Diabetes Snacking Tips

Do people with diabetes have to snack?No, they don’t. But it seems that many think they do. I think it’s worth addressing this issue with our patients, especially if they are struggling to lose weight. Some people with diabetes think that snacks are mandatory to prevent hypoglycemia. Sulfonylureas like glipizide and glyburide, and of course insulin, do increase the risk of hypoglycemia. Thus, patients taking these medications may need frequent meals and snacks to prevent low blood glucose. It used to be that these drugs were patients’ only options. Today we have a variety of medications that do not increase the risk of hypoglycemia, making snacking optional for most adults with diabetes. As health professionals, we can work with both the patients and their prescribers to change or adjust medications for those patients who either have frequent hypoglycemia or fear it. Metformin, DPP-4 inhibitors and bile acid sequestrants have minimal or no risk of hypoglycemia, and many types of insulin can be dosed according to the frequency and amount of food consumption.Another reason many people think that snacks are required is because they’ve been told to eat small frequent meals to lose weight. But research does not support that. In fact, some research conducted only in men suggests that better appetite control comes when they eat three larger meals per day instead of six smaller meals. For many people, snacking just means more calories overall.We can help our patients decide if snacking is right for them by guiding the conversation and addressing whether or not snacking helps control their appetite and if it helps them consume adequate fruits and vegetables or other missing food groups.The bottom line is that snacking should be the patient’s choice. We have a lot of opportunity to educate and help our patients with diabetes.By Jill Weisenberger, MS, RD, CDE