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Type I diabetes: nutrition and exercise| Pediatric Diabetes | Patient Education | UC Davis Children's Hospital

Type I Diabetes: Nutrition and exercise

Nutrition and type 1 diabetes

Foods are made of carbohydrates, protein, and fat – or a mixture of these. Carbohydrates turn into sugar in your body. When you eat carbohydrates you must take an insulin injection.

Which foods have carbohydrates?

Carbohydrates come from starch and sugar in food. Carbohydrates can be found in the following food groups:

  • Starches
  • Milk and yogurt
  • Fruits
  • Foods with added sugar

Finding the amount of carbohydrates in foods

Knowing the amount of carbohydrates in the foods you eat is important to managing your Type 1 diabetes. The following resources can help you find the amount of carbohydrates in the food you eat:

Nutrition facts

If a food has a label, use these steps to count how many carbohydrates you are eating:

  1. Check the serving size.
    • Use a measuring cup or food scale to measure your food portion accurately.
  2. Check the “Total Carbohydrate”.
    • This is the amount (in grams) of carbohydrate per 1 serving. This number includes starch, sugars, and fiber*. Do not count grams of “Sugars” (listed under “Total Carbohydrate”) separately.
  3. Adjust your carbohydrate count if you are eating more or less than 1 serving.

Examples:

  • If you eat ½ cup of the food in the sample label, your carb intake would be 11 grams.
  • If you eat 2 cups of the food in the sample label (1 full container), your carb intake would be 44 grams.

“The Calorie King Calorie, Fat & Carbohydrate Counter” by Allan Borushek

  • There is a section within the book dedicated to fiber. The carbohydrate counts do not include fiber, so it is important to check this section separately if you are going to make an adjustment to your insulin dose.

  • Calorie King
  • Figwee Visual Food Diary
  • Lose It!
  • My Fitness Pal

Diabetes food lists

These food lists may be helpful in estimating carbohydrates when you do not have a food label or other resource available. Remember that each choice is only an estimate of carbohydrate content.

Carbohydrate Food Lists:

  • ½ small bagel or ¼ large bagel (1 oz)
  • 1 slice bread (1 oz)
  • ½ cup cooked beans or lentils
  • ½ cup cooked cereal
  • ¾ cup dry cereal, unsweetened
  • ½ English muffin
  • 20 thin French fries
  • ½ hamburger or hot dog bun
  • 1 pancake (4 inches across)
  • ⅓ cup cooked pasta
  • 3 cups popcorn
  • ⅓ cup cooked rice or quinoa
  • 6 saltine crackers
  • 1 (6-inch) tortilla
  • 13 tortilla chips (1 oz)
  • 1 waffle (4 ½ inches)
  • 6 saltine crackers
  • 1 (6-inch) tortilla
  • 13 tortilla chips (1 oz)
  • 1 waffle (4 ½ inches)

Starchy Vegetables:

  • ½ cup corn or green peas
  • 1 small potato
  • ½ cup mashed potato, sweet potato, or yam
  • 1 cup winter squash (acorn, butternut, pumpkin)

  • 1 small (4 oz) apple
  • 8 dried apricot halves
  • 1 (4-inch) banana
  • ¾ cup blueberries
  • ½ cup canned fruit, in juice
  • 2 Tbsp dried fruit
  • 17 small grapes
  • ½ cup juice (apple, orange, pomegranate)
  • ½ cup kiwi, sliced
  • 1 cup cubed melon (cantaloupe or honeydew)
  • 1 medium (5 ½ - 6 ½ oz) nectarine, peach, or orange
  • ¾ cup fresh pineapple
  • 1¼ cup strawberries
  • 1¼ cup watermelon

  • 1 cup milk
  • 1 cup sweetened soy milk
  • 1 cup plain nonfat or low-fat yogurt

  • 1 small (1¼- inch square) brownie, unfrosted
  • 1 (2-inch square) piece cake, unfrosted
  • ½ cup ice cream, sorbet, or sherbet
  • 1 (3 oz) fruit juice bar
  • 3 small sugar-free cookies
  • ½ cup sugar-free pudding
  • 5 vanilla wafers

Low-Carbohydrate Food Groups

Include vegetables in your diet every day. Remember to count starchy vegetables (such as potatoes, corn, and peas) as carbohydrate.

