Expand All | Collapse All

Managing Diabetes Magazine - diabetes

Smart Snacking
It may help control your diabetes

No question, eating regular meals is important if you have diabetes. Balanced meals at certain intervals help reduce swings in your blood glucose level, and even out highs and lows. Still, like many people with diabetes, you may be confused about snacking. Do you need to snack between meals? What about a bedtime snack? Will snacking add unwanted weight gain or worsen your blood glucose control? The answer to these questions can be both yes and no.

Snacking – friend or foe?

For some people, snacking adds unwanted calories and sends blood glucose soaring. Many snack items, such as chips, cookies, muffins and doughnuts, are high in carbohydrate, fat and calories. People often eat out of habit or emotion, rather than hunger. They eat because they are sad, bored, stressed, or simply need something to do in front of the TV. When you eat mindlessly, it is easy to eat too much or reach for unhealthy choices.

However, a well-planned snack offers many benefits. It can help prevent low blood glucose (hypoglycemia) related to taking certain types of diabetes medications. A healthy snack can also curb your appetite and prevent overeating at the next meal. Moreover, snacking can keep you energized and provide important nutrients for
your body.

To snack or not to snack?

The need to snack varies from person to person. The timing of meals, the types of diabetes medications you use, your activity level, and your personal choice for snacking are all important factors to consider.

If one or more of the following situations describes you, you may benefit from including snacks as part of your day. Speak with your dietitian if you still have questions about the need to snack.
You take diabetes medications that can cause hypoglycemia.

All types of insulin, and some types of diabetes pills (see table), can result in hypoglycemia. Do you manage your diabetes with one or more of these medications? If so, your blood glucose may drop too low due to delayed eating, inadequate food intake or increased activity. In these situations, a snack between meals, as well as a bedtime snack, may prevent your blood glucose from bottoming out.

You have long gaps between your meals.
You let too much time pass between meals, and then you overeat. Sound familiar? Even if you are not at risk of hypoglycemia, a healthy snack is often a good idea if your meals are spaced more than five or six hours apart. It is easier to keep portions in check and make smarter food choices when you are not famished. So the next time dinner will be late, take an afternoon snack break. Your body and your blood glucose will thank you for it.

Diabetes pills with risk of low blood glucose (hypoglycemia)	Diabetes pills with no risk of hypoglycemia when used on their own
Glyburide (Diabeta®) Gliclazide (Diamicron® or Diamicron® MR) Glimepiride (Amaryl®) Repaglinide (GlucoNorm®) Nateglinide (Starlix®)	Metformin (Glucophage®) Sitagliptin (Januvia®) Saxagliptin (Onglyza®) Linagliptin (Trajenta®) Acarbose (Glucobay®) Rosiglitazone (Avanida®) Pioglitazone (Actos®)

You are physically active.
Whether on the job, at school or at the gym, physical activity increases the body's need for food. If your last meal was several hours ago, eat a snack containing carbohydrate before beginning activity. This provides glucose to fuel your body and protects against hypoglycemia if you use diabetes pills or insulin.

Your blood glucose is too high in the morning. High morning blood glucose is a common problem in type 2 diabetes. Have you ever noticed that your blood glucose is higher in the morning than at bedtime the night before, even though you did not have anything to eat or drink? What makes your blood glucose go up? To understand, you need to know some basic body science. Let's look at how the pancreas and liver normally work to maintain healthy blood glucose levels.

• 10 Ideas
  to Get You Started

  • A slice of whole grain toast with a tablespoon of almond butter and a handful of raw vegetables
  • One apple with ¼ cup almonds
  • ½ cup of berries with ½ cup yogurt
  • One cup of hot chocolate, made with low-fat milk, a tablespoon of cocoa
    and a teaspoon of sugar
  • ½ whole wheat pita pocket and ¼ cup hummus
  • Three cups of air-popped popcorn
    and a grape juice spritzer (made with one oz grape juice diluted
    with soda water)
  • 8-10 baked tortilla chips with grated cheese and salsa
  • One slice of thin crust veggie pizza
  • ½ cup baked beans
  • One cup of lentil soup
  Your body breaks down carbohydrate-rich foods (starches, fruit, milk, sugar) into glucose, and your blood glucose rises as a result.
• The pancreas responds to this rise by making insulin. Insulin allows the muscles to take up glucose and burn some right away for energy.
• Insulin also allows the liver to store the remaining glucose to be used later, such as during sleep. When glucose is needed, the liver releases it back into the blood.
• In the absence of diabetes, everything works well together to keep blood glucose levels normal.
• The pancreas makes just the right amount of effective insulin to match the glucose from foods.
  
  • The muscles take up just the right amount of glucose from the blood.
    
