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Diet for Diabetic Gastroparesis Gastroparesis means that food is not able to move from your stomach into your intestines as quickly as it should. Nerves that help your stomach muscles to work may become damaged over time with diabetes. Due to slow stomach emptying, food stays in your stomach longer than normal. This may cause low blood sugar. When the food moves from your stomach into your intestines, your blood sugar may then go too high. Medication no longer matches up with your meal schedule and blood sugars go up and down. You may need to check your blood sugars more often. Keeping your blood sugar under control is important because major changes in blood sugar can impair gastric emptying. Symptoms Bloating/feeling of fullness Poorly controlled blood sugars Nausea Diarrhea Vomiting Constipation Poor appetite Medications that increase stomach emptying may help your symptoms. The times you take your diabetes medicine may need to be changed. Your doctor and dietitian can help you make changes to your medications and diet based on your symptoms. Dietary Changes Eat 5 to 6 small meals daily – keeping carbohydrates in even amounts. Choose low fat foods – fat slows down stomach emptying. Fat in liquid form (such as the fat in 2% or whole milk, milkshakes, and in nutrition supplements) may be tolerated and may be a needed source of calories. Do not restrict fat in liquids unless it is not tolerated. Choose low fiber foods – fiber slows down stomach emptying. Eat very soft foods to ease digestion. Remember to chew foods well before swallowing. Solid foods in the stomach do not empty well. Drink fluids throughout the meal, and sit upright or walk after meals. These practices may help empty the stomach. 1 If symptoms are severe: Start with a liquid or blenderized diet when symptoms are active. Advance your diet to include soft foods as symptoms improve. Include liquid nutrition supplements such as Ensure, Boost, Boost Glucose Control, Glucerna, Carnation Instant Breakfast or Carnation Instant Breakfast No Sugar Added in order to help you consume enough calories and protein. (Check labels for carbohydrate content and choose according to your needs.) Blend in ¼ cup dry milk powder into a cup of liquid milk to increase the protein content of milk as needed. Make a frothy high protein drink by blending ¼ cup pasteurized egg product (such as Egg Beaters) with 8 ounces of juice. Food Guide Try These Limit These Regular cheese Milk and Dairy foods Start with skim milk Try 2% or whole milk as needed Yogurt with berries for more calories. Low-fat cheese, cottage cheese Low-fat or fat-free pudding Blended or custard-style yogurt Broth, blended cream soups Soups made with high Soups fiber foods such as corn, beans, peas Meats Lean beef, pork, fish, poultry with High fat meats including skin removed bacon, sausage, bologna, Breads and Grains Egg (limit to 1 per day) Egg whites (unlimited) hot dogs, fried meats, organ meats Creamy, low-fat peanut butter Peanut Butter—crunchy and regular (not low-fat) White bread and bread products Whole grain breads and Dry cereals with less more than bread products 2 grams fiber per serving Cereals with more than Cream of Wheat White pasta, white rice 2 grams fiber per serving Oatmeal Saltine crackers, Pretzels High fat breads such as donuts, croissants, sweet rolls, pancakes Vegetable juices All raw vegetables Vegetables (Puree/blend as needed) Soft, cooked vegetables such as Higher fiber vegetables beets, green or wax beans, carrots such as corn, peas, dried potatoes (no skin), mushrooms, beans and peas, sauerkraut, summer squash, zucchini broccoli, winter squash Fried vegetables 2 Food Guide Try These Limit These Fruits (Puree/blend as needed) Juice without pulp Prune juice, juice with pulp Canned fruits without skins such All raw fruits except as applesauce, peaches, pears ripe banana Ripe banana Fats and Oils Berries, dried fruits Limit all added fats such as oil, Excessive amounts of added butter, margarine, salad dressing fats gravy, mayonnaise Sweets and Desserts Nuts, seeds, coconut Angel food cake, gelatin, fat-free Cake, pie, cookies, pastries or low-fat frozen desserts without Regular ice cream nuts or berries Vanilla wafers Beverages Meal Water, coffee, tea, diet soft drinks Grams of carbohydrate Alcoholic beverages Number of carbohydrate choices Breakfast 1 slice of white bread or toast 15 1 0 0 15 1 12 1 0 0 42 3 15 1 12 1 27 2 30 2 2-3 ounces sliced turkey 0 0 2 teaspoons mayonnaise 0 0 4 ounces V-8 juice 5 -- 1 cup noodle soup 15 1 50 3 1 teaspoon soft margarine ¾ cup corn flakes 8 ounces 2% milk 1 scrambled egg Morning Snack ½ cup unsweetened applesauce 1 serving sugar-free, low fat vanilla yogurt Lunch 2 slices white bread 3 Meal Grams of carbohydrate Number of carbohydrate choices Afternoon Snack 6 saltine crackers 15 1 0 0 15 1 30 2 2-3 ounces baked fish 0 0 1 cup mashed potatoes ½ cup cottage cheese ½ cup canned, unsweetened fruit Dinner 30 2 ½ cup cooked green beans 5 -- 2 teaspoons soft margarine 0 0 15 1 50 3 30 2 30 2 1 small, ripe banana Evening Snack 1 can (8 ounce) Glucerna For more information, visit the website of the Gastroparesis and Dysmotility Association at http://digestivedistress.com. Rev. 9/06, rev. 8/07, 3/10, 5/13 \\Mcehemcshare\netit patient education$\Mount Carmel Handouts\Diabetes\Diet for Diabetic Gastroparesis.doc ©Mount Carmel 2013 4