  • Artichokes
  • Asparagus
  • Beets
  • Broccoli
  • Carrots
  • Cauliflower
  • Cucumber
  • Eggplant
  • Green beans
  • Lettuce, greens
  • Mushrooms
  • Onions
  • Peppers
  • Radishes
  • Spinach
  • Tomato
  • Water chestnuts
  • Zucchini

Choose lean protein sources more often. Try to eat protein foods with your meals.

  • Chicken or turkey
  • Cheese
  • Cottage cheese
  • Eggs
  • Fish
  • Jerky
  • Lean beef, lamb, or pork
  • Meatless breakfast “sausage” patties
  • Peanut butter
  • Tofu or tempeh

Eat more fat as unsaturated fat, which comes from non-animal sources like avocado, olives, nuts and seeds.

  • Avocado
  • Bacon
  • Butter
  • Coconut milk
  • Cream cheese
  • Margarine
  • Mayonnaise
  • Nuts
  • Oil
  • Olives
  • Peanut/nut butter
  • Salad dressing
  • Seeds

These foods contain less than 5 grams carbohydrate per serving. Limit “free foods” to 3 servings per day.

  • ¼ cup salsa
  • 1 Tbsp low-fat sour cream
  • 2 Tbsp whipped topping
  • 1 sugar-free hard candy
  • 2 tsp light jam or jelly
  • Sugar-free gelatin
  • 1 Tbsp honey mustard or ketchup
  • 1 Tbsp honey mustard or ketchup
  • Vinegar or lemon juice
  • 1 large dill pickle
  • 1 Tbsp fat-free cream cheese
  • Diet soda, diet beverage
  • 4 tsp sugar-free coffee creamer

Exercise and type 1 diabetes

Exercise increases strength, improves heart health, and helps with mood and weight management. People with Type 1 diabetes may see extra benefits from exercise, such as steady insulin sensitivity, better balance, stability, and joint function, and lower insulin needs. Aim for 60 minutes or more of moderate to heavy physical activity every day.

Different types of exercise may affect blood glucose differently.

During exercise, insulin helps move glucose from the blood to the muscle cells. Different types of activities may have different effects on blood glucose levels.

  • Aerobic exercise is continuous, light- to moderate intensity exercise like running, swimming, and biking. This type of exercise may lower blood glucose levels. Less insulin and more carbohydrate may be necessary.
  • Anaerobic exercise is usually shorter in duration with higher intensity and includes activities like sprinting, gymnastics, and weight-lifting. This type of exercise may raise blood glucose levels. More insulin may be necessary. 
  • The stress and excitement of competition may cause higher blood glucose levels, even if the same sport causes low blood glucose during practice or training.

It is important to test blood glucose frequently or use a continuous glucose monitor to follow blood glucose trends before, during, and after activity. Blood glucose may drop for up to 24 hours after exercise is over.

Other things to consider when exercising:

Poor hydration and positive ketones may cause your blood glucose to rise during exercise.

  • Drink plenty of water before, during, and after exercise. Fruit juice or sports drinks can help meet carb AND hydration needs during exercise.
  • Do not exercise if you have positive ketones.
  • Eat carbohydrates right before starting exercise (do NOT cover these carbs with insulin).
  • Aim for blood glucose between 100-120 mg/dl for low intensity exercise (walking, casual biking, bowling).
  • Aim for blood glucose between 150 – 200 mg/dl when starting moderate or heavy exercise.
  • If at any time blood glucose is >350 mg/dl, check for ketones. Do not exercise if you have positive ketones.
  • Remember, each person is different. Test your blood glucose often during exercise so that you can find out how your own body responds to exercise. Competitive athletes will likely have higher carbohydrate needs.