September 2010 Issue Diabetes-Friendly Snacking Options By Lenora Dannelke Today’s Dietitian Vol. 12 Grabbing a quick bite between meals isn’t off-limits for people with diabetes. “Snacking can really contribute to a healthy diet. It ensures that our body gets the fuel that it needs regularly throughout the day—and that’s true for everybody, diabetes or not,” says Beverley Manganelli, RD, BS, CDE, manager of community nutrition services at Hunterdon Medical Center in Flemington, N.J. “What’s different for someone with diabetes is, obviously, what kind of medications they’re on and their blood sugar control.

Snacking can definitely impact that, so you need to pay a little more attention to the things that you choose. Although there are no ‘never’ foods, you do want to get a nutritious bang for your buck.” Because carbohydrate is the nutrient that impacts blood sugar the most, monitoring intake is crucial. “Generally, snacks can be between 15 and 30 g [of carbohydrate], but that’s based on individual needs and what that patient works out with their registered dietitian,” says Manganelli. Caloric intake needs to be addressed as well, especially since many people with type 2 diabetes need to lose weight. However, a patient already at a good weight who works at an active job may need more carbohydrates.

Older patients with long-standing diabetes often struggle with the idea that they can work sugar into their food plan. “They’re used to the old way of thinking,” says Lindsay Fortman, RD, CDE, of Memorial Healthcare’s Diabetes & Outpatient Nutrition Counseling Center in Owosso, Mich. “But with being allowed to eat anything—it’s portion size that matters—we are seeing better compliance.” Time It Right Grazing throughout the day, however, may negatively impact blood sugar. Constantly taking in carbohydrates and extra calories can result in consistently high blood sugar, which leads to weight gain—and that also affects blood sugar.

“For that reason, having a scheduled snack time may be good for diabetics,” Manganelli says. “If they’re eating a midmorning snack, they may need to take a prelunch blood sugar to see what it’s doing.” The same applies to midafternoon snacks and dinner. “That way, they have a big picture of their blood sugar throughout the day,” she says. The goal is pattern management that requires less-frequent checking.

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While most dieters seeking to lose weight avoid evening snacks, people with diabetes may benefit from eating after dinner. “Usually we encourage a bedtime snack to keep the liver from pumping out stored glucose,” Fortman says. “Typically, patients will have a better glucose reading in the morning if they get in a 1- to 2-carb-choice snack at night.” Satisfy Cravings Fiber and Whole Grains “I’m a huge fiber advocate,” says Fortman. “Not only is fiber great for satiety, but there are a lot of studies recently that show that fiber is good for preventing cardiovascular disease and lowering cholesterol and that it regulates the grehlin level, which is a hormone that stimulates hunger.