Help with a diet for a diabetic

Could you please critique this diet for a friend of mine?

Stats:
body weight: 130
body fat %: 23.5% (measured with calipers)

Meal 1
Omelet with oatmeal

Meal 2 (pw)
Steak (4oz) (with yams)
Meal 3
Tuna salad (ingredients: 1 can of tuna, 2 egg whites, 1 tbsp of miracle whip)

Meal 4 (pw)
Chicken salad or chicken sandwich (wheat bread-2 slices) (chicken breast-4oz)

Meal 5
Nuts (1 serving of mixed nuts)

Notes:
-She is a type 1 diabetic (insulin dependent).
-I was thinking of dividing up the 1st meal and adding milk to the oatmeal; what do you think?
-Workout includes Davie’s ‘fat to fire’
-Caloric intake I calculated should be 1142 calories
–Stats for the plan:
calories: 1128
protein: 40% (116g)
cho: 33.3% (94g)
fats: 26% (32g)

If you can give any pointers to this diet, I would much appreciate it.

Also, if you ARE an insulin dependent diabetic, I would like to ask you some questions about handling diabetes so if you could either pm me or reply to this thread

Thank you

Hey, there, dadean. I’m going to assume that your friend wants to lose BF based on your choice of WO programs. If that’s the case, how much BF does she want to lose? Is she wanting to put on any muscle?

Protein and fat requirements are easy to calculate. At 23.5% she carries 99.45 pounds of LBM. Protein requirements per day are 150g of protein. Honestly, I’d really like to see her eating 6 meals a day, which would make her protein requirements per meal 25g each. Eating every 3 hours is all the more important for your friend.

Fat requirements are 45g per day.

As it relates to carbs,

Option A is dividing daily carbs equally between all six meals.

As far as quantity goes, I’d like to see 70g on non-workout days and 100g on workout days. Not sure about Surge & PWO nutrition, though.

Th

Option B is taking in carbs at one or two different times; upon rising (breakfast) and PWO when there is non-insulin mediated glucose uptake. This is where you need input from her doctor or someone here on T-Mag that needs to inject insulin.

Good carb choices in general, but ditch the white bread ASAP. Go for some sprouted, whole-wheat, quality bread from a health food store.

The meal that has nuts only should have some protein. Jerky would be a good choice.

I’d like to see you bring carbs in at 70g on non-workout days and 100g on workout days. That’s going to bring in your calories a bit higher, but that 1100 number is really low.

Okay, that’s the best I got to give on the subject, dadean. Be sure to run the final diet, carb choices and timing as it relates to workout past her doc.

Hey there,

If you need some help feel free to PM me. I’ve worked with a type 1 diabetic as a client in the past and had tremendous results. I’d be more than happy to help you address any issues.

Kinetix,
While the PM feature is great for private discussions, I think it would be nice for you guys to keep this public if you don’t mind.
If you had great success why not share the info in the forum so it can be archived for others in the future??

Thank you for considering my request,

Alicia

Kinetix, for my benefit, how do you manage carbs (i.e., intake, choices, timing), insulin requirements and working out with Type 1 diabetic clients?

It doesn’t have to be a long answer, but I really am interested.

Thank you all for replies. Her goal IS to lose bf, of course. I have had moderate success in getting her glucose levels in order (100 to 140) but weight loss did not drop. The reason the protein and that fat numbers are so low is because her carb number has to be moderately high.

Thank you,
dadean

Kinetix,

I have a few questions concerning type 1.

  1. I have her do Davies’ “Fat to Fast” workout with 5-6 meals a day with the marconutrient ratios given. Is that a good exercise for diabetics or do you suggest she performs something different?

  2. Her glucose level drops during the night (<60). I address it to the fact that she does not eat many carbs in the evening/before bed. In fact, her last meal contains only 6g and is consumed 90 minutes to 2 hours before bed.

