Eating Well with Diabetes Whilst in Hospital

What is diabetes?

Diabetes means the body can no longer control the level of glucose (sugar) in the blood. Our bodies make insulin (a hormone) which allows glucose in the blood to be used by the body for energy. In diabetes:

  • The body doesn’t produce any insulin or        
  • The body doesn’t produce enough insulin or            
  • The body cannot use insulin efficiently (most common)

The body particularly struggles to use insulin when you are unwell. 

Aims of this booklet

When a person with diabetes is unwell, glucose levels often rise as a result of the illness.  High glucose levels can lead to further problems and a longer stay in hospital.  For this reason, your diabetes medication may need to be adjusted. You will have help to do this in hospital. It is also important that you continue to follow a healthy balanced diet.

The information in this booklet is designed to help you to:

  • Understand the importance of a healthy balanced diet in diabetes
  • Understand North Bristol NHS Trust’s menus
  • Understand the importance of making an individualised choice at mealtimes

Does it matter what I eat?

Yes. What you eat affects the levels of glucose and fat in your blood, your blood pressure and your weight. It is therefore important to follow a healthy, balanced diet. The below recommendations are the same as for the general population. 

Health eating involves:

  • If you are overweight, try to lose some weight (when you are well)
  • Eat at regular intervals during the day i.e. breakfast, midday and evening meal. Don’t miss meals
  • Include starchy food (carbohydrate) at each meal (approximately one quarter to one third of the plate). Aim to have about the same amount of starchy food each day. Go for wholegrain, high fibre options where possible
  • Have two or three portions of vegetables each day
  • Have two or three portions of fruit spread throughout the day
  • Limit foods with a high fat content
  • Cut down on sugar, sugary foods and sugary drinks (this includes smoothies and fruit juice)
  • Drink alcohol in moderation
  • Cut down on salt
  • Special diabetic foods are not necessary

Further information is available in ‘Healthy Eating with Diabetes’ leaflet found in the references at the end of this booklet.

So is there a diabetes specific menu in hospital?

No. Healthy eating recommendations are the same as for the general population. There is no need for a specific ‘diabetes menu’ or meal options to be coded as ‘suitable for individuals with diabetes’. The main menu at Southmead Hospital offers a variety of options that allows a person to eat a balanced diet. 

Please note: some main courses from the menu already contain a portion of starchy carbohydrates. For example; cheese and potato pie already has a portion of carbohydrate in it in the form of potato. In this instance, you may wish to choose two vegetable side dishes rather than a further potato, pasta or rice accompaniment.

Menu options which contain high amounts of sugar should be limited

Some options on the menu are higher in calories and sugar. Examples include: fruit crumbles, sticky toffee pudding, bread pudding or parkin cake, sponge puddings, rice pudding, chocolate crunch etc

Due to their high sugar content, these options may significantly increase blood glucose levels. Intake of these options should be limited. Small portions of these can be enjoyed occasionally.

Lower sugar and calorie alternatives include:

  • fruit in natural juices
  • a portion of stewed fruit
  • a small pot of yoghurt

Some patients in hospital may be identified as being at ‘higher nutritional risk’:

  • If the patient is underweight
  • If the patient has recently lost weight
  • If the patient has a poor appetite and intake

These patients are encouraged to increase their nutritional intake. They will benefit from having some of the higher calorie and sugar options, as per above.  This is not the case for everyone in hospital and meals should be chosen on an individual basis. Please ask the ward staff for support if you are unsure.

Hospital meal times

Meal times in hospital may be at different times to at home. Depending on the type of medication or insulin you take to manage your diabetes, the difference in meal times could increase your risk of having a ‘hypo’ (blood glucose less than 4mmol/L). 

If you take rapid-acting insulin (NovoRapid™, Humalog™, Apidra™ or Fiasp™) with meals, it is advised that you wait until your meal has been served to you before injecting your insulin. This reduces your risk of having a hypo if the meal is delayed, is different to what you ordered, or you don’t expect to eat the full portion.

Snacks such as cereal, toast, sweet biscuits and milky drinks are routinely available on the ward. Please ask a member of ward staff if you require a snack to prevent a hypo if your meal is delayed, at a different time to home, or, if you have been advised to have a snack before bed.

References

North Bristol NHS Trust Healthy Eating with Diabetes

British Dietetic Association (July 2012) The Nutrition and Hydration Digest: Improving Outcomes through Food and Beverage Services

Diabetes UK (May 2011) Evidence-based Nutrition Guidelines for the prevention and management of diabetes

National Institute of Clinical Excellence. NICE. (Last updated July 2016) Type 1 diabetes in adults: diagnosis and management

National Institute of Clinical Excellence. NICE. (Last updated May 2017). Type 2 diabetes in adults: management 

This edition published November 2020. Review due Novemer 2022. NBT003110

Eating Well with Diabetes Whilst in Hospital