Nearly 27 years ago I was pregnant with my daughter Sarah and living with type 1 diabetes. I was considered high-risk. That meant many ultrasounds, finger pricks (CGMs weren't invented yet), and doctors closely monitoring both her and my weight.
To ensure a healthy pregnancy, I had to keep very strict blood sugar control. It was then that I received the most important advice from a dietitian. This is advice I've continued to follow for 40+ years now with T1D.
The BEST Advice I've Received with T1D
I learned how a balanced plate was essential to better predict how my blood sugar would respond. This meant I needed to combine a protein and healthy fat with complex carbohydrates. If I left one or both of these macronutrients out of a meal or snack, my blood sugar would spike. This method worked and it sure helped me deliver a healthy baby girl.
Adding healthy fats to the mix...
I continue using this balanced plate method (which does work) but now I am more aware of how my love for healthy fats causes a delayed blood sugar response. How to eat is the biggest hurdle in managing diabetes, and it's not just about the carbs.
Now that I am putting more healthy fats into my eating plan, I am more aware of the types and portion sizes. I see how too much fat, even the healthy kinds, can cause a delayed glucose response 1-3 hours after dosing and eating.
How Fat Affects Your Body's Response to Insulin.
Carbohydrates are the most talked about type of food when looking at increases in glucose, but how do fat and even protein contribute to the end result? Great questions, and quite the topic in the diabetes community!
There are many opinions about what type of "diet" or foods you should avoid, to keep your blood sugar in check. Should you avoid or reduce fat in your diet to ensure how your cells absorb insulin and how blood sugar responds, one hour, two hours, and up to three hours following a meal?
"Researchers found that higher fat levels in the blood caused insulin resistance by interfering with glucose transport into the muscles. This can happen within three hours. One hit of fat can start causing insulin resistance, inhibiting glucose uptake after just 160 minutes." Mechanism of free fatty acid-induced insulin resistance in humans. - PMC (nih.gov)
The process goes something like this:
You eat a high-fat meal or snack (this is the fun part).
In a few hours, the fat begins to digest and this continues for several hours.
The level of fat in the bloodstream (triglycerides) rises.
High triglycerides in the bloodstream cause the liver to become resistant to insulin.
When the liver is insulin resistant, it produces and secretes more glucose than usual.
Balance is still key, as our diets need variety from the four macronutrients (carbohydrates, fiber, protein, and healthy fat) and the micro-nutrients from different types of food.
Tips for Crafting Balanced Meals with Healthy Fats
Adding essential fatty acids to your diet is important to optimize brain function, support joint health, and provide you with sustained energy. Healthy fats support hormone balance and when combined with other macronutrients, make for a delicious and well-balanced diet for women managing diabetes.
Here are 9 healthy fats you can include in a balanced meal:
• Olive oil
• Coconut oil, coconut milk, and coconut butter
• Grass-fed ghee or butter (unless sensitive to dairy)
• Animal fats from grass-fed animals
• Nuts and seeds
• Nut and seed butters
• Organic dairy from cows, goats, or sheep (full-fat cheese, full-fat raw milk, kefir)
• Fish oil and cod liver oil
Portion size matters!
So how much do you need per day? Will eating too much fat contribute to insulin resistance?
There is no direct answer to these questions. You must experiment with different fats and portion sizes to measure how your blood sugar responds.
In this process, you learn what is the best formula for you in relation to your optimal glucose levels 1 to 3 hours following a meal.
Get enough healthy fats in your diet without sabotaging your blood sugar goals.
This is not a one size fits all approach to eating with diabetes. You must look at your own dietary and lifestyle needs around your daily routine. When other factors like exercise, hormonal stages, and stress levels are out of balance, it can hinder your insulin sensitivity.
By tracking the amount of fat in a meal, with the timing of meals and insulin doses, you can better pinpoint if this is leading to a delayed glucose response and over time increased insulin resistance.
4 Tips to avoid a delayed glucose response:
Prepare meals that include complex carbs with fiber, protein, and healthy fat.
Focus on more vegetables, both non-starchy and starchy when you need them.
Use the palm of your hand to measure 3-4 ounces of plant or animal-based protein for each meal.
The portion size of fat needs to be monitored with your own blood sugar response.
Analyze your meal, maybe even relying on a macro-counting app to tell you how much insulin to dose. It's a true guessing game, estimating the best you can to see how your blood sugar responds.
Trying to reach your goal "blood sugar number" shortly after a meal involves a few factors and for women with type 1 diabetes, avoiding insulin resistance is still a thing. It's important to monitor types of food and portion sizes to estimate and time your insulin dose around each meal.