Diabetes diet - diabetes
This document is part of the ACI Diet Specifications for Adult Inpatients. It is not to be used for patient education.
Aim
To provide a diet that optimises blood glucose and lipid levels in patients with diabetes where carbohydrate portion control is specified.
Characteristics
Ensures a set range of carbohydrate at each meal and mid-meal (30–75g per main meal; 15–30g per mid-meal). Reduced saturated fat (<7% energy from saturated fat), added sugar and sodium. Moderate fat. Includes one low glycaemic-index food (GI ≤55) at each meal.
Indications
Type 1 and Type 2 Diabetes Mellitus and steroid induced Diabetes Mellitus. This diet is appropriate for patients on insulin pump therapy, however carbohydrate amounts of main meals and snacks can vary.
Gestational Diabetes Mellitus and diabetes in pregnancy – see separate specification, Diabetes in pregnancy.
Nutritional adequacy
Nutritionally inadequate.
Precautions
It is appropriate to serve patients with diabetes from regular unrestricted menus, with consistent amounts of carbohydrate at meals and snacks. Special sugar-free and diabetic foods are not required.
The energy level and carbohydrate distribution will be individually determined by the dietitian, but a typical meal plan would include the following number of 15g carbohydrate portions per meal (and is inclusive of all meal items).
| Meal | 15 portions per meal |
|---|---|
| Breakfast | 2-5 |
| Morning tea | 1-2 |
| Lunch | 2-5 |
| Afternoon tea | 1-2 |
| Dinner | 2-5 |
| Supper | 1-2 |
Default mid-meals should provide one carbohydrate portion (e.g. half sandwich or two portion-control plain biscuits).
Paediatrics
Suitable for use in paediatrics when combined with an age-appropriate diet.
Specific menu planning guidelines
| Allowed | Not allowed | |
|---|---|---|
| Hot main dishes | Main dishes ≤15g fat, ≤5g saturated fat, ≤45g carbohydrate and ≤15g added sugar per serve Lean meat, skinless chicken, fish, eggs Soy products, e.g. tofu, textured vegetable protein (TVP) Cooked legumes | Fatty meat (e.g. bacon, sausages, hamburger mince), offal Deep-fried and shallow fried meals |
| Sauces, gravies | Sauces and gravies with <1.5g saturated fat and <15g carbohydrate per serve Cranberry and mint sauces in small amounts | Cream-based sauces |
| Starchy vegetables / pasta / rice | Dishes with <1.5g saturated fat per serve Dishes prepared with small amounts of mono or polyunsaturated oil (e.g. mashed and steamed potato, sweet potato) Use low-GI rice (e.g. basmati or doongara) if possible (see GI website for full list) | Dishes with >1.5g saturated fat |
| Vegetables | <1.0g saturated fat per serve Plain steamed or boiled vegetables Vegetables prepared with small amounts of mono or polyunsaturated oil | Vegetables with >1.0g saturated fat per serve |
| Soups | Low-fat soups (≤5g fat and ≤1.5g saturated fat per serve) | Soups made with cream or full fat milk |
| Sandwiches | ≤15g fat and ≤5g saturated fat per serve Preferably made with monounsaturated margarine, but polyunsaturated also allowed | Butter |
| Salads, dressings | All salads ≤15g fat and ≤5g saturated fat Low-joule dressings, or dressings made with mono or polyunsaturated oils | Cream or full-fat dressings or mayonnaise |
| Breads, cereals | Wholegrain / wholemeal breads (preferably grainy low-GI breads) are default White bread may also be available Higher-fibre breakfast cereals only (e.g. rolled oats, muesli, bran cereals, Guardian®, wheat biscuits) At least two low-GI cereal choices per breakfast (see GI website for full list) | Highly sugared breakfast cereals (>30% sugar, unless primarily from added fruit) Sweet breads |
| Spreads | Jam, yeast spread, honey, peanut butter (1 portion control unit per meal in addition to margarine) Preferably monounsaturated margarines, oils or mayonnaise, but polyunsaturated also allowed | Saturated fats (e.g. butter, shortening, lard, cooking margarine) |
| Hot breakfast choices | Hot breakfast items with <3g saturated fat per serve for example boiled, poached or scrambled egg and omelettes Mushrooms, baked beans, tomatoes | Fried egg, fatty bacon, sausages Hash browns Pancakes/hotcakes/waffles |
| Fruit | Fresh, frozen or unsweetened canned fruit in natural juice or light syrup Dried fruit <15g carbohydrate per serve | Fruit canned in syrup |
| Yoghurt | Yoghurts with <5g saturated fat and <30g carbohydrate per serve | All other yoghurts |
| Desserts | Desserts with ≤2g/serve saturated fat and ≤30g carbohydrate per serve Low-fat ice-cream and diet jelly Low-fat custard and creamy rice Tapioca, sago | Full-fat ice-cream High-fat and sugar pastries and pies Regular jelly and jellied fruit |
| Milk and cheese | All milks (unsweetened) for tea, coffee and cereal only Low fat cheese (e.g. ricotta and cottage cheeses) Hard cheese <5g fat per serve | Full-fat cheeses and cheese spreads Full fat milk drinks |
| Beverages | Water, low-fat milk, tea, coffee, low-joule soft drinks or cordial, plain mineral water Fruit juice without added sugar (maximum 1 serve per day) | Regular soft drinks and cordial, flavoured mineral water, alcoholic drinks, full fat milk drinks |
| Biscuits | Plain low fat biscuits and crackers with ≤2g saturated fat per serve (e.g. Granita™, Shredded Wheatmeal™, Milk Coffee™, Milk Arrowroot™) – maximum 2 serves per day | Cream or chocolate biscuits |
| Miscellaneous | All herbs and spices; nuts Artificial sweeteners 1 sugar sachet at breakfast Salt (maximum 1 sachet per meal) Pepper | Cream Potato crisps, chocolate |
| Celebratory foods, special occasions | 20g chocolate easter eggs on Easter Sunday |
References
- American Diabetes Association. Standards of Medical Care in Diabetes – 2016 Abridged for Primary Care Providers. Clinical Diabetes. 2016;34(1):3-21.
- Glycemic Index Foundation, University of Sydney. The GI Index and GI database. [accessed 12 October 2015].
- Dietitians Association of Australia. Nutrition manual. 9th ed. Canberra: DAA; 2014
Change log
| Change date | Section updated | Change |
|---|---|---|
| April 2021 | Title of Specification | Title changed from Diabetic diet - diabetes in pregnancy to Diabetes diets - diabetes in pregnancy |
| September 2022 | Specific menu planning guidelines | Created a new food group row under Miscellaneous, titled Celebratory foods, special occasions |
| September 2022 |
Specific menu planning guidelines - Celebratory foods, special occasions | In Allowed, added 20g chocolate easter eggs on Easter Sunday |