A Guide to Eating Out With Diabetes
When you are first diagnosed with any type of diabetes or prediabetes it may feel like your social life is over or eating out with diabetes is impossible.
Special occasions like birthdays, weddings and Valentine's Day begin to seem less like events to celebrate and more like endurance tests, food-wise.
It can be relatively easy to make healthy food choices at home but faced with a gloriously indulgent piece of cake, a glass of champagne or even a carb-fest of a buffet, and it can be challenging to stay on the straight and narrow without looking like a party pooper and feeling like the odd one out.
The good news is that you don't have to completely give up all that is "bad" for a person with diabetes. Because in reality, nothing is truly wrong if enjoyed in moderation.
No Food is Banned
In the past, I had bought products from that section for my Grandma who had diabetes. I thought it was lovely that I could buy her specialist treats. Little did I know that I was overpaying for food items which had earned the higher price tag simply with the addition of the “diabetic friendly" label.
My nutritionist soon put me right and informed me that all food is diabetic food. No food is banned. You just have to be careful about how much you eat or drink and if on medication, adjust accordingly. In fact, she told me I was not eating enough carbohydrates, which can lead to a hypo – diabetic hypoglycemia when your blood sugars drop too low.
The advice to diabetics is the same as it is to the rest of the population – eat a healthy balanced diet which is low in fat, sugar, and salt and make sure you include plenty of fruit and vegetables in your choices.
If you want to eat healthily and enjoy meals out, you are going to have to learn a little more about nutrition to keep your blood glucose stable and low and your heart, eyes, and nerves healthy and operating as they should.
Track Your Blood Sugars
Keeping track of your blood glucose levels is vital. There are a variety of ways to do this – finger prick blood tests, have an implant which sends information to a wireless device or with regular HbA1C tests which check the trend over some months.
Many people with diabetes use tablet-based medication and it’s important to keep on top of these. Buy a pill sorting box if you have trouble remembering whether you’ve taken the right tablet at the right time and if necessary ask someone with sharp eyes and nimble fingers to help you load the little boxes for the week ahead.
If you are using insulin, it’s even more important to check your sugars regularly and adjust your dose accordingly. Don’t be tempted to guess even if you know what it usually is after a pizza for instance.
If you feel embarrassed about testing or injecting in a busy restaurant, you can just nip to the restroom or ask the server if there’s somewhere private you can discreetly inject.
I’ve found however that people are more curious than freaked out by learning someone is an insulin dependent diabetic so you could use your blood glucose check and maintenance as an opportunity to educate those around you a little more and banish some of those myths.
Read the Labels
Keeping an eye on how much sugar is in your diet is relatively easy when you are buying tins, boxes, and packets at the grocery store. I quickly learned to read food labels and to spot the hidden sugars.
Did you know there are at least 61 different names for sugar listed on food labels including sucrose and high-fructose corn syrup, as well as barley malt, dextrose, maltose, and rice syrup, among others?
What to Watch Out For
So it's Valentine's Day coming up, and your loved one is treating you to a dinner out. What should you be looking out for to avoid a very unromantic hypo or hyper?
French Cuisine
French is traditionally the food of love, but you might find it tricky to order healthy food straight off the menu. Lots of dishes are smothered in cheese or creamy sauces, but you can choose healthier options like mussels cooked in wine not cream, Bouillabaisse, the traditional low-fat fish broth and Nicoise salad.
Skip the cheese course and of course, avoid too many French Frites both in the Bistro or any other restaurant!
Thinking of Drinking French Wine?
The French are known for their good wine, but if you have diabetes, you have to be careful about drinking wine.
According to the American Diabetes Association, drinking wine or in fact, any alcoholic beverage can lower blood sugar for up to 24 hours because alcohol blocks the production of glucose in the liver. Because of this, they recommend checking your blood sugar before you drink, while you drink, and monitoring it for up to 24 hours after drinking.
Now I know what you are thinking, but no, you cannot have a couple of glasses of wine and hope it lowers your blood glucose enough to offset that giant slice of frosted cake you’ve spotted on the menu.
Some alcohol can raise blood sugar levels – it's hard to predict how you will react.
The American Diabetes Association recommends that if you do want to drink alcohol, that you do so with food and test your blood glucose if you can for up to 24 hours after drinking.
Intoxication and low blood sugar can share many of the same symptoms, so failing to check your blood glucose could cause others to assume you’re feeling the effects of an alcoholic beverage when in reality your blood sugar may be reaching dangerously low levels.
Drinking spritzers or coolers can be a great compromise while some studies have revealed that one glass of red wine a day can help reduce heart disease in people with diabetes. That’s one glass, not one bottle. Drinking more than one glass will void any potential health benefit.
Chinese Food
If you're opting for Chinese food, avoid deep fried items and choose a healthier stir-fry. Some restaurants prepare it right in front of you so you can decide what goes in. Then choose boiled rice or noodles over egg-fried rice as your carb portion.
