Scripps Cancer Center

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Managing Diabetes - Nutrition Basics

Medical Nutrition Therapy

 

About

Managing blood sugar (also known as blood glucose) before, during, and after cancer treatment is important. Some cancer treatments may impact blood sugar, but nutrition and lifestyle modifications can help manage these levels.

Foods with carbohydrates increase blood sugar. Carbohydrates should be in the diet, but some food sources provide more nutrients and do not increase blood sugar quite as high as others. To help blood sugar stay in the preferred range, eat a balanced plate that includes protein and fiber along with carbohydrates in a proper portion size. Speak to a Registered Dietitian Nutritionist for an individualized approach.

 

Foods That Have Carbohydrates
Breads & grains Dairy and dairy alternatives Starchy vegetables	Fruit Desserts Beverages with calories

 

Plate Planning

Foods with Carbohydrates

Below are foods that contain carbohydrates and carbohydrates increase blood sugar. Eat these foods in moderation and monitor portion sizes.

 

Foods With Carbohydrates (1 serving = 15 grams of carbs)
Breads & Grains Bread (1 slice or 1 oz) Bagels (1/4 large, or 1 oz) Bun, hamburger/hotdog (1/2 each) Chips (3/4 oz or about 10 each) Crackers (5-6 each) Oatmeal, cooked (1/2 cup) Pasta, cooked (1/3 cup) Pita bread (6 inches) Quinoa (1/3 cup) Rice, cooked (1/3 cup) Tortilla chips (13 each) Tortilla, flour (6 inches)	Fruit Apple (1 small) Bananas (1/2 large or 4 oz) Berries (3/4 cup) Cherries (15 each) Dried fruit (2 Tbsp) Grapes (15 each or 3 oz) Mangoes (1/2 cup) Melon (1 cup cubed) Oranges (1 medium or 6.5 oz) Peaches (1 medium or 6 oz) Pears (1 small) Tangerines (3 each)
Dairy & Dairy Alternatives Milk- fat free, 1%, 2%, whole (1 cup) Rice milk, unsweetened (1 cup) Soy milk, plain (1 cup) Yogurt, plain (6 oz)	Sweets & Desserts Cake, frosted (1 inch) Ice cream or frozen yogurt (1/2 cup) Jelly, jam, syrup, honey (1 tablespoon) Muffin (1/4 medium or 1 oz)
Starchy Veggies Beans, cooked (1/2 cup)* Corn, cooked (1/2 cup) Lentils, cooked (1/2 cup)* Peas, green (1/2 cup) Popcorn, air-popped (3 cups) Potato, mashed (1/2 cup) Squash, acorn or butternut (1 cup) *Contains protein	Beverages with Calories *Rarely consume* Coffee, sweetened with real sugar Fruit juice, unsweetened (4 oz) Soda, regular Sports drinks, regular Tea, sweetened with real sugar

**Not a comprehensive list

 

Additional Resources

• American Diabetes Association: https://www.diabetes.org/

• Association of Diabetes Care and Education Specialists: https://www.diabeteseducator.org/

 

Foods with Little-to-No Carbohydrates

Below are foods that contain little to no carbohydrates. Include these with meals and snacks as they can help manage blood sugar readings. 

Foods With Little-to-No Carbohydrates
Non-StarchyVeggies Asparagus Broccoli Brussels sprouts Carrots Cauliflower Celery Cucumbers Eggplant Green beans Lettuce Mushrooms Onions Peppers Spinach Tomatoes Zucchini	Meats and Proteins Eggs Cottage cheese Cheese Fish/seafood Meat (beef, pork, lamb) Poultry (chicken, turkey) Nut butters Nuts Seeds Soybeans Tofu	Fats Unsaturated(anti-inflammatory) Avocado Nut butters Nuts Oils (vegetable, avocado, olive, canola, etc.) Olives Seeds Saturated (eat in moderation) Butter/Margarine Coconut oil Cream cheese Shortening Sour cream   *These foods are high in calories, monitor portion size

**Not a comprehensive list

 

Nutrition Tips

General: Servings of carbohydrates and grams of carbohydrates - what is the difference?

