Diabetes Self-Management Blog

It has often been said that breakfast is the most important meal of the day, and another piece of evidence has just been added in favor of this statement: Research recently presented at the Institute of Food Technologists’ (IFT) Wellness 12 meeting shows that what you eat in the morning — and in particular, the glycemic index of what you eat — can have a significant impact on your blood glucose levels throughout the day.

The glycemic index of a food is a ranking from 0 to 100 indicating how much that food raises a person’s blood glucose level. Foods with a high glycemic index are quickly digested and can cause spikes in blood glucose levels, while foods with a low glycemic index are digested more slowly, resulting in a more gradual rise in blood glucose levels. A number of factors can affect a food’s glycemic index, including how finely milled the food is, what type of fiber it contains, and what type of starch it contains.

At the recent IFT conference, researchers presented information indicating that eating foods with a low glycemic index at breakfast can help with blood glucose control through lunchtime. In particular, a study by Richard Mattes, MPH, RD, showed that eating approximately 33 whole almonds, a low-glycemic food, as part of breakfast caused participants to feel full for longer and to have lower blood glucose levels after breakfast and lunch than people who had not included almonds as part of their breakfast. According to Mattes, while it is important to take the calorie content of foods into account, a moderate amount of almonds can be incorporated into the diet without affecting a person’s weight.

Other low-glycemic foods suggested by the IFT include rolled oats and groats, whole grains, and flaxseed. A database of the glycemic index of hundreds of common foods can be found here.

“Most of the risk factors [for Type 2 diabetes] are things that can be managed and modified,” notes Kantha Shelke, PhD, a presenter at the IFT conference. “We can reverse prediabetes and prevent it from becoming diabetes. Food has become the reason for what’s ailing us, but it can actually be a solution in a number of different ways.”

For more information, read the press release from the Institute of Food Technologists or see the study in the journal Nutrition and Metabolism. And to learn more about the glycemic index, check out the articles “Glycemic Index Update” and “Carbohydrate Counting, Glycemic Index, and Glycemic Load: Putting Them All Together.”

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Comments
  1. As a diabetic with some very negative experience with trying to use the Glycemic Index as a blood glucose management aid, I think the GI ought to be approached with caution by people with diabetes.

    I agree that High GI foods are likely to spike blood glucose. Just because a food is low GI does not mean that it is ok. Case in point: oatmeal. Oatmeal is practically guaranteed to have an adverse effect on blood glucose levels. I don’t care if its rolled, steel-cut, instant or slow cook.

    Add the generic “whole grains” to the GI deceiver list. Try checking blood glucose after a couple of pieces of “whole grain” bread. “whole grain” is being promoted a a healthy alternative to processed flour by an organization called the Whole Grain Council, whose web site claims to be a “consumer advocacy” group. But when you Google them and look at the list of members on the web site, you see a who’s who of the grain industry.

    On a positve note: flaxseed is a really good ingredient for diabetics.

    Posted by Fred Wuensche |
  2. According to my CalorieKing database, 33 whole almonds is 229 calories and 20 grams of fat. It may be low carb, but it’s not a moderate amount.

    Posted by Deb |
  3. I always get confused by the conflicting information regarding tight and lose glucose controls for type 2 diabetics. In the one camp are people who feel we should strive to maintain relatively consistent glucose levels throughout the entire day. In the other camp are those who (like my doctor) feel that moderate swings in glucose levels are natural and your HbA1c is far more important in establishing how well your disease is controlled than daily glucose readings.

    I know what works for me, which is sensible diet (I don’t worry about glycemic index or counting carbs) exercise, and being careful to take my meds on time. My glucometer readings vary, going from the low 90s to around 170, depending on time of day and meals. I’ve almost never been below 80 (except after surgery) and only hit 200 a couple of times in the past ten years. My A1c runs between 6.6 and 7.0. Am I missing something? Is there any evidence that I should I strive for tighter controls? My doctor seems fine with how I’m doing.

