Nutrition and home care for diabetes

How to build a meal

A practical approach is the plate method:

• half the plate with non-starchy vegetables;
• a quarter with protein, such as fish, lean meat or suitable alternatives;
• a quarter with foods that contain carbohydrate, preferably with fiber, such as whole grains, potatoes or legumes.

Carbohydrate is the nutrient that raises glycemia most after a meal, so its amount and type matter; protein and unsaturated fats slow the rise. The total amount and composition are adapted individually. Legumes contain both carbohydrate and protein.

What to choose more often

Prefer vegetables, whole grains, legumes and whole fruit in suitable portions. Use olive oil or other unsaturated fat sources, mindful of the amount, and limit saturated fat and salt (this also helps blood pressure and the heart, see diabetes and cholesterol). Water is a suitable choice of drink. Limit sugary drinks, fruit juices and sweets; alcohol is used with care, because it can cause hypoglycemia. A “sugar-free” label does not mean carbohydrate-free or calorie-free.

Do bread and fruit have to be removed

Not automatically. The type, portion and distribution through the day matter. In type 1 diabetes, carbohydrate counting helps to match food to the insulin plan. Do not start fasting or a very restrictive diet without discussing the effect on medication and hypoglycemia.

Daily care at home

• Measure glycemia as your doctor plans; note unusual episodes.
• Do suitable physical activity and break up long periods of sitting.
• Check your feet every day for wounds, redness or new changes.
• Keep a plan for hypoglycemia and for sick days.

Hypoglycemia (glycemia below 4 mmol/L, that is below 70 mg/dl) appears with hunger, shaking, sweating, palpitations, drowsiness or confusion, and is treated with fast-acting carbohydrate (fruit juice, glucose tablets), rechecking after 10–15 minutes. Do not delay or skip meals without a plan when taking insulin or medicines that can cause hypoglycemia.

When the plan should be reviewed

Seek advice if readings stay out of target, hypoglycemia recurs or weight, appetite or activity change. Nutrition does not replace insulin in type 1 diabetes and does not automatically replace medication in type 2 diabetes. Follow-up is every 6 months to a year, or sooner when the doctor considers it reasonable.

Care at Tirana Polyclinic: we offer endocrinology consultation and individualized advice on nutrition, monitoring and follow-up of diabetes or prediabetes.