• One serving of carbohydrates equals about 15 grams of carbohydrates

Food choices: Eat a well-balanced diet with a focus on vegetables, fruit, whole grain, low or nonfat dairy, and lean protein. According to the American Diabetes Association

1. Eat more of these: whole unprocessed, non-starchy vegetables

   1. Examples: broccoli, cauliflower, green beans, tomatoes, bell peppers

   2. Why? These have fiber and very little carbohydrates

   3. Make this half of your plate

2. Eat some of these: whole grain/wheat, minimally processed carbohydrate foods

   1. Examples: fresh fruit, quinoa, whole wheat pasta and bread, oatmeal, beans

   2. Why? They contain many health benefits (i.e., fiber, vitamins), and they have carbohydrates

   3. Make this a quarter of your plate

3. Eat less of these: refined, highly processed carbohydrates

   1. Examples: white rice, white bread, sugary drinks and cereals, sweet desserts

   2. Why? These contain easily digested carbohydrates and raise blood sugar quickly

Snacks

• Try choosing options from the "Foods with Little-to-No Carbohydrates" list

• If eating a carbohydrate good, include a non-starchy vegetable, protein, and/or fat food source too

  • This will provide better blood sugar reading than eating a carbohydrate food alone

Beverages

• Choose low calorie beverages without added sugar such as water, tea, or coffee

• Choose diet drinks or those with artificial sweeteners, in moderation

  • Artificial sweeteners do not increase your blood sugar

  • Read the food label to make sure there are no carbohydrates

• Avoid fruit juice, sugary coffees, regular sodas, sports drinks, and energy drinks with calories

 

Label Reading Basics 

1. Labels are based on one typical serving size

   1. Check the "Serving Size" listed and determine if this is how much you plan to eat

      1. Example: one serving size is "1 slice" here

   2. Note how many servings are in one container. If you eat more than one serving, multiply the calories and nutrients by how many servings you eat

      1. Example: if eating two slices - multiply the "Calories" by 2, you will consume 240 calories

2. Look at the "Total Carbohydrate"

   1. This is measured in grams (g)

   2. To determine how many servings of carbohydrates are in 1 serving, take the total and divide by 15

      1. Example: if eating two servings, multiple the "total carbohydrates" by two (23 x 2 = 46 g) and then divide by 15 (46/15 = 3.1)

         1. This means there are 3 servings of carbohydrates in two servings

3. Other information - what are "Added Sugars" and how are they different from "Total Sugars?"

   1. Total Sugars includes sugar naturally found in foods

   2. Added Sugars are sugars added to a food. These can be table sugar, brown sugar, syrups, honey, agave, etc. Keep this number low as it provides calories with minimal nutritional benefit and increase blood sugar very quickly

 

Lifestyle Tips

Take diabetes medications, as prescribed by your doctor

Food habits: small changes can greatly improve blood sugar control

• Monitor portion sizes - especially foods that have carbohydrates

  •  Read the food label to determine what one serving size is

  • Use measuring cups and spoons or a food scale to measure foods high in carbohydrates (i.e., pasta, chips, potatoes, beans, corn)

• Avoid eating too much of one food

  • Variety and moderation are important for overall health

  • Overeating a high carbohydrate food can increase blood sugar level

• Eat meals throughout the day

  • Eat some carbohydrates in each meal, spread out all day

• Do not skip meals

  • If not hungry, consume a snack with a protein and carbohydrate to keep blood sugar stable

  • An extended period without food can lead to a decrease in blood sugar

Exercise and physical activity can help control blood sugar values

• With movement, the body uses the sugar in your blood, and this can improve blood sugar control

• Aim for 150 minutes of moderate physical activity every week

• Ask your doctor what exercises and amount are safe for you

Monitor blood sugar, as prescribed by your doctor

• If you do not have a blood glucose monitor, ask your doctor

• Keep track of blood sugar readings and amount of medication taken

  • Let the healthcare team know about changes in blood sugar

 

Additional Tips

• Sick days: even when not feeling well, it is important to manage blood sugar

  • Stay hydrated and continue to take your diabetes medications as prescribed

• Sometimes blood sugar increases due to reasons other than the food eaten

  • Eat a balanced diet and drink plenty of water

  • If blood sugar stays high for no apparent reason, contact your healthcare team

• Hyperglycemia: high blood sugar

  • Monitor blood sugar regularly

  • Some steroids and cancer treatment may cause blood sugar to increase

  • Many times, side effects from high blood sugar are not felt, but you may feel very tired, thirsty, urinate often, and/or experience blurred vision

  • Ask your doctor if you need to adjust diabetes medications

  • Maintain a balanced diet and speak to a Registered Dietitian Nutritionist

• Hypoglycemia: low blood sugar

  • Common side effects:

    •  Dizzy	•  Lightheaded	•  Quick to Anger
    •  Weak	•  Tired	•  Unstable or lose balance
    •  Shaky	•  Confused	•  Clammy or sweaty

  • The Rule of 15 

    • If experiencing any of the above symptoms and suspect a low blood sugar:

      • Check your blood sugar. If below 70 mg/dL, your blood sugar is too low

      • Take 15 grams of fast-acting carbohydrates

        • Examples: 4 ounces of juice, 1 cup of milk, Glucose tablets

      • Wait 15 minutes, then recheck your blood sugar

        • If still below 70 mg/dL, eat another 15 grams of carbohydrates

        • If it is above 70 mg/dL and you plan to have a meal within one hour, eat the meal. If you do not plan to have a meal within an hour, eat a snack