Kirstie Lithgow is a second year internal medicine resident at the Cumming School of Medicine in Calgary, Alberta.

It is standard care to start patients with type 1 and type 2 diabetes on a “diabetic diet” at the time of admission to hospital. However, some of the menu items offered as part of this diet are suboptimal for glycemic control. Many of the patients with diabetes for whom I have cared have independently raised this concern to me. These patients have specifically stated that their sugars are more labile during admission owing to some meals being higher in carbohydrate content than what they would typically consume at home.

I fully disclose that I have no formal training in nutrition or food sciences. Developing a province-wide hospital menu plan is a huge undertaking, and although I am sure there is room for improvement in many areas, I am admittedly not qualified to weigh in on this. However, one blatant deficiency I have noticed upon reviewing the diabetic menu plan at my institution is the inclusion of fruit juice as a beverage option. I recently contacted the executive director for food and nutrition services for my zone to express my concern. I was assured that the current menu was developed based on recommendations from Canada’s Food Guide, with a focus on providing consistent carbohydrate content with each meal. However, I did not receive a satisfactory explanation for why juice is provided on the diabetic menu. ...continue reading →