Diabetes Forecast

8 Tips for Smart Snacking

Bites can help you manage blood glucose, cravings, and weight

By Tracey Neithercott , ,

To snack, or not to snack? That's the question a lot of people with diabetes ask themselves when cravings strike or when defending against hypoglycemia. Read on to find out why the answer is more personal than you might think.

The Battle for Blood Glucose

There was a time not too long ago when snacking was as important to insulin-treated diabetes as frequent finger sticks. Long-acting insulin had higher peaks, and short-acting insulin lasted a lot longer than today's rapid-acting versions. To keep blood glucose from crashing when insulin peaked, people with diabetes would have a snack. Eating something was especially important before bedtime because pre-dinner insulin doses could peak overnight, leading to dangerous lows during sleep.

Thankfully, long-acting insulin used today is steadier and there's less of a peak effect. And current rapid- and short-acting insulins work faster, so their peaks better coincide with meals. "Both of those innovations in insulin have made eating with diabetes much more flexible than before," says Karen Chapman-Novakofski, RD, LD, PhD, a professor of nutrition at the University of Illinois–Urbana-Champaign.

You and your health care provider can agree on a snacking plan that works for you. Here are a few tips:

Frequent lows? Consider altering your insulin regimen. Even with newer insulins, some people still rely on snacks to stave off hypoglycemia, a practice that's not always necessary and may lead to weight gain. If you tend to go low throughout the day or overnight, talk to your doctor. He or she can determine if you need to cut back on your background or mealtime doses, if a different insulin may work better, if mixed insulin should be separated into two doses, or if a pump, which can deliver very small doses of insulin over time, would be a better fit for you than daily injections.

Find the best insulin-to-carb ratio for you. If you frequently go low after covering a snack with insulin, take a look at how you dose for snacks. Most likely, the culprit is an out-of-whack insulin-to-carb ratio, which helps determine the units of insulin needed to cover a given food. For someone sensitive to insulin, the ratio may be 1 unit of insulin to 15 grams of carbohydrate. "For someone not very sensitive at all, it may be 1 to 5," says Chapman-Novakofski. With the wrong ratio, you could dose too much insulin for too little carbohydrate, so talk to your provider about adjusting if you suspect a problem. Some people find they may need more insulin to carbohydrate in the morning, when they are less sensitive to insulin, yet have a different ratio later in the day.

Examine how your body reacts to insulin. Knowing the type of insulin you use to cover meals can also prevent you from going low after snacking. "[Short- and rapid-acting insulins] have different peaks and clearance rates," Chapman-Novakofski says. To determine how your mealtime insulin's onset, peak, and duration affect your post-snack blood glucose, test before you snack, two hours after you take your first bite, and note your next premeal result, too. Do this for three or more days to help spot any patterns. Also, keep in mind: Snacking without taking insulin can lead to high blood glucose. (Chapman-Novakofski says people with type 2 diabetes who take certain oral medications don't usually have to snack to prevent lows. Sulfonylureas, however, may require snacks or regular mealtimes to prevent lows.)

Fighting Hunger

Practically speaking, there's a very good reason to snack between meals: You're hungry. Maybe you ate breakfast at 7 a.m. and have a lunch meeting at 1 p.m. A mid-morning snack can tide you over. And the good news is, you don't have to eat a lot, risking weight gain, to quell hunger pangs. A study published earlier this year in the journal Food Quality and Preference found that small snacks satisfied people just as much as high-calorie ones.

Eat filling foods. Smart snackers will consider more than calories and carbs when choosing something to eat. Look for a mix of protein and carbohydrate with plenty of fiber. Protein and fiber may make you feel full longer, says Nicole Brent, RD, LD, CDE, a registered dietitian and diabetes educator in Austin, Texas. Try an apple with 1 tablespoon of peanut butter, crackers and 1 ounce of low-fat cheese, or one of Kashi's low-fat, high-fiber, high-protein granola bars.

Aside from preventing stomach growling, snacking to fight hunger can help you avoid overeating, too. If you're hungry but not starving before a meal, you're much less likely to overindulge.

Not a fan of snacking but fighting late-afternoon hunger? Eat more filling meals. "The favorite time to snack is in the evening because you're not busy and you get to relax," says Brent. And, you may be unconsciously making up for calorie deficits during the day. Add chicken (protein) and some whole wheat bread (carb) to your lunch salad to stay satisfied until dinner.

Munch on fruits and veggies. If you're going to snack, make it worth your while nutritionally. Use snacks to make up for any food-group deficiencies in your diet: Reach for an apple or pear. Dip peppers, broccoli, and green beans into hummus if your lunch and dinners are lacking in the veggie department. Make a point to snack on low-fat yogurt.

War on Weight

If you've ever stared down a bag of potato chips, you know the precarious position snacking can put a person in. Though it can keep hunger at bay, it is very easy to overindulge. Sure, you mean to eat only a handful, but the bag is right there and the chips are perfectly salty and, well, the bag's now empty.

Mind your portions. When it comes to snacking, portion control is key. Without it, those light bites might end up having as many calories as your meals. Shoot for between 100 and 150 calories per snack, says Brent.

While buying individual-sized bags can help you keep portions in check, you can also measure out single servings of foods bought in bulk. Set aside one portion, then wrap the rest up. That means pouring potato chips into a small bowl instead of eating from the bag.

Avoid nonstop grazing. Snacking too much in one sitting isn't the only possible cause of America's expanding waistlines. A 2001 study in the journal Obesity examined 20 years of U.S. snacking habits and found that people didn't eat more calories per snack but instead snacked more times per day. Consider this: Eating six small snacks per day can raise your daily intake by 600 to 900 calories. And that's assuming you don't overindulge. "The more times you go over on portions, the more likely you are to gain weight," says Chapman-Novakofski.

Stick with a couple of snacks a day. To prevent eating too frequently, consider your motives before you grab a snack. "First and foremost, are you really hungry or are you bored?" Brent asks. You'll be surprised how often your answer is the latter.

Plan ahead. If easy-to-find snacks are too hard to resist, make them less readily available. "If I don't want to snack between breakfast and lunch, I don't keep snacks in my drawers," says Chapman-Novakofski. "For some people, it may be that there's always something to eat in the break room." Prevent mindless snacking by taking breaks elsewhere (bonus: go for a walk and burn some calories) or preparing healthy eats ahead of time.

"The thing that makes this hard is when you don't have a plan," Chapman-Novakofski says. "It's easier to have the extra snack." Prepping ahead of time will also help you integrate your snacking plans with your diabetes management.



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