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    Behavior Management Tips
    Eating Out

    The behavioral tips for managing a special restaurant meal versus a time we are just catching a quick bite while running around are very different. So, we begin this section by asking you to reflect on each dining out experience separately by asking yourself these 3 questions:

    What is your intention or goal for this meal? Will the amount of food (especially carbohydrate-rich food) be:

    1. Less than the typical meal you eat at this time of the day
    2. About the same as any other meal you eat at this time of the day
    3. A little bit more than the typical meal you eat at this time of the day
    4. Significantly more than the typical meal you eat at this time of the day
    5. Dramatically more than the typical meal you eat at this time of the day

    How do you expect this meal to effect diabetes control in the next 24 hours?
    No change from usual good control
    No change from usual poor control (Time to get some medical attention)
    Slight effect, raising blood sugar modestly for a few hours. Simple efforts to adjust my diet and exercise will bring my blood sugar down.
    ∑Moderate effect, raising blood sugar significantly for several hours. I will need to make a significant effort to adjust my diet and exercise to bring my blood sugar down over the next 12 - 24 hours.
    Substantial effect, raising blood sugar to a high range for many hours. It will be hard for me to bring my blood sugar down. (For those who take Insulin, dose adjustment advise by physician may be necessary.)
    Is the expected effect of this meal worth the effort to recover from it?

    If no, pay close attention to the behavioral tips to maintain a near-normal diet pattern while eating out
    If yes, be sure you limit the number of times in a month that you are eating out with negative consequences for diabetes control.
    If this is an important special occasion, and you take insulin or diabetes medications, ask your physician or diabetes educator for guidelines on individual medication adjustments you might be able to make.

    Behavioral Tips For Maintaining a Near-Normal Diet Pattern

    1. Be knowledgeable. Know your carbohydrate exchange target for the meal you are eating and be familiar with carbohydrate-rich foods and their portions.


    2. Be assertive. Identify menu items with carbohydrate. Ask the food server to describe the portions that are served.

    Example: Bread for a sandwich

    Question: Do you serve the sandwich on sandwich size bread slices,
    large oval slices or a roll?
    Answer: A French roll

    Question: How large is the roll? Do you know how much it weighs?
    Answer: It is "this large". (Shows you)

    Question: Do you have a scale to weigh it?
    Answer: What?

    Question: Can you help me with this? It is important to me. Thanks.

    3. Be choosy. Don't eat the free appetizers that have carbohydrate if you want to enjoy the carbohydrate in the meal you ordered. Lower carbohydrate appetizers (salad, vegetable plate, ceviche, lean meats, fish or poultry) are usually available.

    4. Limit liquor. Drink diet sodas, mineral waters, seltzers or plain water to quench your thirst. If you order an alcoholic beverage, do not begin to drink it until you have begun to eat your meal. Order only one serving of alcohol.

    5. Be flexible. If you self-test blood glucose, test before your meal.

    A. If your blood sugar is high, you may benefit from one or more of these strategies:
    Delay the meal an hour or so, and, if possible, go for a walk to bring your blood sugar down
    Adjust your insulin as advised by your physician or diabetes educator
    ∑Eat mostly vegetables and lean protein in the meal; take less starch, fruit or milk than usual now. You may find you need the carbohydrate exchanges later in the day, especially if you have increased medication and/or exercise.

    B. If your blood sugar is low or low-normal (80 mg/dl or less), follow these strategies:
    Begin your meal with a carbohydrate-rich appetizer (a slice of bread, a piece of fruit, 1/2 cup fruit juice) or start eating the carbohydrate food served with your meal (rice, pasta or potato) before the meat. This will allow your carbohydrate food to digest first.
    Do not eat high fat food (nuts, olives, avocado, cream or butter sauces) at the beginning of the meal. They will slow digestion.
    Avoid alcohol altogether at this meal
    6. Be heart-smart. Select lean beef or pork, fish, shellfish or skinless poultry as meat dishes. Tofu, other soy dishes or cooked dried beans and peas (legumes) are good alternative meatless entrees. Limit butter and cream dishes. Ask for olive oil on the side for a bread dip or avocado in your salad if you need more fat in the meal. Or, if you are watching calories for weight loss, skip the added fats wherever possible.

    7. Enjoy the tastes - Unless your blood sugar is low and you need immediate carbohydrate, try to eat slowly. Chew well and hold the food a little longer in your mouth to fully enjoy the subtle flavors of the meal.

    Eating is one of the finer pleasures of life. Having diabetes doesn't mean you can not nurture and pleasure yourself with the tastes, textures and satisfaction of a wonderful meal. It does mean you can not over-indulge in too much carbohydrate, saturated fat and alcohol without consequences. Be informed, selective and smart.



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