    Posted by Joe |
  4. Almonds are good, but 33 is more than most people want to eat, and might be a bit pricey. I agree with Fred about so-called “whole grains.” You can’t go by the labels. But I have heard that “sprouted grains” really are much slower acting than refined flour breads. Is that true?

    Posted by David Spero RN |
  5. I am new to the diabetic life, and I am not understanding all of the talk about A1c and all, but I have some questions do you mean to say that oat meal wether rolled or steel cut is not a good thing for diabetic to eat each mornings, I don’t eat the other cerals I have always liked my oatmeal(fruits,nuts added and thats all). I do like almonds but I don’t want to eat them all the time.

    Posted by Willie Smith |
  6. I had pneumonia and bronchitis the first part of the year, and it takes a long time for my morning bg to return to normal levels afterwards - even with the addition of Victoza. What I have finally discovered is that when I eat dinner early, at about 5 p.m., before I exercise, and don’t eat any large meals afterwards, my morning values are terrific! This has been a struggle lately, and I’m glad I’m finally seeing some progress.

    Posted by catgirl |
  7. Joe’s comments are the most sensible I have ever seen. Kudos to you and your doctor. I’m trying very hard to increase exercise and eat better foods. If I get A1C readings under 7.5 I’ll be very pleased. Thank you for your entry.

    Posted by Pete Colby |
  8. Does anyone have any good ideas for breakfast for a working person. Something easy and proper for a type II diabetic.

    Posted by Linda |
  9. I have been a type2 diabetic since 2000, 12 years.
    I agree with Joe comments. Watching your diet and exercise very important. I keep my A1C under 7.0 but after a while you dont need a meter to tell you about lows and highs. Worry about the lows and decreasing your nightly insulin by two works for me if you suddenly have repeated lows. It sounds like reverse but decrease is true for me and this came from my diabetes doctor.

    Posted by Bob |
  10. My A1C has been at 7 to 7.3 for a while. Can’t seem to get it lower. Always used to be 6 to6.5 but since it went to 7 it never changes. My Dr. doesn’t say anything is wrong. I take pills for various problems and wonder if that has any baring for the A1C.

    Posted by Ada Ryan |
  11. My breakfast consists of one serving of steel cut oats with almond milk, one fruit serving (usually an orange) and 7 pecan halves! The steel cut oats are very low glycemic and the almond milk does not raise blood glucose like the Cows milk. The pecans (sometimes almonds) counteract the hi glycemic orange and I NEVER have an out of range reading! If I am out of pecans or almonds a spoon full of almond butter does the same thing!

    I learned to do this on the diet I am following called the Acid/Alkaline diet which has been a Godsend on controling my blood sugars!

    Posted by Dan Kashefska |
  12. Regarding whole grains. I was also fooled for about a minute. Read the label. If it says 5 grams of whole grains, look under fiber and it is probably more like one gram of fiber. I stick to Kashi and truly whole grain bread with at least 3 grams of fiber per slice.

    Posted by Sandi |
  13. While this article seems quite helpful to those who’ve experienced spikes, I don’t seem to be troubled by those; I, on the other hand, have experienced glucose plunges, and I have absolutely no idea how to anticipate them other than not going more than 3 hours without eating something at least 2 carb servings. Whether it’s fruit, a small sandwich, a fiber or cereal bar, or something else, that’s the only time I know I won’t experience the crying, sweating, nervousiness/anxiety and shaking of a sugar-drop. I absolutely hate them.

    Posted by M.S. |
  14. I cannot eat any kind of cereal without my blood sugar going over 200 and approaching 300. If I use skim milk, it goes up to 300 and with Almond milk, it goes to 200 or over. Does anyone have any ideas because I love cereal and it is so easy, I hate to have to give it up totally. By the way, those readings are even with my insulin dosage.

