If you have a small appetite, healthy eating for diabetes may not be appropriate. You may need to think about increasing your intake of protein and high calorie foods.

Some ideas to help you achieve this:

• have three meals per day as well as two to three snacks and milky drinks
• for protein, include a portion of meat, chicken, well-cooked eggs, cheese, nuts or lentils at least twice a day
• include a starchy food at each meal, such as bread, potatoes, rice or pasta
• use at least a pint of full cream milk daily (blue-top, silver-top, sterilised or UHT)
• have at least six to eight cups of fluid each day. Taking drinks after meals rather than before meals may help if you feel full easily
• have some fruit and vegetables daily. Drink a small glass of fruit juice per day with your meal or snack if you are managing very little fruit
• a small amount of alcohol may stimulate your appetite if taken before a meal, please check with your doctor first
• a short walk just before a meal may also help.

How to enrich your foods

• Add two to four tablespoons of milk powder to one pint of full cream milk to make enriched milk.
• Grated cheese, cream, dried milk powder, evaporated milk, dumplings, beans, pasta can be added to soups.
• Add grated cheese, cream, butter or margarine, milk-based sauces and/or fried onions to potatoes and vegetables.
• To breakfast cereals, add enriched milk, fresh or dried fruit, natural or fruit-based yoghurt and/or fromage frais with added cream.
• Cream, evaporated milk and/or grated cheese can be added to milk-based sauces. Spread margarine, cream cheese, peanut butter or pate over bread.
• Use fats generously with vegetables and potatoes and use oil to fry foods.
• To puddings add cream or dried fruit. Make low sugar milk puddings using enriched milk. Use enriched milk to make up sugar-free jellies and instant whips.
• Have tinned fruit in juice with cream, ice cream, evaporated milk or custard made with enriched milk.

Ideas for snacks

• Two plain biscuits, such as rich tea, digestives, garibaldi, fig rolls or Hobnobs.
• Two crackers or digestives with butter or margarine and cheese or peanut butter.
• Scone with butter or margarine or cream and a thin spread of jam.
• Small handful of dried fruit and unsalted nuts.
• Slice of malt loaf spread with butter or margarine.
• Cubes of cheese (30g).
• One hard boiled egg.
• Thick and creamy yoghurt (125g).
• One mini blueberry muffin.
• One mini croissant (maximum weight 26g).
• Three small cheese straws.
• Mini pork pie (50g).
• Three mini sausage rolls.
• Two small onion Bhajis or vegetable pakoras.
• One scoop ice cream.
• Three small squares chocolate/ individual treat size bar (16g)/ One small individual chocolate from box.
• One multipack size packet of corn/ puffed based crisps such as cheese curls (Quavers or own brand), prawn cocktail shells (Skips or own brand), cheese puffs (Wotsits or own brand).

Use enriched milk to make:

• Hot drinks - Cocoa with sweeteners, low-sugar chocolate drinks, coffee made with all milk and instant soups. Keeping a flask filled with one of the above, will help to make it easier.
• Cold drinks - No-added sugar squashes, mashed banana and yoghurt. Make a milkshake with milk – you could also add yoghurt, fruit or ice cream.

Oral nutritional supplements

In some cases, oral nutritional supplements (ONS) are required to support dietary intake. Although ONS contain sugar, this does not mean they are unsuitable for patients with diabetes. Dietitians will prescribe the most appropriate option. See the following tips to prevent spikes in blood glucose if taking ONS;

• use enriched milk to make powder-based supplements
• fortify bottled ONS with one to two tbsp double cream
• offer ONS little and often throughout the day, for example, 30ml every two hours.

You may need to monitor your blood sugars more closely during illness. Do not stop taking insulin, in fact you may need to increase the insulin units. Seek advice from your diabetes specialist, nurse or GP.