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Diabetes 101: Making the Right Diet Choices

April 3, 2017 11:00 AM with Harriet Salzberg, RD, LDN, CDE

Making healthy diet choices is always encouraged, but becomes even more important for patients with diabetes. Choosing the right foods for your condition can sometimes feel overwhelming, especially with the increasing amount of choices out there. Harriet Salzberg, Registered and Licensed Dietitian and Certified Diabetes Educator within the Department of Endocrinology and Diabetes, would like to pass on her knowledge to you. Join her for a chat on diabetes and diet; she’ll be taking questions on topics such as making healthy food choices, knowing your numbers and maintaining a healthy weight.

Kathryn (Moderator) - 11:00 AM:
Our diet and diabetes chat is now open. You can send your questions at any time during this chat.

Harriet Salzberg, RD, LDN, CDE (NorthShore) - 11:01 AM:
Hello and welcome to the online chat on diet for diabetes - I am ready to answer questions.

  Angie (Highland Park, IL) - 11:01 AM:
What are the worst times to eat for a diabetic?
Harriet Salzberg, RD, LDN, CDE (NorthShore)
Thanks for the question. Meal timing is dependent on your usual schedule and what medication for diabetes you are on. We recommend at least 3 meals per day about every 4-6 hours. Snacks between meals and at bedtime are not necessary for everyone; it depends on the individual person. Late night eating is probably when most people have problems controlling their food intake. I hope this answers your question.

  Rashmi (Chicago, IL) - 11:06 AM:
Are there any good vegetarian diet plans for people with diabetes? What foods can be good to start with?
Harriet Salzberg, RD, LDN, CDE (NorthShore)

Hi Rashmi,

Thanks for your question. It is a good question. Vegetarian diets can be beneficial in controlling blood sugar. It also depends on what type of vegetarian diet you follow; Lacto-ovo (people who eat eggs and milk products), vegan (who only vegetable proteins, no animal products at all), or pescatarian (people who eat fish, but not meat or chicken). It can be a little tricky for some people because most of the foods are not only a source of protein, but are also higher in carbohydrates. A good place to start is the American Diabetes Association website or a site called Diabetic Living.

Other websites that can help you with this are dLife and

Any foods are good in the right portion. We would recommend beans, tofu, some rice or Indian breads. Again, it will depend on what you usually eat and in what portions. Please contact a dietitian if you need additional help planning your diet.

  Kristin (Chicago, IL) - 11:17 AM:
How does alcohol consumption affect type 1 diabetes? Do you have any recommendations for safe alcohol intake for diabetics? I have a family member in his twenties who has only had a diagnosis for one year and is still making life changes.
Harriet Salzberg, RD, LDN, CDE (NorthShore)

This is a good and important question. Alcohol can initially raise blood sugar right after drinking it, but over 4-7 hours, it may have a blood sugar lowering effect because it has an effect on the liver to limit glucose production if their blood sugar starts to drop.

We always recommend people eat when they are drinking. I usually recommend not giving insulin for the carbohydrate in the alcohol, but give insulin for the food they eat. Some people need to give a little less insulin with their food at a meal when they are drinking.

It is important to check blood sugars more often during the time a person is drinking, before they go to bed and again in the middle of the night. They need to be aware of their blood sugar patterns with alcohol. We would usually recommend limiting alcohol intake to 1-2 drinks.

  Chris (Wilmette, IL) - 11:25 AM:
What is the latest thought regarding the use of cooking with coconut oil as a healthy fat? I've heard conflicting opinions. Which cooking oils are recommended as the healthiest for diabetics?
Harriet Salzberg, RD, LDN, CDE (NorthShore)

Hi Chris,

This is an interesting question because there is so much information about is coconut oil a good fat or not. The American Heart Association still recommends to avoid saturated fats to prevent heart disease. Because coconut oil is a saturated fat, it is recommended to avoid it or use it very sparingly.