  3. With the diet that she follows now (what I have in the thread), her glucose levels are very steady but her body fat does not drop and her weight fluctuates between 125 and 130. Should there be an additional restriction on the calories (where should the restiction occur for I am afraid to restrict her carbs since she is already either perfect or sometimes even goes too low)?

Note: She IS getting a pump soon, which I hope will help with the injections and how much insulin she will need without the guesswork.

Thank you for your time,
dadean

kinetix: I would also be interested in seeing your reccomendations for diabetics. Please share if you have the time.

I’ll wait and watch this one for a bit since I have experience with diabetics as well.

Fair enough. I’m off to work shortly so I’ll ring in on this topic later.

I think Terry is onto something with Cals being too low; her body may be trying to preserve energy stores.

Additionally some info on her insulin curve (dosage) could be of help with regards to meal and carb timings.

Total calories will also affect blood sugar levels, not just CHO intake so dropping carbs a bit and raising fat and protein can theoretically balance out.

I worked with a friend’s dad who was type 1. put him on the t dawg diet and r-ala, he lost 10 lbs and quit…couldn’t stay away from the carbs.

:frowning:

Regarding the drop in glucose level during the night I contacted the good people of T-mag and the advice that was e-mailed to me was to increase the amount of carbs at night and even switch the diet from ‘t-dawg’ to berardi’s ‘don’t diet.’ We are on winter break right now but I will suggest that to her next semester as well as increasing the calorie intake.

Thank you all for your suggestions and keep them coming.

dadean

Okay…here we go…

First things first. How long has your friend been training? As I’ve had a look at the Fat to Fire program and I think it might be a little complex for a beginner. Assuming this is the case, start with a program that is not as technically complex, but emphasizes the major compound movements. If she’s more advanced ignore everything I just said.

As far as diet, I’m in agreement in that you MAY be feeding her to little. One question I might ask is whether or not you allow her any “cheat meals”? If not, you’ll definately want to increase her caloric intake substantially. The Harrison-benedict
equation has always worked well for me in predicting caloric intake (you’ll have to subtract 500 calories per day for each pound you want her to lose each week). If she is allowed a cheat or two per week she’ll be fine with around 1200 kcals on the other days.

Once she gets “the pump” you are correct to assume things will be easier. In the meantime she should be fine with consuming surge or maltodextrin in her post-workout shake provided that she takes her insulin with it. Remember that there is some non-insulin mediated glucose uptake with exercise (mechanism unimportant here) and she probably won’t need as much insulin as she usually would for the same amount of carbs. With my client this was a trial and error process. She would have her shake and then test her blood sugar repeatedly until it came down again (note: sometimes it’ll go too low because the body is taking up some on it’s own without the insulin). Together you can adjust her post-workout dosage to make sure that her blood sugar doesn’t go too high or low.

At night she’ll have to consume some carbs as insulin dependent diabetics will often have a drop at this time. My client got carbs in her meal within 1 hour before bed and her blood sugar still got very low by the morning sometimes. In fact, my client got carbs at every meal divided up over the day. Because of this her dietary protein intake was slightly lower than I might normally suggest, but she still had incredible gains.

I think I covered everything you asked, but I might have forgotten something. Let me know if you have any other questions.

I’ve been a type one diabetic for about 3 years and im pretty used to all of the ins and outs and implications of the disease related to nutrition and trying to keep on some kind of a plan.

But the main and most important thing is not to steadfastly remain on the plan , but to keep blood sugar levels in mind more than anything else. I would worry about getting her in better control before the diet thing comes up.

As far as care for myself goes, i use the lantus and humalog insulin… the humalog for the meals and lantus which works pretty much 24 hours a day. That glucose of <60 kind of scares me because that means that she may need to change what kind of insulin she uses or use less for din din or use less. Keep in mind that chronic hypoglycemia can result in brain damage i mean your brain runs on 2 things : oxygen and glucose and your muscles and organs can use fatty acids but thats all your brain gets. And its not that bad i mean your brain has a gazillion nuerons and we lose the weak ones every day but there is no sense in losing a lot more everyday b/c we dont take care of ourselves.
-Clay

First of all, thank you for replies.

