“I'm a diabetic, FYI.”

Is it safe? A type 2 diabetic's guide to reading Nutrition Facts labels

Tuesday, September 24, 2019

Jason Tu
By Jason Tu

<br />Jasmine: Is it safe?<br />Aladdin: Sure, do you trust me?<br />Jasmine: ...what?<br />Aladdin: Do you trust me? 🙂<br />Jasmine: ...yes...<br /><br />—Aladdin (1992). Photo by @ryanquintal on Unsplash.

Jasmine: Is it safe?
Aladdin: Sure, do you trust me?
Jasmine: ...what?
Aladdin: Do you trust me? 🙂
Jasmine: ...yes...

—Aladdin (1992). Photo by @ryanquintal on Unsplash.


In your first few months as a diabetic, choosing foods is a whirlwind of emotion.

How do you choose? How do you know what’s safe, and what’s not?

What if your friends invite you to dinner? How do you pick out safe foods on a restaurant menu?

Ah, screw it – what if you’re hungry now, and you just have to eat something?

I think it’s rocky for everyone, as one develops their intuition for diabetic-friendly foods from measuring one’s blood sugar after meals. An important part of this intuition is the ability to interpret a food’s Nutrition Facts label.

As of 2016, the U.S. Food and Drug Administration (FDA) decrees that all Nutrition Facts labels follow this format:

<br />You may see different labels depending on the product’s age, or your country (this is the U.S. Food and Drug Administration’s label). Regardless, we generally have the right info to determine diabetic friendliness.

You may see different labels depending on the product’s age, or your country (this is the U.S. Food and Drug Administration’s label). Regardless, we generally have the right info to determine diabetic friendliness.

The FDA also provides a wonderfully interactive website, explaining each aspect of the Nutrition Facts label. However, I think it does a poor job of explaining what to focus on if you have type 2 diabetes.

As a type 2 diabetic, you are chiefly concerned with managing your blood sugar. So you should focus on those numbers that have the greatest blood sugar impact:

  1. Carbs: without the fiber, please.
  2. Protein: watch this too.
  3. Compute your daily insulin load.
  4. Don’t worry about the rest of the label.
  5. But read ingredients lists carefully.

1. Carbs: without the fiber, please.

The number 1 thing to examine is the Net Carbohydrate content of the food. This is done by taking the Total Carbohydrate amount, and subtracting the Dietary Fiber amount.

Remember: our bodies convert carbs into sugar in our blood – exactly what we want to minimize! However, we subtract the Dietary Fiber because our bodies don’t process fiber. That is, fiber has no glycemic effect.

So taking the label above as an example:

Net Carbohydrate = Total Carbohydrate - Dietary Fiber
Net Carbohydrate = 37g - 4g
Net Carbohydrate = 33g

Depending on the severity of your diabetes and your level of insulin sensitivity, 33 grams of carbs might be fine for you. (Measure your blood sugar to find out.) However, that’d be a big no-no for me, and my blood sugar would go through the 140 mg/dL roof. 😛 Suffice to say, it’s a good idea to choose foods that contain low net carbohydrate.

2. Protein: watch this too.

The second thing to examine is the food’s Protein content – specifically, the number of grams. Protein is a unique macronutrient, in that our bodies use protein to maintain and build muscle mass. However, our bodies convert excess protein into sugar too. So you have to keep an eye on the amount of protein you’re eating.

3. Compute your daily insulin load.

If you keep a log of all the foods you eat in a day, their Net Carbohydrate, and their Protein, you can compute your insulin load for the day. Insulin load is a simple formula that spits out a number, giving you some idea of the amount of insulin required to metabolize a (day’s) worth of food:

Insulin Load = Net Carbohydrate + 0.56 × Protein

This is important because as diabetics, we are insulin-deficient. We may be insulin-resistant, and our cells don’t respond to insulin properly. Or some of the beta cells in our pancreas may have burnt out. We have less available insulin to move energy (blood sugar) into our cells, and thus we push our blood sugar out of range when we eat above our daily insulin load.

Thus, insulin load is a useful number for establishing a threshold. That is, if your blood sugar is regularly too high, you should lower your daily insulin load until your blood sugar lowers to a satisfactory level.

For example, if you consumed these macronutrients within the span of 1 day:

Screenshot of the
Screenshot of the "Macronutrient Targets" pane in Cronometer (https://cronometer.com/).

The insulin load for that 1 day would be as follows:

Insulin Load = Net Carbohydrate + 0.56 × Protein
Insulin Load = 19.5g + (0.56 × 83.3g)
Insulin Load = 66.148g

On this particular day, my blood sugar wasn’t too shabby:

My blood sugar trends corresponding to the previous insulin load computation.
My blood sugar trends corresponding to the previous insulin load computation.

Thus, an insulin load of ~66 grams is fine for my level of insulin sensitivity.

4. Don’t worry about the rest of the label.

Besides serving info (which you should consider in computing Net Carbohydrate and Protein), the rest of the label is less relevant for blood sugar management.

Calories and fat matter of course, but if you eat wholesome, unprocessed meals without binging on any particular food, you shouldn’t need to track these numbers.

The Daily Value % is perhaps least useful, as everyone has a different caloric requirement and metabolic rate.

5. But read ingredients lists carefully.

Manufacturers typically place ingredients lists near Nutrition Facts labels, and you should scrutinize these carefully.

It turns out that added sugar hides in many of today’s foods, and food manufacturers can deceive us by downplaying the sugar content given an appropriate serving size:

A typical Caesar Dressing label. Seems fine...
A typical Caesar Dressing label. Seems fine...

But you ain't foolin' nobody.
But you ain't foolin' nobody.

For honing your intuition, SugarScience has a good list of names for sugar. As a rule of thumb, you should avoid mystery meats like hot dogs or gyros, and steer clear of (some) zero-calorie sweeteners that are actually just sugar.

High Fructose Corn Syrup (HFCS) is especially bad for diabetes, as it directly contributes to insulin resistance.


Pleasant surprises

And there you have it! You now have the power to interpret any (packaged) food for diabetes friendliness. In absence of a Nutrition Facts label, you can always google and guesstimate.

Diabetes doesn’t mean that you can’t eat delicious foods anymore. You still can! You just have to be diligent about reading labels, and finding foods that work for your level of insulin sensitivity.

The lovely thing is that once you’ve been reading labels for awhile, you’ll find many low-insulin-load comfort foods:

Fried eggs on 90 second keto bread.
Fried eggs on 90 second keto bread.

Happy eating, and until next time! ❤️