By Ann S. Williams, Ph.D., RN, CDE

Listen to Living with Diabetes and Visual Impairment—Healthy Eating Audio

Healthy eating is where all diabetes care begins. Controlling carbohydrates and fats, using whole grains, and eating plenty of fresh vegetables are familiar guidelines to most people living with diabetes. At the same time, people with diabetes can have very different nutritional needs. For example, a retired grandparent with diabetes won't have the same dietary needs as a teenager with diabetes who is used to clearing hurdles on the high school track team. It is generally recommended that every person with diabetes meet with a dietitian for an individualized meal plan.

Regardless of the specifics of your diet, it is your responsibility to implement it safely and consistently. If you also have vision loss, it means learning adaptive techniques for grocery shopping and preparing meals, and giving special attention to measuring portion sizes accurately.

Maintaining a Healthy Diet

Many people who have diabetes do better when they eat about the same amount of food every day and at about the same time. It also helps to plan the amount of carbohydrates (carbs) so they are spread out evenly throughout the day. That way, you can manage your blood glucose and obtain the energy and appropriate nutrients to keep you going all day long. Keeping track of your carbs does not have to be difficult during the holidays if you follow a few simple guidelines.

To help you plan your meals, remember that each portion of carbs represents one carb choice or 15 grams of carbohydrate. Most women can have 3-4 carb choices per meal and most men can have 4-5.

For a typical meal, you could have 3-4 ounces of lean meat, fish, or protein of your choice, 1 cup of mashed potatoes or pasta, 1 or 2 servings of cooked vegetable, and a slice of bread or a roll. Foods such as non-starchy vegetables that have fewer than 20 calories (or 5 grams of carbs) are considered "free," so load up on raw vegetables or vegetables cooked without added fats.

In Good Measure

Self-management of healthy eating is all about balancing what goes into your body and in what proportion. Here%27s a simple set of devices and techniques that will help ensure accuracy at mealtime:

For Your Pantry

  • Try nested measuring cups—a set of various cup sizes that stack neatly inside one another. These can feature enlarged or raised numbers for easy identification. Color-coded cups are also available.

  • Divided plates have tactile dividers (similar to TV dinner plates), which act as easy-to-use portion control devices for people with visual impairments.

  • If you need precise food measurements (for example, if you are on dialysis, or if you have high carbohydrate sensitivity), you might consider a talking food scale. There are several affordable versions on the market, including scales that speak French, German, and Spanish, as well as English.

Your Best Estimate

If you do not need to measure your portions exactly, you can estimate your portions using these low-tech measuring devices:

Hands (for average-sized hands)

  • The palm of the hand (about the size of a deck of cards) is about the size and thickness of three ounces of meat, fish, or cheese.

  • A fist is approximately the size of one cup, or two portions, of most starchy foods and fruits, such as pasta, potatoes, oatmeal, or applesauce. A half-fist, or one portion, is about the size of a tennis ball or a light bulb.

  • Two hands cupped together hold about two cups, or one portion of green salad.

  • A thumb is about the same volume as a tablespoon, or a serving of salad dressing.

  • The tip of the thumb is about one teaspoon, or one serving of butter or margarine.

The Plate Method

  • For lunch and dinner, imagine that your plate is divided in half, and that one half is divided into two sections that are each one fourth of the entire plate. Low-calorie vegetables should fill half of your plate. Lean meat, fish, eggs, or low-fat cheese should fill one fourth of your plate (about three ounces). A starchy food should fill the remaining fourth of the plate (about one cup). You can add to your meal one cup of milk or yogurt, and a small dish serving of fruit.

  • For breakfast, the portion sizes are similar, although most people in the United States prefer not to have vegetables for breakfast. (However, you may eat vegetables if you want.) Hot or cold cereal counts as a starchy food. The amount in one portion of cold cereal varies greatly, so it%27s important to get information for the particular cereal you eat.

Common Kitchen Tools

  • Most serving spoons and soup ladles hold about a half cup, or one serving size of a starch, fruit, or cooked vegetables. (Try measuring a typical serving from your serving spoons or ladles to confirm this for the ones you use.) Keep track of how many spoonfuls you serve yourself.

  • For bowls, glasses, and cups, measure how much each holds. If the amounts are substantially more than you should eat or drink in one serving (as with those convenience store "big gulp" containers), then consider replacing these items with ones that hold portions that are right for you. For example, if you want to drink only a half cup of juice for breakfast, get a half-cup juice glass, and so on.

  • Scoops: keep a scoop of the appropriate size near food that you need to measure often—for example, a one-cup scoop near your cereal.

For More Information

    Perfect Portions. Learn more about the divided plate for portion control.

  • Idaho Plate Method: Control Your Diabetes. This site explains how to control your portions with the plate method.

  • Ezweightplate. This site offers an easy way to weigh food and maintain portion control.