Thank you to our sponsors at Nemours and Sofia Gomez-Rubio, RD, LDN a clinical pediatric dietitian at Nemours/Alfred I. duPont Hospital for Children, for writing this article. 

Dining out is a fun, cultural and social affair that everyone should be able to take part in, including people with diabetes. It can seem daunting for those who need to count carbohydrates and administer insulin. But with preparation, guidance, and practice, dining out with diabetes can become a smooth process! Below are tips for before, during, and after dining to help ensure an enjoyable experience.

Before:

• There is no need to change the types of restaurants frequented. Continue visiting your favorite ones and do not feel limited to ones that offer “healthier” options. In time, you may develop a list of preferred locations due to the helpfulness of staff and information made available by the restaurant.
• Search for the restaurant’s website online and see if the menu and nutritional information are available.
• If there is no restaurant website, try calling the restaurant and asking for the same information.
• If both the menu and nutritional information are available, choose potential appetizers and/or meals and make note of carbohydrate counts.
• If only the menu is available, choose potential appetizers and/or meals and use apps like the Calorie King to find the appropriate carbohydrate counts.
• Making a reservation can help with sticking to a meal schedule.

During:

• Once at the restaurant, the server may be able to provide nutritional information if it’s still needed.
• Since May 7, 2018, the Food and Drug Administration (FDA) requires that restaurants or retail food establishments provide calorie and other nutritional information, including total carbohydrates, if they are part of a chain of 20 or more locations. Restaurants that do not meet criteria can still voluntarily register to follow these requirements.
• If the restaurant does not have nutritional information available, choose a dish. Once the dish arrives, estimate the portion based on portions eaten at home, and use your calorie app to find the appropriate carbohydrate count. Consider how the dish is prepared (e.g. added sweet sauce, added croutons, or starchy side dishes such as chips or french fries). If you feel uncomfortable estimating the portion size for a specific high carbohydrate food, such as french fries, one option is to choose an alternative, like a side salad or side of seasoned vegetables.
• All-You-Can-Eat buffets are trickier:
  • Plan on only having one plate
  • Look at all food options before building a plate
  • Once food selections are made, serve your plate
  • Estimate portions based on portions eaten at home and calculate total carbohydrates with nutritional information or by using Calorie King or other website or app.
  • If you decide to get a second serving of food, you will need to count carbohydrates for the new food and possibly administer more insulin depending on the type of food it is.
• Be mindful of portions. Many restaurant portions are larger than those served at home. Make sure to dose insulin only for the amount you will eat.
• If the portion is too large for one sitting, share with another diner or put in a to-go container for lunch the next day. You will already know the carbohydrate counts.
• Always carry your insulin kit, which should include: everything needed to administer insulin, medications, at least three hypoglycemia treatments, and carbohydrate/protein snacks–such as a granola bar, nut trail mix, or peanut butter or cheese crackers.
• Before administering insulin, consider making a trip to the bathroom where there is access to a sink to wash your hands and administer insulin privately.
• Although it is often out of your control, try timing insulin administration to 10-15 minutes before starting to eat.
• Make sure there is at least one source of protein in the meal and try to eat the protein first to better control the subsequent blood sugar spike.
• Choose water, milk or other zero-carbohydrate drinks with meals. Remember that sugary beverages cause significant blood sugar spikes and provide little to no nutrition. It is best to save sugary beverages, such as juice, for low blood sugar treatments.
• Eat slowly and enjoy your food, company and environment!

After:

• Keep documentation of carbohydrate counts from previous dining experiences–this makes going back to the same restaurant much easier.
• Limit dining out to once per week. Homemade meals tend to be healthier because there is greater control over ingredients used and preparation methods.
• These tips will hopefully make the dining out experience more manageable and enjoyable for people with diabetes. With practice and personal experience, you will learn what works for you and your family!

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If you are someone that wants to learn more about the YMCA of Greater Branywine's Diabetes Prevention program, please visit Health Management and Disease Prevention for more information.