Mealtimes can be challenging when you're living with diabetes, particularly for someone like me who lives with type 1 diabetes and has an extremely active life. Everyone has a different body and we all use different types and doses of insulins. So the exact amount of insulin to inject for certain meals can vary - it's your Sherlock Holmes mission to figure out the best dose.
I'm no stranger to challenges - from running 30 marathons in 30 days to cycling 1500 km in 9 days from Brussels over the Alps to Geneva (and I hate cycling!). You could call me a "DiAthlete".
Day-to-day life with type 1 diabetes is tough! For an active person like me, mealtime management of my diabetes can be as challenging as a marathon.
Living with diabetes is never straightforward and sometimes it won't go to plan - heck with nearly 17 years of experience living with type 1 diabetes I can tell you it very seldom goes to plan. However, from every low to every high-blood sugar level there are always lessons to be learned.
When your blood sugar peaks and troughs, as it ineveitably will, you can ask yourself a few questions to understand why these events happen. Take into account what your blood sugars were, what you ate, what you last took insulin for (bolus and basal), and what your day entailed. By asking these questions you can narrow down the reasons why your blood sugar levels might have fluctuated. Yes, I am suggesting you take on a Sherlock Holmes approach.
The challenge of mealtimes is trying to lessen the blood sugar spikes after meals. These spikes are influenced by what you eat - the higher the level of carbohydrates, the higher the blood glucose levels tend to go up after a meal, even if you take the correct amount of carb-counted bolus (quick acting) insulin before a meal. Such insulins need time to kick-in and some rapid insulins do kick-in sooner than others. So ideally you should aim to take your insulin in advance of your meal, to help prevent those blood sugar spikes.
What you eat has a big impact on your blood sugar levels, so an understanding of carbohydrate counting is really important. There is a brilliant course that patients can go on called DAFNE (dose-adjustment for normal eating) in the UK, but there needs to be much more of this available.
Every person and every meal is different, from the different portions to different ingredients. There are always calculations to be made; living with type 1 diabetes trains you to become a mathematical genius.
Eating out is perhaps the most challenging part of managing your diabetes at mealtimes. If you do not have a clue what portions are going to be on your plate, such as in a restaurant, figuring out the insulin you need to take becomes guesswork, which is not recommended. In this situation, I would pull the waiter aside and get him to ask the chef about the portion sizes and ingredients. If they don't know, the next best alternative is to wait and see what gets served first, and make your insulin decision based on that information. If you are on a date and you're worried about looking fussy about your food, don't worry. Living with diabetes means food is a passion, that's an appealing quality in a person. And besides, diabetes always makes for interesting conversation.
You are the boss with your diabetes - sure if you make a mistake your diabetes will let you know about it, but that gives you the opportunity to learn and make adjustments in the future. So be the Sherlock Holmes of diabetes, a dia-detective if you will. Be confident and positive and there'll be no reason why you can't go on and live life to the fullest.
This page is intended for UK healthcare professionals only
UK/WB/1016/0057 November 2016
Information about diabetes and mealtime management of the disease.
Find information on symptoms and effects of post-meal hyperglycaemia, including short and long-term complications.
For educational videos, including commentary from clinicians and patients on the importance of mealtime management of diabetes.