    Posted by Betty |
  15. 21-yrs ago I went “diabetic” while pregnant w/ my son. I had an urgent session w/ my RD & was shocked at ‘portion sizes’ - thought it wouldn’t feed a bird. I was eating for 2 after all :-)). I was only given a week on diet control & phoning in my glucose levels daily to get things under control. Nope, not good enough, so another urgent session w/ the nurse specialist for instruction on use of insulin 3-4x daily & eating like a ‘little bird’. Fortunately, the diabetes self-corrected after my son was born & I came off the insulin. BUT, I guess I was set-up for a repeat, as I was diagnosed type-2 5-yrs ago, placed on oral meds, took an 8-class diabetes course (again that dang portion control, but I certainly was not eating as tho I were pregnant either). I was physically active too. My most recent A1C was 5.6, yet my daily glucose readings can fluctuate quite a bit at times. I think it might have something to do w/ my sleep patterns, which can be quite erratic. I have tried to eat via GI, but is just too stressful & tiring for me to figure, plan & execute & generally crazy-making. So back to ‘portion’ size, eat from the earth w/ small amounts of animal protein. Dr. Oz says, mix 4-tsp white vinegar, 1-tsp psyllium fiber in 8-oz water & drink b-4 each meal, to help slow down glucose spikes after meals & the processing of carbs. I have seen improvement w/ this when I have been diligent, but keep forgetting to do it!!! It really doesn’t taste too bad either. Nuff said for now….great day to all.

    Posted by Tandi |
  16. It can be potatoes, popcorn, rolled oats, rice, etc. - it raises my b/s a lot. I’m diabetic 17 yrs now, b/s was 400 when I found out. I can’t get health insurance because of diabetes, so I have done it without doctors or meds all these years and I have no symptoms. The trick? Low Carb. It works and I eat very healthy. Salads at dinner with raw veggies and low carb salad dressing without MSG, maybe a turkey burger or chicken breast, etc. Vegetables and protein. Use spices and vary recipes. I make an egg and veggie omelet, or my low carb muffin I make using almond flour, ground flax and protein powder - that’s my “flour” which I make cookies, pancakes and anything else you can think of. I’ll even take my cinnamon muffin, break it up and put almond milk on it like a cereal. I don’t miss a thing. My sugars are 90-120. It’s the only way to go. I don’t use lots of fats in the diet like most low carbers do.I do use olive oil but I also get my fats from fish oil, flax etc. There are high fiber low carb wraps that will not spike sugar out there. If there is something you miss -make a low carb version of it and mind portion control - another biggie. Get a walk in every day and you’ll see a huge chance but you have to eliminate grains - you get enough carbs from veggies. If I want fruit, I’ll eat it with a few nuts (granny smith apples, strawberries, blueberries, - the lowest carb ones or I’ll put it with a protein shake) Once you do it you will feel so good! Plus you can have many years without symptoms. It doesn’t make sense to eat all the foods that raise your blood sugar and then have to take meds to lower it again. Get to the core issue - diet!

    Posted by Marge |
  17. The reason of failure of the GI is whole wheat bread is still made of “chalk” or what I like to call flour.

    Yes, avoid flour of any grain ground into fine chalk. Think about the white stick you use to write on a chalkboard. That’s what you are eating every time you eat flour. No wonder we get so sick.

    Even soured flour does not work too well to keep blood sugar down, i.e. sourdough bread, etc., even authentic ones.

    However, if you sour whole grains not ground (you know into chalk) they work very good as low glycemic food. I have found steel cut or thick oats soured overnite very good for breakfast.

    I always have energy and feel good after. No high-sugar let down.

    Posted by Bimbam |
  18. GI is an indication of how a particular food may contribute to BG spikes relative to other foods and is useful in certain respects. Obviously other factors ultimately determine accuracy for an individual. As far as breakfast goes, I add a handful of almonds (maybe 8-10) and two tbs ground flaxseeds to hot or cold cereal every morning (also some walnuts to cold cereal) and add almonds to my mid-morning snack of soy yogurt. My Dr. also suggested a few nuts after lunch. Nuts and seeds are an important part of my diet and help control spikes and my A1c - which has averaged 5.7 for a few years. A few nuts before retiring has long been a recommendation to help control nighttime lows which can lead to higher early morning spikes.

