood sugar can help people living with diabetes avoid complications and live a full and healthy life.