Type 2 diabetes can be controlled with proper diet and exercise, but it can be difficult to control when dining out when you are surrounded by so many choices.
We speak to our resident expert, Susan Watkins, CDE, RD for some great tips for dining out to avoid unnecessary blood sugar highs.
What are the best menu choices for starters?
When eating out, Watkins says it is best to skip the appetizers. “Most restaurant appetizers are high calorie, fried foods and this combined with a large portioned meal can throw your blood sugar (and weight) through the roof!” she says.
Often after ordering appetizers, people already consumed enough calories for the entire day. Watkins suggests a better way to go would be to order a side salad (with dressing on the side) or a broth-based soup (vegetable or chicken can be good choices).
Some places offer raw vegetables with a low-fat dressing or hummus. However, be careful with the amount of hummus you consume before the meal.
“The vegetables can be a great option because it takes a lot of time and work to chew and they contain very little calories and lots of nutrition and fiber,” she explains, “this can help fill up your stomach before the meal, so you have less room for the higher calorie items.”
What are the best menu choices for the main course?
Watkins urges people to think of the balanced plate model: Half of the plate or more being vegetables, 1/4th protein, and 1/4th starch.
Examples would be grilled chicken or fish with a side of vegetables and potato or rice. You can ask if they offer brown rice or a healthier alternative like quinoa.
If the potato is large, which almost always is, Watkins says to cut in half and take the rest home. It can help to put the other half in a box before you start eating to reduce temptation.
You can do the same with the rice or other grain if it looks like a big portion (more than 1/4th of a plate).
Ideally, Watkins says to control blood sugar, the starch (pasta, rice, potato) should be about 1 cup at a meal or less.
Be sure to talk with your doctor or RD/CDE for specific recommendations. The total amount of carbs you can tolerate depends on your size, activity level, stress level, medications, etc.
She advises against ordering a pasta-based dish, instead go for a protein-based dish such as chicken, turkey or fish with a side of pasta and vegetables.
If ordering a rice bowl you can ask for 1 cup of rice only and the rest vegetables and protein (or even better ask for ½ cup beans and ½ cup rice only).
Soft tacos can also be a good choice, 2 grilled fish or chicken tacos (if double wrapped take off one tortilla with each taco), with ½ cup of beans.
Watkins says if you are trying to lose weight you can ask for whole beans instead of refried.
Also, you can ask for your meal to be without the rice and sub steamed vegetables or a salad to decrease carbs and calories.
A meal with tacos, rice, and beans can contain over 100 grams of carbohydrate, which Watkins warns is well over the general recommendation of 30-45 grams total carb per meal for women and 45-60 grams total carb per meal for men.
Other good options can be a large salad with chicken and light dressing. Just be sure to remove some of the higher calorie items, such as croutons, cheese, bacon, etc.
Choose your favorite high-calorie item to leave on and remove the rest, Watkins suggests.
What should you know about your medication?
The registered dietician says to be careful when eating out if you are on insulin or diabetes medications that can cause hypoglycemia (low blood sugar). If you don’t know, ask your doctor, pharmacist or CDE.
If you are at high risk for hypoglycemia then Watkins says you would want to add some carbs to your meal of salad and chicken, such as beans, corn or whole-wheat bread.
If you do not want to add carbs to your meal you may need to talk to your doctor about adjusting your insulin dose, medication or adding a snack, including carbs, a few hours later.
What method of preparation is best?
Grilled and baked are the best ways to go when ordering out to keep the calories down. But beware that most restaurants grill with a lot of butter, which adds an extraordinary amount of both calories and fat.
To control calories you can ask for your meats (chicken, fish, beef), “dry grilled” this means they grill it without all of the added fat.
“Fried foods or foods with a creamy sauce contain a lot of calories for a small portion and can wreak havoc on your health if consuming regularly,” Watkins says, “so look for wine, lemon, broth-based sauces and if you are not sure, ask for it on the side which will give you control to limit the portion.”
What are the best menu choices for dessert?
Except for special occasions, Watkins says it’s a good idea not to get in the habit of not ordering dessert out. “For most people, it is addicting and hard to control the portion,” she says. “Also, the portions are also very large and calories, fat, and carbs are high.”
But, she suggests if you are going to partake be sure to count it into your meal plan. So, she says this would be a good time to order a meal that contains minimal carbs, such as a salad with chicken (no bread) or grilled protein with vegetables.
“This way you can have a small slice of cake or dessert and still possibly stay in your carb limit for the meal. You can also try to stick to single serving portions such as a single scoop of ice cream versus a big brownie sundae that can be way too much even if you share,” she recommends.
If you do end up overindulging on dessert, she says to remember that exercise can act like invisible insulin, so go for walk after the meal to help burn calories and keep your blood glucose at bay.
If you are on bolus insulin you may need to adjust your premeal dose to account for the dessert you will eat or take a correction dose later (talk to your doctor about your options).
Any other thoughts when it comes to dining out?
The key, according to Watkins is to try to limit the number of times per week you eat out. This can help control your blood sugar and weight.
Also, she recommends testing your blood sugar before and after meals (2 hours from the first bite) to determine which meals seem to work and which do not – be sure to look for patterns.
For the meals that cause a spike in your blood sugar, you may want to have only occasionally or try exercise (such as walking) after.
“How careful you should be when eating out really depends on how often you do it,” Watkins says. “If you eat out 3 or 4 times a week you would want to be more careful with making good choices. But if you only eat out once a week, or on special occasions, you can allow yourself a little extra and maybe take a long walk after to balance out your blood sugar.”
The key, Watkin says is to enjoy going out and eating delicious food while still staying healthy and feeling good about yourself afterward.
Susan Watkins is a Registered Dietitian and Certified Diabetes Educator. She is the manager of the Center for Health Promotion at St. Joseph Health and the coordinator for St. Joseph’s ADA recognized diabetes program. She also manages their HMR weight program, which has been nationally recognized by U.S. World News and Report as a best, fast weight loss diet in the country for the last 3 years. In addition to diabetes, she creates programs and educates patients on a variety of conditions such as IBS, heart disease, kidney disease, and liver conditions.