Eating Out With Diabetes: Blood Sugar Friendly Restaurant Orders

You were just told your A1C is creeping up, or you've been managing type 2 diabetes for years, and now the group chat wants to try the new ramen place on Friday. You don't want to be the person who orders a plain side salad and watches everyone else eat. You also don't want to spend the evening guessing what that "house glaze" will do to your blood sugar.

You're far from alone: the CDC's National Diabetes Statistics Report estimates about 40.1 million people in the US have diabetes and 115.2 million adults have prediabetes. The good news is that eating out with diabetes is very doable once you know what to look for on the plate and on the menu. Here's how.

Why is eating out harder when you have diabetes?#

Mostly because you can't see the carbs. At home you know how much rice went in the bowl and whether the sauce has sugar. At a restaurant, portions are bigger, starches often take up most of the plate, and sugar hides in sauces, marinades, breading and drinks.

The CDC's tips for eating out note that three in five Americans eat dinner out at least once a week, and without a plan, big restaurant portions make overeating easy. A few habits fix most of the problem:

• Decide what you'll order before you go. Most menus are online.
• Ask the server to skip the bread or chips before you order, not after you've had three pieces.
• Drink a big glass of water as soon as you sit down.
• Plan for a late dinner. If the meal will be later than usual, the CDC suggests a small snack with fiber and protein, like a handful of nuts.

How do you use the Diabetes Plate Method at a restaurant?#

Picture a 9-inch plate split into sections, then nudge your order toward that shape. The American Diabetes Association's Diabetes Plate Method fills half the plate with non-starchy vegetables, one quarter with lean protein, and one quarter with carbohydrate foods, with water or another zero-calorie drink on the side. NIDDK recommends the same layout.

Restaurant plates are usually larger than 9 inches and flipped the other way: a mountain of pasta, rice or fries, with a little protein and a garnish of vegetables. To rebuild the plate:

• Order vegetables on purpose. Ask for a double side of vegetables, add a side salad, or swap fries for steamed broccoli or green beans.
• Anchor the meal with protein. Grilled chicken, fish, shrimp, steak, eggs, tofu or beans.
• Shrink the starch to about a quarter. Eat roughly a fist-sized portion of rice, potato or pasta and box the rest. The CDC recommends splitting an entrée or eating half and taking the other half home.
• Choose the cooking method. The CDC points you toward dishes that are baked, steamed, grilled or broiled, and away from fried, breaded or creamy ones.

How do you estimate carbs in a restaurant meal?#

Break the dish into parts and estimate each one; carb counting works the same way at a restaurant as at home, just with more guessing. The CDC's carb counting guide uses about 15 grams of carbs as one "carb serving," and notes that a small baked potato is about 30 grams, or two servings. Restaurant portions are often bigger than "small," so expect more.

A practical way to do it:

1. Find the starches and sugars. Rice, noodles, bread, tortillas, potatoes, breading, sweet sauces, juice and dessert.
2. Estimate each portion. Compare it with a measuring cup or your fist, then add up the parts.
3. Check chain nutrition info. Larger chains often list carbs online, which helps you calibrate your eye.

For a step-by-step version of the component method, see how to track macros when eating out.

If you take insulin, carb estimates matter more, because they may feed into your dose. Talk with your doctor or diabetes care team about how to dose for restaurant meals, especially high-fat ones that can raise blood sugar later than you'd expect. This article isn't medical advice. The CDC also suggests asking your doctor about diabetes self-management education and support, where an educator helps build a plan around your own needs.

Where do hidden sugars hide on restaurant menus?#

In the sauce, the coating and the glass. The CDC specifically flags dishes described as BBQ, glazed, sticky, honey or teriyaki as ones that usually carry added sugar. Watch for:

• Sweet sauces and glazes: teriyaki, sweet and sour, orange chicken, hoisin, BBQ, honey mustard, balsamic glaze.
• Breading and batter: fried chicken, tempura, schnitzel, battered fish and anything "crispy" add starch on top of the main carbs.
• Dressings and dips: many vinaigrettes are sweetened, and dipping sauces are easy to overdo. Ask for them on the side and use just enough for flavor, as the CDC suggests.
• Drinks: regular soda, sweet tea, lemonade, juice, smoothies and many cocktails. NIDDK recommends drinks with little or no added sugar, such as water, unsweetened tea or coffee, or sparkling water.

Menu language is a strong clue. Our guide to menu words that signal hidden calories covers many of the same red flags.

A note on alcohol. MedlinePlus explains that alcohol can cause low blood sugar for hours after drinking, especially if you take insulin or certain diabetes medicines, and that mixed drinks can also add carbs. It advises drinking only with food and only if your provider says it's okay for you.