Diabetes diet - higher energy

Aim

To provide a diet that supports blood glucose management while providing a higher energy density than the Diabetes diet.

Characteristics

Moderately high energy and a moderately even spread of carbohydrate per meal (30–75g per main meal; 15–30g per mid-meal). Includes at least one low-glycaemic-index option (GI <55) at each meal and snack. Default meals should provide a minimum of two carbohydrate portions. Default mid-meals should provide one carbohydrate portion (e.g. half sandwich or one portion-control pack of two plain biscuits). The fat and protein level of this diet is higher than that of the Diabetes diet with preference for mono and polyunsaturated fats.

Indications

For patients with diabetes who:

• are malnourished
• are at risk of malnutrition
• are eating poorly
• have higher energy needs.

Nutritional adequacy

Nutritionally inadequate.

Precautions

Generally not suitable for patients with unstable insulin-requiring diabetes or for women with diabetes in pregnancy (see separate diet specifications: Diabetes and Diabetes in pregnancy).

It is appropriate to serve patients with diabetes from regular unrestricted menus. Special sugar-free and diabetic foods are not required, but artificial sweeteners are offered with tea and coffee to support patient choice.

Paediatrics

Suitable for use in paediatrics when combined with age-appropriate diet.

Specific menu planning guidelines

	Allowed	Not allowed
Hot main dishes	Dishes with ≤60g carbohydrate per serve.	Fatty meat (e.g. bacon, sausages, hamburger mince), offal Dishes cooked in saturated fat (e.g. shortening, lard, palm oil, coconut milk)
Sauces, gravies	All	-
Starchy vegetables / pasta / rice	All, including high-protein mashed potato	-
Vegetables	All, including steamed, boiled, or fried or roasted with mono or polyunsaturated fat	-
Soups	All	-
Sandwiches	All, preferably made with monounsaturated margarine, but polyunsaturated margarine and butter also allowed All breads, including low-GI breads (see GI website for full list)	-
Salads, dressings	All	-
Breads, cereals	All breads, including low-GI choices (see GI website for full list) Breakfast cereals with <30% sugar, unless primarily from fruit; at least two low-GI options per breakfast (see GI website for full list)	Breakfast cereals with >30% sugar, unless primarily from fruit
Spreads	Jam, yeast spread, honey, peanut butter Preferably monounsaturated margarines, oils and mayonnaise, but polyunsaturated also allowed Butter	-
Hot breakfast choices	All	-
Fruit	All	-
Yoghurt	All	-
Desserts	All desserts with ≤45g carbohydrate per serve, which may include regular jelly and jellied fruit	-
Milk and cheese	All, including flavoured milk	-
Beverages	Water, milk, tea, coffee, low-joule soft drinks and cordial, plain mineral water Fruit juice with no added sugar (maximum 2 serves per day)	Regular soft drinks, cordial
Biscuits	All	-
Miscellaneous	All herbs and spices, nuts Sugar (maximum 1 sachet per meal and midmeal allowable) Salt, pepper Artificial sweeteners	Cream Potato crisps Chocolate bars
Celebratory foods, special occasions	20g chocolate easter eggs on Easter Sunday

References

1. American Diabetes Association. Standards of Medical Care in Diabetes – 2016 Abridged for Primary Care Providers. Clinical Diabetes. 2016;34(1):3-21.
2. Glycemic Index Foundation, University of Sydney. The GI Index and GI database. [accessed 12 Ocober 2015].
3. 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