Meal Planning 101

As a dietitian and diabetes educator, some of the  comments I’ve repeatedly heard from many people with diabetes over the years are "I need a diabetic diet" and "I can’t figure out those exchanges. Just tell me what to eat." It’s true that meal planning can be challenging when you have diabetes. The good news, though, is that meal planning has changed quite a bit over the years. In fact, there’s no such thing as a "diabetic diet" anymore. The best "diet" for you is one that is flexible enough to fit in with your lifestyle and help you control your blood glucose levels. In fact, there are many different ways to help you eat and manage your diabetes at the same time. This week, we’ll explore a couple of different meal planning methods that are available.  Next week, we’ll look at some more.


If you’re a history buff, you might be interested to know that before insulin was discovered in 1921, the only way to “treat” diabetes was essentially by starvation. People with Type 1 diabetes were fed diets that were very low in calories, high in fat, and contained very little carbohydrate. Later, in 1950, the American Diabetes Association introduced the exchange system. The exchange system is still used today, although other meal planning methods, such as carbohydrate counting, have become more popular.

The exchange system is a meal planning method that divides foods into six different groups: starches/breads, fruit, milk, vegetables, meat/protein and fat. The foods in each group have specific portion sizes, and are all similar in calories, carbohydrate, protein and fat. You can “exchange” a food on the list for another food on the same list. For example, instead of eating 1 slice of bread, you can eat 1/3 cup cooked rice. Your dietitian figures out how many exchanges (also called “servings” or “choices”) you should aim for from each food group for each meal and snack. The number of exchanges you need is based, in part, on your calorie needs, activity level and eating style. While some people find the concept of “exchanging” to be confusing, this meal planning approach is actually pretty helpful and flexible once you get the hang of it.

Another meal planning approach that is well suited for people new to diabetes is called the plate method. No complicated lists or counting is needed. All you need is your plate! First, start off with a 9-inch dinner plate. Fill half your plate with non-starchy vegetables, such as broccoli, green beans, carrots, summer squash, or salad. Then, in one quarter of the plate, put 3 to 4 ounces of lean protein (poultry, fish, lean meat). Fill the other quarter with a carbohydrate food, such as brown rice, whole grain pasta, or a small baked potato. Supplement your meal with either an 8 ounce glass of skim or lowfat milk or a small piece of fruit, as well as 1 to 2 teaspoons of a heart healthy fat (tub margarine, olive oil or salad dressing), and there’s your meal! Pretty easy, right? The Plate Method is great for people with diabetes, but is also useful for anyone trying to control portions.

Talk with your dietitian if you’re interested in learning more about either the exchange system or the plate method. Next week, we’ll look at two different ways of carbohydrate counting.

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  • crushing2004

    my dietitian and i discussed the weight watchers and she said that it was the perfect diet for someone with diabetes. because it helps you keep track of your portion sizes and helps you to make better choices in food because friut and vegetables and less points so you can eat more healthy foods to stay satisfied and less junk food that doesn’t stay with as long. the only problem i have with being able to stick with that diet is that we’re staying with my in-laws and she puts bacon grease or butter and lots of salt in her vegetables when she cooks them.

  • cgause58

    I appreciate your insights regarding diabetes. I was diagnosed with Type II diabetes in 2000. Right afterwards I lost 25 pounds and guarded what I ate. After awhile I gave up the discipline and went back to the way I was eating before. I gained the weight and had to increase the Metformin. Recently I started being more careful with my eating plan. I have lost 22 pounds and have been able to cut back on Metformin and blood pressure medicine. I am walking 30-60 minutes every day. My blood sugars have been great. I am planning to make this a way of life and eventually get off the Metformin completely. I feel so much better!

  • roca

    Does anyone have trouble taking Metformin? One of the side effects is diaarehia, whichI get about twice a week. I then take an Imodenine pill to stop the diaarehia. Anyone else solved this problem. I don’t want to give up Metformin because it works enough not to drop my readings to low like Glyabride did. I also take Byetta and have lost 14 Lbs.
    Any help with Metformin is appreciated.

  • karen

    what is the maximum amount of carbs type 2 diabetic should intake per day?

