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What is Normal Eating with Diabetes?

Ellyn Satter, one of my original dietitian heroes, wrote this in 1983 and it has never been truer than today.

I updated her original with my comments about what normal eating might be for someone with diabetes: ⁣

Normal eating is going to the table hungry and eating until you are satisfied.

Diabetes edition: same! If you're taking insulin for food, try dosing up front for 50% of what you plan to eat, then take the rest later on for extra flexibility.

Normal eating is being able to choose food you enjoy and eat it and truly get enough of it – not just stop eating because you think you should.

Diabetes edition: same! If you're feeling restricted, see my blog post on restriction and/or consider talking to your diabetes clinician about adjusting your medication to help with BG management without restriction.

Normal eating is being able to give some thought to your food selection so you get nutritious food, but not being so wary and restrictive that you miss out on enjoyable food.

Diabetes edition: nutrition for diabetes is personal - checking in with blood sugar before and after eating can be helpful to see how different foods affect blood sugar. But caution! If you have a history of dieting or restricting, this might be tough for you. That's ok - talk with your diabetes management team about ways to manage blood sugar without rigidity.

Normal eating is giving yourself permission to eat sometimes because you are happy, sad or bored, or just because it feels good.

Diabetes edition: SAME! Worst case scenario: your BG goes higher than normal for a few hours or even a day. It will either come down with time or with correction insulin, the same way it would when your pancreas was functioning at 100%. It is also very much ok for your blood sugar to be elevated at times. We can't expect blood sugars to never be elevated.

Normal eating is mostly three meals a day, or four or five, or it can be choosing to munch along the way.

Diabetes edition: If you're on fast-acting insulin [mealtime/correction or novolog/humalog], try spacing at least a couple of meals and snacks at least 3 hours apart so you can be sure to leave room for a correction dose.

Normal eating is leaving some cookies on the plate because you know you can have some again tomorrow, or it is eating more now because they taste so wonderful.

Diabetes edition: If BG is out of range, give yourself permission to eat them now, or later if you know that you won't feel great.

Normal eating is overeating at times, feeling stuffed and uncomfortable. And it can be undereating at times and wishing you had more.

Diabetes edition: SAME!

Normal eating is trusting your body to make up for your mistakes in eating.

Diabetes edition: with a little help from medications!

Normal eating takes up some of your time and attention, but keeps its place as only one important area of your life.

Diabetes edition: same! Managing blood sugar can feel incredibly overwhelming sometimes. Mindset & self-compassion are KEY rather than restriction & obsession. The goal is still for eating to take up some of your time and attention, not all or the majority of your time and attention.

In short, normal eating is flexible. It varies in response to your hunger, your schedule, your proximity to food, and your feelings.

Diabetes edition: normal eating with diabetes SHOULD be flexible. Sometimes it varies in response to your blood glucose, and that is ok! The key is sometimes.



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