  • The liver stores and then later returns just the right amount of glucose into the blood.

However, in type 2 diabetes, this glucose-balancing act goes haywire because there is a lack of insulin or it is not working well. As a result, the muscles and liver are unable to take up glucose efficiently, leaving blood glucose too high after you eat. Overnight the liver 'leaks' too much glucose into the blood, resulting in high morning blood glucose.

Some people with diabetes find adding a small carbohydrate snack before bed lowers morning blood glucose. Eating a snack may help the pancreas make more insulin and keep the 'leaky' liver in check. This solution does not work for everyone, so you need to experiment. If a bedtime snack does not improve your morning blood glucose, talk with your diabetes care provider about a possible change in your diabetes pills or insulin.

You are a small eater.
If you have a small appetite and have trouble eating all the food you need during meals, snacks can help. This is often the case for young children, older adults and during times of illness. Snacks provide opportunities to fit in the recommended number of servings from each key food group.

You enjoy snacking.
Some people like snacking, while others do not. There is no evidence to support that snacking is harmful, as long as you keep portions in check and your snack choices nutritious. On the other hand, if you do not like to snack but you need to do so to avoid hypoglycemia, speak with your diabetes care provider. It may be possible to adjust the timing and dosing of your diabetes medication. Certain types of diabetes pills and insulin are also less likely to cause hypoglycemia. As much as possible, your diabetes medications should work around your eating habits, not vice versa.

The need to snack varies from person to person. When planned carefully, snacks help improve blood glucose control, control appetite and provide important nutrition to your body.

Smart snacking made easy

If snacking is right for you, use the following suggestions to guide your snack selection. It's as easy as 1-2-3.

1 Start with carbohydrate to energize.

• Choose a carbohydrate food from one of the key food groups from Canada's Food Guide for the best possible nutrition. Carbohydrate is found in:
  
• grain products
  
• vegetables and fruit
  
• milk and alternatives
  
• Keep snack size at 15 to 30 grams of carbohydrate. Adjust the size of your snack based on hunger, activity level and timing of your next meal.
  (See sidebar for ideas.)

2 Add protein to stabilize.

• Protein is not needed in every snack, but a small amount can help if you need a snack to sustain you (such as at bedtime or if your next meal is more than two to three hours away).
  
• Some foods like milk and yogurt do double duty, providing both carbohydrate and protein.
  

1 Include 'free foods' to fill up.

• Add the items in the 'free foods' column (below) to your snacks to add more variety and interest. They contain low amounts (less than five grams) of carbohydrate and calories (less than 15 calories).

CARBOHYDRATE	PROTEIN	FREE FOODS
Grain Products One slice of whole grain bread ½ whole wheat English muffin or pita One multigrain waffle ½ cup high fibre cereal (such as All Bran® or  shredded wheat) ¼ - ¹/₃ cup Muslix™ or granola 3 cups of popcorn, air-popped  6 small, 4 medium or 2 large whole grain crackers 8-10 tortilla chips Vegetables and Fruits One fresh fruit about the size of your fist One cup of cut fruit or berries ½ cup unsweetened apple sauce One individual fruit cup ½ cup canned fruit, in juice ¼ cup dried fruit	One ounce of lower fat cheese (20% milk fat or less) One cheese string ¼ cup of cottage or ricotta cheese 1-2 tbsp of nut butter ¼ cup nuts and seeds  ¹/₃ cup of hummus ½ cup shelled edamame (soybeans) One egg ¼ cup egg white ¼ cup of canned fish	1 cup of non-starchy vegetables, raw or cooked ¼ cup salsa ½ cup of sugar-free gelatin dessert (such as • Jell-O® Light) 1 sugar-free Popsicle® Water, soda water, mineral water Clear broth Coffee Tea Drinks with less than 5 grams of carbohydrate (diet soft drink, Crystal Light) 1 tbsp cocoa powder 1 tbsp light or fat-free cream cheese
	MILK AND ALTERNATIVES
	• One cup of low fat milk • One cup of plain soy beverage • One cup of low fat yogurt, plain or no sugar added • ½ cup chocolate milk

More articles from this section

Article Listing

FAMILY HEALTH is written with the assistance of

FAMILY HEALTH is written with the assistance of

While effort is made to reflect accepted medical knowledge and practice, articles in Family Health Online should not be relied upon for the treatment or management of any specified medical problem or concern and Family Health accepts no liability for reliance on the articles. For proper diagnosis and care, you should always consult your family physician promptly. © Copyright 2019, Family Health Magazine, a special publication of the Edmonton Journal, a division of Postmedia Network Inc., 10006 - 101 Street, Edmonton, AB T5J 0S1    [DI_MDb12]