    Posted by sunburst |
  19. I eat oats(unprocessed and cooked with 1/3 cup skim milk and 1/3 cup water) and 4 oz. light Activia yougurt for breakfast and seem to do OK. I can’t eat nuts due to diverticulitis every time I do. I add cinnamon to my oats and sometimes 1 tablespoon of peanut butter since I can eat that. Would the peanut butter work the same as nuts? Someone told me it would be good for protein instead of eating the nuts. Love nuts and really missing them.

    Posted by Linda Martin |
  20. I recently went to a seminar at a local hospital regarding diabetes. The presenter suggested that of the patients he saw, some 80-90% suffered from sleep apnea.I would urge all folks with diabetes to be tested for sleep apnea. I happen to be a type 2 who has progressed to type 1. I have sleep apnea and use a CPAP. I have never slept better in my life since I began using the CPAP. The use of the CPAP has also improved my A1c.

    The other thing I would urge all folks with diabetes to do is get a hold of a CGM for a trial,at least a week. You will learn so much about how YOUR body reacts to different foods, exercise and stress. After I had used a CGM for 5 months my A1c went form 9.4 to 7.7.

    Posted by Axel Sjogren |
  21. Hi! I have been a type 1 diabetic for almost 40 years now. I have to disagree with some of what is being told. Each person with diabetes is different. You cannot cookie cutter us and think that the same foods will work for everyone. An example? My doctor told me to treat low bloodsugar with a 1/2 cup of milk. This will shoot my sugars up to 300+. Flaxseed does the same. We may have the same disease but it reacts differently with each of us. I try a new food recommended and then test alot to see what the outcome is. If it isnt good, then it isnt for me.

    Posted by GiGi |
  22. I have found that eating protein in the morning helps considerably. I try to eat either an egg, a piece of string cheese, or lowfat turkey sausage, along with a low GI fruit. The protein keeps me feeling satisfied until lunch, so no cravings late morning.

    Posted by Jamie |
  23. Jamie dead on target. This is my plan as well and keep the dam grains to minimum and keep calorie load in am to minimum as body starting back up after all night shutdown.

    Posted by jim snell |
  24. What did Axel Sjogren mean by CGM posted April 18th?

    Posted by Joe |
  25. Where are the answers to everyones questions?
    I agree with jamie and jim stay away from most of the heavy carbs and grains.Stick with the protiens

    Posted by Carol weikel |
  26. I agree with Jamie - no starches at all in the morning works best for me. For a quick (and portable) breakfast I have a hard-boiled egg and a glass of tomato juice. Anyone have more ideas like this?

    Posted by Chris |
  27. A meal plan depends on the individual. One can find what works for the individual but it does take a bit of time! Then too, over the years our system will change and we need to know when to change and what to change. Always a mystery but I have found that to be aware, use a Daily Log to know what did and did not work helps me continue to enjoy life for 55 years as a Type 1.

    Today, I use a low carb b’fast of fruit (11 grams of carbs usually, and one piece of multi grained toast (7 grams of carbs per piece). It works for me just fine. My total carbs for a day is not usually more than 80. My exercise is cleaning house, and gardening and a stationary bike. My weight holds at 134 lbs. We an adult sona nd daughter both very healthy!I am 77 years old and plenty active as a Type 1 for 55 years. Use a pump for the past year.

    My control has not always been great - if we want to we learn and things do become easier.

    We need to realize that not every idea that is presented to diabetics may or may not work for us all!

    Relax, find what works for YOU, and enjoy life!
    Good Luck!

