For optimal glycemic control, people with diabetes should stick to the same meal schedule every day. Obviously, in some situations, it is difficult to keep to the regular schedule; for example, when something unexpected happens, a restaurant outing, or a meal with friends.
People with diabetes at risk of hypoglycemia should make a few adjustments when a meal is either delayed or eaten earlier than planned. This primarily concerns people being treated with:
- insulin injections.
- insulin secretagogues, which increase insulin production by the pancreas: gliclazide (Diamicron® and Diamicron MR®), glimepiride (Amaryl®), glyburide (Diabeta®, Euglucon®) or repaglinide (GlucoNorm®).
What to do when a meal is delayed?
If your meal is delayed, here are some suggested adjustments you can make to prevent hypoglycemia and stave off hunger. Consult a healthcare professional to be sure that these measures are right for you.
For a meal delayed by about an hour:
Have a snack containing approximately 15 g of carbohydrates (1 exchange of starches or fruit) at your normal meal time. You should subtract this 15 g of carbohydrates, or exchange, from your next meal to stay within your daily meal plan.
For a meal delayed two or three hours:
Have a snack containing 15 g to 30 g of carbohydrates (1 to 2 exchange of starches or fruit) and some protein (e.g.: 30 g or 1 ounce of cheese) at your normal meal time. You should subtract this snack from your meal count.
If your daily meal plan calls for an evening snack and the delayed meal is your supper, you can reverse the order of the snack and supper.
Take your antidiabetic medication or insulin injection with the delayed meal, except if your antidiabetic medication must be taken at the same time every day, with or without food. For more information about this, consult your doctor or pharmacist.
And if the meal is early?
If your meal is early by less than an hour, you don’t need to make any adjustments.
However, if you eat the meal one or two hours ahead of schedule, eat part it, and keep at least 15 g of carbohydrates to eat at your normal meal time.
Tips so you’re not caught off guard
- When you are not sure of the time of your next meal, plan to eat a snack containing carbohydrates to help you out, if needed.
- If you’re invited for a meal at a friend’s house, ask exactly when it will be served. Then you can plan for adjustments, if necessary.
- Try to anticipate the serving delay when you eat out in restaurants so you can take appropriate measures.