Some rat studies have been done on coconut oil, and their effects on type 2 diabetes, and they found that they may reduce the blood glucose levels, but the same study found that that there was a greater fat build up and higher insulin resistance.

The American Heart Association recommends you limit saturated fat to 7% of total calories, or for someone on a 2000 calorie diet, about 16 grams of saturated fat per day. One tablespoon of coconut oil has 117 calories and 14 grams of fat. In general, if you want to use coconut oil, use virgin coconut oil, and very sparingly.

  Robert (Waukegan, IL) - 11:38 AM:
Should breakfast be the biggest meal of the day for diabetics?
Harriet Salzberg, RD, LDN, CDE (NorthShore)

Hi Robert,

Thanks for asking this question. Breakfast should definitely be included in a healthy diet for all people, including those with diabetes.

Some people have more insulin resistance in the morning, so we may recommend a smaller breakfast, and others can have a bigger breakfast. In general, we recommend 3 balanced meals, avoiding excess carbohydrates at one meal and having much less at another.

It is the portions of the food at each meal that help control blood sugar. We always like to take an individualized approach based on your blood sugar and your medications.

  Sheree (Chicago, IL) - 11:46 AM:
Is diabetes a lifelong illness once you have it, or can you get rid of it completely with a better diet?
Harriet Salzberg, RD, LDN, CDE (NorthShore)

Lifestyle changes can put your diabetes in good control. You may never get "rid" of it.

We know that for those people who have prediabetes, we can apply lifestyle changes such as diet and exercise to delay or avoid advancing to a diagnosis of diabetes.

By the time someone is diagnosed with diabetes they have already lost 50-80% of their beta cell function. This is where insulin is produced and released. I have definitely seen people who have lost weight with good diet and exercise significantly reduce or discontinue some of their medications.

The important thing to remember is that you need to make sure your diet changes are sustainable for a lifetime. Avoid any fad diets that you can't stay on for very long. Work exercise into your day, and again, make it something you can do for a long time. I have known people who tried to walk 5 miles twice per day, and while it is good to do, it is hard to maintain for a long time. I hope this answered your questions.

  Mary (Lyons, IL) - 11:54 AM:

I have hypoglycemia/ "borderline" diabetes. I normally use Splenda as my sugar substitute, but would like to find a healthier alternative. I have tried Stevia, but don't care for the aftertaste.

Coconut palm sugar has been suggested to me, but I am hesitant to try it without knowing if this is a "workable" choice for hypoglycemia. Is this safe for me, or can you suggest any other options?


Harriet Salzberg, RD, LDN, CDE (NorthShore)

Hi Mary,

First of all, make sure you eat 3 regular meals. Eating snacks with some protein and carbohydrates will help prevent low blood sugar.

Avoid any concentrated sweets or juices or sweetened beverages since they may increase your blood sugar and then may also cause a sudden drop in your blood sugar later on.

Eat meals about every 5 hours and snacks about 2-2.5 hours after meals, especially at the time of day the hypoglycemia usually occurs.

To answer your question about the coconut palm sugar - it has the same carbohydrate and caloric content as regular sugar, and is not recommended for prediabetes, "borderline" diabetes or hypoglycemia.

Research shows that all of the artificial sweeteners on the market are safe in small quantities and would recommend you continue with Splenda if that is the one you prefer.

Kathryn (Moderator) - 11:55 AM:
This will be our last question.

Kathryn (Moderator) - 12:02 PM:
This will be the end of our chat - thank you for your questions. We will work on additional content to provide answers for those we did not have time for today.

Kathryn (Moderator) - 12:02 PM:
For more information on diabetes and diets, or to speak with a specialist like Harriet, you can contact the department of Endocrinology and Diabetes.

Harriet Salzberg, RD, LDN, CDE (NorthShore) - 12:06 PM:
I want to thank everyone for your interest in this topic. Thanks for the questions and sorry if I could not get to all of them.

This chat has ended.

Thank you very much for your participation.