    Posted by joan |
  28. Hi Joe,

    Thanks for your question. Mr. Sjogren was referring to a diabetes tool known as a continuous glucose monitor. You can learn more about these devices by reading the article “Continuous Glucose Monitoring: Making Sense of Your Numbers.”

    Thank you for your interest in Diabetes Self-Management!

    Sincerely,
    Diane Fennell
    Web Editor

    Posted by Diane Fennell |
  29. Hi, on june 14, I had a heart attack and discovered I was a diabetics. I probably knew it but was in denial. Overall, a total life change, stop smoking, diet, low fat, low cholesterol, low sodium. Exercise three times a time. I am taking insulin (15ml before breakfast and dinner). I am seeking spikes between 150 to 70. I feel I am not getting the right balance of food. After exercise I can feel the low blood sugar so I nibble of various things, raisins, crackers, cheeses. Doctor suggested that I lower the insulin to 12ml and my sister (also a diabetic) suggest with all the exercise (I lost 10-15lbs since June 14, 3-4 inches off the waist), i should skip one of the insulins. I tried that once and didn’t feel weak after an exercise but then again I did add more protein thinking I was not getting enough.

    Anyway, any advice? It sounds like still have lots to learn about myself. So far so good, but I feel I can do better with a more balance meal.

    Posted by Louis |
  30. Its astonishing how people still persist with this nonsense about how Oatmeal has a limited effect on blood sugar and is actually good for diabetics or people with impaired glucose tolerance. An article in Livestrong actually goes so far as to say that you can eat as much of it as you want! Id be interested to find one person with impaired blood glucose who can eat oatmeal in any meaningful amount and keep their sugars below 130 (or 7.2 in the Uk).Dr William Davis, author of `Wheat Belly’, claims that in tests on his patients, Oatmeal caused a huge spike in blood sugar and is one of the worst offenders amongst the grains. I agree - it does the same to me and Im not even pre- diabetic yet.

    Posted by frank green |
  31. I’m at this blog because I, too, have recently experienced ridiculous spikes after eating oatmeal. Several years ago, after being diagnosed, it took me about a year to attack the disease to the point that my A1c went from 10.9 to 5.9 with Metformin, and I held 5.9 after taking myself off the meds. That worked so long as I was diligent about the diet — having lost 40-50 pounds, way too skinny, but feeling GREAT. Then I got lazy, got married, and now have had to go back to testing many times a day to get it back together. Last time, I ate oatmeal often but never noticed a spike. This time, I was confused about why I was spiking, pointed at various culprits, but finally decided the only consistent food related to spikes (except for the obvious things I knew I should NOT be eating) was oatmeal. This blog has affirmed the problem. So I am echoing a thought expressed many times above but with a twist: not everyone with diabetes reacts the same to any particular diet as another might, but also your effective diet of today may have to be revised later! Be vigilant! And anyone else with breakfast options will be welcome.

    Posted by Paul Fletcher |
  32. I have been a Type II diabetic for 6 years now. My original fasting BG was 299. I was put on Metformin and watched my diet closely and withing a few weeks my BG was better with my A1C around 6.5 which I thought was pretty good. A few months ago I start the Fast Metabolism Diet (which is really more a new way of looking at food then a diet). I did this to loose the 30 lbs. of stubborn belly fat I had and to see if I could get my morning BG down below 130-140. At the end of my first two weeks I was down 6 lbs. and several inches in the places I could never loose before. More impressive is my blood work results…I no longer needed my blood pressure meds, my cholesterol meds or my diabetes meds! Oh, and my A1C was 5.5 (non-diabetic). Don’t get me wrong, this way of eating is not easy, but I feel soooo much better on it and don’t ever worry about my blood sugar now. I continue to monitor my morning BG which is now always between 80-100. I have also found that I can now cheat a little, 1/2 cup ice cream or other sweet snack without any spike in my BG. I am so excited I finally found something that works. Feel free to email me with any question.

    Posted by Lynn |

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