  • acampbell

    Hi Karen,

    There’s really not a set answer to your question. The max number of carbs one can have is dependent on many factors, such as weight, gender, calorie needs, activity level and level of blood glucose control. For this reason, it’s usually best if a dietitian can help determine what your specific carb needs are. Also, it’s more important to think about number of carb grams or servings per meal, rather than per day. To get you started, you could aim for about 45 grams of carb (3 carb servings) per meal and then if you eat a snack, keep your snacks at no more than 15 grams of carb. Hope this helps.

  • Ileana

    Hi Karen. I am the care giver of my husband Michael he is 41 and got diagnosed with type 1 diabetes 5 years ago. I need help to know exactly the portions he should be eating, and what can we do to ease his cravings which some times are hell for him and we both get the sabotaging ball rolling.

    Pleas help us.

  • acampbell

    Hi Ileana,

    It sounds like your husband (and you) should meet with a dietitian who will help him determine how many calories and carbs he needs (and who will also help with portion sizes). There’s no one meal plan for diabetes that works for everyone — much of it is based on age, gender, activity level, weight, and food preferences. A dietitian can also help with curbing cravings (his cravings may be due, in part, to his blood glucose levels). Your husband’s doctor may be able to refer him to a dietitian; if not, you could try calling your local hospital or diabetes center, or go to and click on “Find a Nutrition Professional.”

  • laurie

    I just found out yesterday that I have type 2 diabetes. The dr. also put me on cholesterol medicine. I’m completely confused because I don’t know how to watch my carbohydrates and watch for food with cholesterol. Frankly, I’m afraid to eat anything. Please give me some directions as to wear to start.

  • acampbell

    Hi Laurie,

    It can be very overwhelming to find out that you have diabetes, especially on top of having high cholesterol. The good news is that a meal plan that’s good for your diabetes is also usually a heart-healthy one, too. However, the best step for you to take right now is to make an appointment with a dietitian, particularly one who works with people who have diabetes. You need to learn how food affects your glucose and you should have a meal plan that fits with your lifestyle and food preferences. Ask your doctor for a referral to a dietitian or check out diabetes programs that may be offered at your local hospital or medical center. You can also find a dietitian in your area by going to


    I am trying to loose weight now for the last year i had type 2 now for 11year with my last child i am only 4’11sn s half an my weight is 185 i really don’t know what to do i do love to walk but i need to walk more but my knee has fulid on it.PLEASE HELP ME….ACHE EVERYDAY..

  • acampbell


    I have two suggestions for you: One, ask your doctor for a referral to a dietitian, preferably one who works with people who have diabetes. A dietitian can help you with an eating plan that’s geared to weight loss, while also taking into consideration your diabetes, your food likes and dislikes, your schedule, etc. You can also check with your local hospital as they likely have dietitians in their outpatient department. The other suggestion is to consider joining a commercial program, like Weight Watchers, Jenny Craig, or Nutrisystem. All of them have programs for people with diabetes, and you can learn more about healthy foods and portion control. As far as exercise, can you ask your doctor what kind of exercises are OK for you to do without bothering your knee? Perhaps swimming or some type of water exercises would be OK. You may be able work with a physical therapist, who could prescribe the right types of exercise for you. Again, your doctor could give you a referral.

  • Tracy

    I have recently been prescribed Metformin to help with symptoms of PCOS. I do not have diabetes, but have had problems with low blood sugar in the past. Would it be beneficial to follow a meal plan that someone with diabetes would follow since the Metformin will affect my the way my body processes sugars?

  • acampbell

    Hi Tracey,

    Metformin is often prescribed to women with PCOS to help lower insulin and androgen (male hormone) levels, and to hopefully induce ovulation. Metformin works by decreasing the amount of glucose released by the liver and increasing the uptake of glucose by muscle cells, thereby reducing insulin resistance. It certainly could be beneficial to follow an eating plan that will control your carbohydrate and, if necessary, help you lose weight in order to further reduce insulin resistance. Think about meeting with a dietitian to get started on a healthful eating plan. You don’t need to stop eating carbohydrate foods, but choosing the right types (whole grains, fruits, vegetables, beans) and controlling the amount can certainly be helpful.