Asian style hotpot or steamboat is a good choice.
You can choose a broth (there’s usually a choice of spicy or not spicy and meat-based or vegetable based broth) then add healthy choices like vegetables and seafood or lean meat. Everyone at the table shares the broth, dipping ingredients in like a fondue but without the high-fat, high-carb naughtiness.
At the end of dipping, you drink the now flavorsome soup with or without noodles. It’s a lovely sociable low carb choice
Italian Food
Maybe you fancy an Italian treat? Pizza is nice but be careful which toppings you add.
Roasted vegetables and olives are much better for you than spicy meats and sausages. Some restaurants now offer a slimmer’s pizza which is a lighter thin crust and has a hole in the middle filled with salad.
If your favorite restaurant doesn’t do this, choose thin crust with a side of salad instead of garlic bread! Oh, but don't forget to watch out for those salad dressings. Opt for vinaigrette, a splash of Balsamic vinegar or no dressing at all.
Lasagna (and in fact many pasta dishes) can be a high-fat luxury.
Remember, Not All Food is Bad
As I said before no food is banned for those with diabetes so if you must have a creamy pasta dish, why not ask for a half portion or choose from the children’s menu.
All the taste but half of the carbs, fat, and calories. Or if you must have the whole portion, skip dessert, especially if there’s Tiramisu on the menu.
If you don’t want to feel left out, maybe opt for an Italian coffee to sip while others eat dessert. Beware of carb-laden milky coffees like latte and cappuccino though. Choose espresso or Americano or a brew you can add just a dash of milk.
Good Choices for Diabetics
- Indian food. Perhaps not a traditional choice for Valentine's Day but one who is getting more popular with people who don't necessarily want a set menu with an inflated price tag. There are lots of types of Indian cuisine depending what region the chef is from (much like Chinese), but generally, you can choose a Tikka dish that doesn't come smothered in a creamy sauce or a dryer dish like Biryani. There are usually good vegetarian options too including ingredients like chickpeas and lentils which are an excellent source of fiber.
- Mediterranean restaurants are great if, like me, you love skewered meat grilled or cooked over coals. Meals often come served with boiled rice and salads, or you can choose half fries, half rice – one of my favorite options! Enjoy heart-healthy olives, couscous, and hummus and say no to moussaka, gyros (doner kebab) and baklava.
- Vegetarian restaurants will often have a good choice of healthy options with refreshing salads and imaginative ingredients. However just because a meal is vegetarian does not mean a meal is diabetes-friendly – watch out for cheese-laden dishes in particular.
Portion Control and Substitutions
Try asking for a half portion and fill the rest of your plate with salad, or take the full sized portion and request the restaurant to give you half in a take-home box.
I use my husband as my portion control – he’s always delighted to eat half of my meal as well as his own!
This portion advice applies to many meals actually, and most restaurants are happy to give you a "doggy bag." Think portion control, don't be embarrassed to inform the waiter that you need a smaller portion "for medical reasons" and avoid all you can eat buffet restaurants if you want to stay healthy with good blood glucose control.
If you must go to a buffet restaurant, offer to drive, so you aren’t tempted to add alcoholic drinks to your intake and limit your carbs.
They are there to increase the restaurant’s profit anyway so skip the bread rolls and eat more shrimp! Stay away from chocolate fountains and unlimited ice cream deals. Your blood glucose will skyrocket.
Asking for Substitutions
Don't be afraid to ask for substitutions either. Most good restaurants are used to dealing with special diets, so mix and match off the menu – swap fries for salad, ask them to hold the cream, add some vegetables – the possibilities are endless.
If you are not sure about what swaps to make, ask your server if they can ask the chef for suggestions for a low-carb, low-sugar option. They will almost certainly have studied nutrition and specialist diets as part of their training and may even cook you up a unique dish. It’s always worth asking.
If they can't or won't help you create your dish it might be a sign that everything is pre-prepared, frozen and microwaved, so you don't want to eat there anyway. Perhaps mention your specialist diet when booking and ask if substitutions would be accommodated, especially if you know the time or date you have scheduled is likely to be busy – like Valentine's Day for instance.
Consider Eating at Home
Maybe the best idea would be to cook your loved one a meal at home – or persuade them to cook for you! Then you can choose luxury foods like prawns, grilled steak or baked fish, pick out your favorite vegetables to have on the side (and maybe some chocolate dipped strawberries for dessert?) and have full control of the portion sizes and carbohydrate content.
If you're hosting a party, and if guests ask if they can bring anything, remind them gently that you have diabetes to avoid being given gifts of candy or chocolate. It’s all too easy for your willpower to fail at the end of a lovely sociable meal and to end up dipping your hand into the chocolate box as it goes past while you are chatting.
Cooking for friends and family can be a lot of fun, and you don’t have to prepare anything expensive or elaborate. You can use them even as an opportunity to try out some diabetes-friendly recipes – there are loads online. You will probably save quite a bit of money compared to eating out too – bonus!