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Nutrition Troubleshooting


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High Fat = BG Confusion

Have you ever had pizza and wondered why after two hours your blood sugar reading was still 200+?


It’s because pizza is not only a high carb meal, but it’s also high in fat. During the holidays, we need to be extra diligent with these high fat, high carb dishes -- they’re everywhere. From baked casseroles to pizza; burgers to Auntie Marla’s famous bread pudding. If you're looking for some helpful advice to tackle the "pizza problem," check out this article by Certified Diabetes Educator Gary Scheiner.

High Fat BG Confusion
Milk Choices

Milk Choices


There are so many dairy and non-dairy milk options available in grocery stores nowadays, it might feel overwhelming to choose. Taste is definitely personal, but we may be able to help you choose a higher protein and lower carb milk to lessen blood sugar spikes after having milk. Especially if you're an avid milk drinker or like to have milk with other higher carb foods like cereals, cookies, or pasta.

For dairy options, the American Academy of Pediatrics recommends full fat milk for children 1-2 years old and then switching to skim or low-fat (1%) milk at the age of 2. Ultra-filt
ered milk (such as Fairlife or Kroger's CarbMaster) can also be a great option for those with diabetes because it has half the amount of carbs and more protein compared to regular milk. It’s also lactose free for those who are lactose intolerant.



Non-dairy options are great for those who are vegan, have dairy allergies, or simply prefer the taste of plant-based milk over cow’s milk.







By comparing protein and carbohydrates, the best choices for non-diary milk would be soy milk and pea milk, but since pea milk tends to be harder to find and more expensive, soy milk would be the winner. We hope this helps you find a milk that also fits your taste and budget!

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Glycemic Index

Glycemic Index

Have you heard about the GI or Glycemic Index? It's a rating system for food containing carbohydrates. The lower the score, the slower the increase of blood sugar after eating. Low-glycemic foods have a rating of 55 or less, medium-level foods have a glycemic index of 56-69, and foods rated 70-100 are considered high-glycemic foods. Typically, foods with lower glycemic scores are higher in fiber, protein, and/or fat. Foods with higher scores are often more processed, quickly digested, or more sugary. However, the glycemic index can be confusing at times. Some seemingly healthy options might have a higher glycemic score than foods that are considered carb-dense. For example, ice cream has a glycemic index of 57, but watermelon has a glycemic score of 72. Does that mean we should eat ice cream for all snacks instead of watermelon? (No, although that would be a dream come true!)

Why does the GI seem misleading?

There are two reasons:

  1. The glycemic index doesn't count how much we are eating. 1 cup of Ben and Jerry's chocolate ice cream has 50g of carbs, but 1 cup of watermelon cubes has only 11g of carbs.

  2. The glycemic index assumes food is eaten on an empty stomach and with nothing else. Most of us don't eat just one food at a time. Mixing different food groups can slow down the increase in blood sugar. For instance, cooked white rice has a glycemic score of 87, which is high on the glycemic index. But we can pair it with grilled chicken (GI=0) and asparagus (GI=15) to lower the overall glycemic effect.

So is the glycemic index useless then? No, the glycemic index still provides guidance when we're comparing similar food. For example, instant oatmeal's GI score is 83, but oatmeal made from old-fashioned oats (rolled oats) has a GI score of 55. That is part of the reason that most of us see a sharp increase in blood sugar after instant oatmeal, but not so much when having old-fashioned oats.
Although the glycemic index may be an imperfect system, it is a helpful tool to guide us toward healthy eating. Lower-glycemic foods are usually more nutrient-dense. We can also GI scores to make food pairings that can lower the spike of blood sugar after eating, like the chicken + rice example above.


Cereal: Tips & Tricks


Cereals are a popular breakfast choice especially for school days because they are quick and easy, but many parents also notice cereals spike their child's blood sugar. Cereals spike blood sugar because they are often made with highly processed grains and a lot of added sugar. The process of making grains into cereals takes away the fiber from the grain, and the lack of fiber makes cereals much easier and quicker to digest and increase blood sugar. Additionally, cereals are usually low in protein and fat causing us to feel hungry before lunchtime.

Most sugary cereals are similar to desserts based on the amount of carbs and sugar they contain. For example, one cup of Froot Loops has about the same amount of carbs and sugar as a frosted cinnamon bun! If we think of cereal as basically a breakf
ast dessert, we can try to balance it the same way we do with desserts. Yes, blood sugar can be more challenging to manage, but it doesn't mean we can't have sweet treats!

Here are some ways to deal with cereal highs:

  1. Have cereal less often. Eating a dessert as breakfast every day is likely to make blood sugar harder to manage. Maybe try having cereal only on the weekend when parents have more time to correct high blood sugar if needed.

  2. Have a smaller portion. Instead of only eating cereal for breakfast, try making a part of the breakfast along with other higher protein foods. For instance, pair 1/2 cup of cereal with some scrambled egg or a few turkey sausages. Another way to have less cereal is to use yogurt instead of milk and eat it as a yogurt parfait. This results in smaller portion of cereal and helps balance the amount of carbs and protein.

  3. Try lower-carb milk with cereal. Consider having a highly-filtered, lower carb milk like Fairlife, which has 6g of carbs per cup instead of 12g in regular cow's milk, plus more protein. Or try unsweetened soy milk, which has only 3g of carb per cup and about the same amount of protein as cow's milk. 

  4. Try adding nuts and seeds to increase the fiber and protein content. Chia seed, ground flaxseed, or hempseed are great options.

  5. Try lower-carb cereals. There are many low-carb and keto cereals available on the market. Feel free to explore different options to see which one your child prefers. You can also try mixing sugary cereal with keto cereal. For example, Froot Loops and Kashi Go Keto are both loop shape cereal. Mix them in 50/50 ratio to lower the overall amount carb while increasing fiber and protein. 

  6. Dose insulin sooner. Without enough fiber and protein, cereals can raise blood sugar quickly. If your child does not have a low blood sugar before eating cereals, try dosing insulin a little sooner than normal, at least 15-25 minutes before eating.

  7. Adjust your insulin to carb ratio. Talk to your diabetes team about adjusting your child's breakfast insulin to carb ratio to decrease blood sugar spikes from cereals.

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