There can’t be many of us who don’t enjoy a meal out, and having diabetes shouldn’t stop you.
However, changes to eating routine, unknown ingredients and carb content in food, often generous portion sizes – these are just a handful of some of the issues which dining out can present, and are worth thinking about.
Whether you have diabetes or not, these tips can help you keep the balance right when eating out and about.
Portion sizes
We've all had a meal in a restaurant that either seems really huge, or really small when it finally arrives on the table. While the latter can be disappointing, it's receiving a mountain of food that can really impact your otherwise healthy diet. Judging portion sizes can be tricky at the best of times, and made even harder when you're not preparing the dish yourself. If you're concerned about overeating or having more of a certain food than you should, read our advice on portion sizes.
Making healthy choices
Not only are so many options on a menu tempting, there's also the added disadvantage of not knowing exactly how the food has been prepared or what's gone into a meal. There are lots of ways you can maintain your healthy diet when eating out, such as choosing lighter, smaller versions of mains, opting for grilled meats that will likely be lower in fat, ask for dressings to be served on the side, and checking for steamed or grilled food as opposed to fried. For lots more tips, check out our information on eating out.
Are you discovering that meals out are affecting your diabetes management? Read on for some useful nuggets of info that we’ve compiled to help take the stress out of popping out for a curry or heading to your local pub. People living with type 1 and type 2 diabetes share their own experiences and tips on how they deal with unfamiliar restaurant territory...
“I have to decide when the best time to inject is as I can’t guarantee how long the meal will take to arrive. It’s good to be aware of extra sugars and carbs in restaurant food – drinks in particular can be full of sugar.”
Carb counting
If you carb count, and feel confident about the amount of carbs in your meal, you will be able to adjust your insulin to match the carb content. However, estimating the carbs in a restaurant meal may be more difficult than normal as you won’t know exactly how the dish is prepared.
There are some great apps around which you can download to help estimate the carb content of your food. Many restaurants also have nutritional info available on their website – if it isn’t available, don’t be shy about asking your waiter or waitress… they are quite used to this, with many people these days now following some type of diet.
Changes to timing
Meals out often involve a change to your usual routine, especially in respect of meal times. If you are on a flexible insulin regime, or an insulin pump, varying your meal times may be easier as you can delay your insulin before you eat. However, if you’re on twice-daily insulin injections, and eating lunch later than usual, your situation might be a little different.
You may need to eat a carb-containing snack before you go out, or have a bread roll or other form of carb as soon as you arrive – this will help to avoid having a hypo. If you’re having an evening meal later than usual, it may be possible to simply delay the timing of your evening insulin.
“Avoid soft drinks from pumps. Too many times have I been given a full sugar drink by mistake. Opt for bottled drinks so you can see the label and make sure it’s sugar free.”
It’s best to be as accurate as possible, but, if you can’t accurately assess the carb content, try to underestimate when eating out and about to avoid hypos. This is particularly important if you’re drinking alcohol while you’re out as this can lower blood glucose levels.
In a restaurant setting, it’s far easier to eat foods that are higher in fat than ones you may normally choose, and eating may take place over a longer period of time. Fat slows down the absorption of carbs into the blood stream, which means dishes such as pizza, curry and fried fish and chips may take hours to affect your blood glucose levels. This can mean that when you administer your bolus insulin, it may have finished working before all the carbohydrate has been absorbed. It can also result in a hypo on a full stomach, as the insulin you’ve injected is absorbed faster than the carbs in your meal. You may need to alter how you give your insulin, such as by splitting your insulin injection.
Insulin adjustment
You may also want to think about doing this if you’re having a carb-heavy meal (which calls for large doses). We know the action of any quick-acting insulin may be delayed when large doses are injected at any one time (especially those over 14 units). Consider splitting the insulin injection if a large amount of carbs - and therefore a larger amount of insulin – is needed for your meal.
If you’re ordering more than one course, it may be advisable to inject separately for every course once the food has arrived on the table, especially if the courses are far apart and contain more than 30g of carbs.
If you’re on a pump, a standard bolus might not be the most appropriate choice for a meal out. The type of bolus you choose for a meal will depend on the carb content, glycaemic index, fat and protein content of the meal. For example, for high fat, high protein and low glycaemic meals, you’re more likely to need a split bolus (a bolus that gives you some insulin immediately, and then some over a longer period of time). There are different names as pump manufacturers call them different things.
Generally, you should do the extended part of the bolus over at least two hours, but this is very individual and will probably require a fair bit of experimentation. Most healthcare professionals would recommend two hours as a starting point, but do liaise with your healthcare team for individual advice.
Regular testing is key - keep a note of what works and what doesn’t, so you know how to successfully manage, and enjoy, any future meals out.
Bon appetit
With a little extra thought and planning, eating in restaurants, cafes, pubs and bars shouldn’t stop you from enjoying yourself. If you’re living with diabetes, or know someone who is, it’s a question of thinking about what type of meal is being eaten, what it contains and how it might have been prepared – which may impact the restaurant you choose; working out much insulin you require and how best to inject it for your needs; keeping an eye on your blood sugar and how it’s being affected; being aware of any issues, such as sugary drinks and fatty sauces; and, most importantly, having fun.
So, go ahead and make that table booking… what are you waiting for?
