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I am a 45 year old diabetic with IDDM for 15 years. I travel constantly and eat irregular fast food meals. I sometimes have wine at dinner. I have had numerous insulin reactions over the years. On my last hospital admission my blood glucose was 350.

Can you help me with my meal planning around "fast foods" because my schedule and travel commitments will not allow me to have "home cooked meals?" Can you also advise me to control my blood glucose levels?


I do think you can achieve the levels of blood sugar control in your everyday life that are considered ideal whatever lifestyle you run, given your ability to self-manage your diabetes. Therefore you can have the right choices of "fast foods" (this means less solid fats and animal meats, instead more oils, carbohydrates and fish, nowadays available in more and more fast foods) and some good light wine (in small amount it can decrease the "atherogenesis" of "junk" fast food meals!) aiming at normal body weight.

This means of course you should talk to the nutritionist in your diabetes team to be sure that your average food intake is adequate and that you understand how to substitute one fast food for another. I do not know your actual insulin regimen, but taking fixed doses of insulin prevents the flexibility that you want. Then you can discuss with your team how various forms of "intensive insulin regimens" (using Regular or lispro insulin [Humalog®] for the short-acting component premeals and NPH or Ultralente for the basal dose) can match your schedule.


Additional comment by Dr. Lebinger:

The nutritional value of foods from many fast food chains is available in booklets put out by both Eli Lilly and Becton and Dickson companies. Knowing the nutritional content of foods you order (especially the carbohydrate content) can be a great help in managing your blood sugars when eating out. A nutritionist should be able to obtain these brochures for you and help you fit fast foods into your meal plan.


Original posting 3 May 97


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