Kinetix,
My friend started training with me in late August. She has been doing compound lifts under my supervision and had perfect form in most of the beginner lifts before we moved on to more challenging workouts.

I have a quick question regarding ‘cheat meals’? What do you mean by cheat meals? Do you mean a “carb-up” day or “throw the diet out the window” day? She was doing the latter version of the cheat day and did not lose any body fat during the diet. Now I am starting to think that the cheat days were not the problem but the fact that her body was starving and was using the crap that she was eating during the cheat day as reserves.

Clay,
I am sorry to say that I have no idea what she uses for her insulin but I will ask her. As I have said before, besides the nightly drop her glucose levels have been pretty level (unless she goes out drinking or on a cheat day where the levels rise up to 400).

Thank you,
dadean

Cheat day? above 400? Well i mean its her body and life but i realize that im NOT normal and i cant go around acting like i am. I drink but i dont get that drunk and when i do i dont let the blood glucose get that high. 400 levels should be reserved for when you have an accident or something not something to be planned. 200 is the renal threshold where your kidneys start getting chewed up. Dialysis would suck ( no more protein !), going blind would suck ( cant train blind) , getting your foot chopped off would suck ( cant run or do squats w/out a foot) i mean i beleive that my body is the most important thing to me, w/out it i cant do squat ( pun intended) so i would encourage your friend to stay healthy and you should have some play while your at it
-Clay

Clay,
I think my last post came out as if her glucose levels have reached 400 frequently when in fact that is no longer true (at least not as frequent). She is relatively new with diabetes (diagnosed sometime in the fall of 2002) so I still give her the benefit of the doubt that she is trying to cope with diabetes and enjoy her life as much as possible. I am coming to her defense a little here for I have seen the struggles that she is going through trying to figure out her “new life” in a way and I also understand your concerns and will try to relate them to her.

That brings me to a new question: do you find your glucose levels “out of whack” during high stress situations? She told me that her levels were constantly high during the finals week and I just wanted to make sure that was normal.

Thank you,
dadean

Dadean,

I just wanted to say that I think it’s really cool that you’re stepping up and helping this girl out. You interested or what?

Anyway, my client was allowed to have two cheat MEALS per week. Each meal was approximately one hour in length or roughly the time it’d take you to eat at a restaurant. During this time she could eat a dinner that definately wouldn’t be considered “clean” and have a dessert. She was also allowed to have one glass of wine with each cheat. I don’t give my clients cheat DAYS because I know the amount of damage that I’m capable of within 24 hours. :slight_smile: For a diabetic this could be dangerous.

As for exams, the stress may be having an effect on her hormones or something, but I’d first look at the obvious. I remember that when I was writing finals my eating and training habits went to shit. This could be the reason above all else.

Kinetix,

Haha, nah, there are no hidden motives here :). We’ve been close friends for a long time and when I read about diabetes and some consequences (lumbernac listed a few “surprises” already) I offered to help out. It would not feel right to just sit there and watch someone get completely messed up knowing that you might have done something to help. Plus a challenge of getting someone on the right track with a condition such as hers is a big ego booster (as you must have felt with your client).

I will suggest the cheat meals with the higher caloric intake (and other suggestions) to her when we start off next semester. Thanks to everyone once again who helped me out with this.

Also, concerning the “foods” do you have any problems with consuming a moderate amount of Splenda? She is one of those people that MUST have something in her mouth when she studies/does nothing hence the constant gum/food intake. Gum became too expensive for her so she moved on to Splenda and claims that there is no sugar in Splenda. I advised her on brushing her teeth and drinking water when she wants something to eat but she still stuck on Splenda. Should she stop the habbit or is Splenda too “innocent” for diabetics/dieters in general?

Thank you,
dadean