Diabetes at the Dinner Table: Valentine’s Day Edition

By Marcia Kadanoff and Katie Bowles

Special occasion meals take special skills to navigate – my top five tips for enjoying Valentine’s Day

Editor’s note: this article is in Marcia’s perspective of living with type 2 diabetes, as written by Katie Bowles

Pink and red hearts everywhere, overpriced dinners, wondering if you’ll have a date (or if you got your partner an appropriate gift) – ah, the joys of Valentine’s Day. I’m stressed just thinking about it.

As a person with diabetes, my stress may be a bit different than general Valentine’s Day anxiety.

By this point, my spouse knows enough not to get me chocolates – my biggest landmine food!

But the hard thing is getting a reservation at the right kind of restaurant and (as always when living with diabetes) planning out my meal. Special occasion meals take special skills to navigate. This article is to help you enjoy your special night without diabetes taking center stage.

The problem that I face is that where I live (the San Francisco Bay Area), many restaurants have Valentine’s Day specials that consist of three to five courses.

There’s nothing wrong with eating a multi-course meal, but it does make diabetes management more difficult. From bread, to creamy soups and crouton-laden salads, to heavy entrees, to a potentially cake-oriented dessert, multi-course meals can quickly add up to a large amount of carbohydrates, which is a major driver of high blood sugars.

Basically, even if you choose the “healthier” set menu, you should still be thinking about what each portion is bringing (quite literally) to the table.

1. Upon arrival: Hold the bread

For me, it’s easier to ask the server to remove the bread basket from the table rather than rely on self-control. That way, I eliminate the danger of me stuffing five pieces of bread before the meal even starts. Adam Brown, Senior Editor of diaTribe, has written about this very trick here!

2. Appetizers: Try Low Carb, Healthy Fat

Choose a small, low carb, healthy fat (LCHF) appetizer, if possible. Research has shown that for people with obesity and/or type 2 diabetes, eating protein and vegetables before carbs results in 29% lower blood sugar levels and lower insulin levels than eating carbs prior to protein and vegetables. LCHF options include:

  • Caesar salad, hold the croutons
  • Beef or Salmon Carpaccio (if you’re adventurous–the meat is raw)
  • Ceviche
  • Shrimp and avocado
  • A shared cheese or salami plate

We’d love to hear your favorite LCHF restaurant dishes – write us here!

3. Main course: Choose wisely

I order my entree with vegetables only, meaning that I request/substitute vegetables for any carbs that come with the meal. This is something I do every time I eat out, not just during multi-course or special occasion meals.

Typically, I avoid rice, potatoes, pasta, anything with a crust or puff pastry and anything fried. And, stay wary of hidden sugars in sauces, dressings, and condiments. As mentioned in the research above, studies have shown that sugar doesn’t raise blood sugar any more than starches do – just because something’s not sweet doesn’t mean it won’t raise your blood sugar.

Another thing I keep in mind: If you eat too much protein in one sitting, your body will convert the excess protein into glucose. While protein doesn’t affect blood sugar as much as carbohydrates, I’ve found that large quantities can have a significant impact on my blood sugars.

So if I’ve had already protein as part of my appetizer, I’m going to limit myself to:

  • 100% of fish entrée
  • 75% of chicken entrée
  • 50% of steak entrée

In other words, I’m just watching how much protein I’ve had in my meal as well. This works for me, based on how my sugars respond to different meals in the past, but I encourage you to experiment and use your diabetes data to figure out if a large amount of protein spikes your blood sugars…or not! For many, protein has a minimal impact on blood sugars.

Another good rule of thumb, particularly during multi-course meals, is to aim to have leftovers – I like to box mine up and enjoy them the next day, benefitting me both health- and wallet-wise. A recent study out of Tufts University found that 92% of 364 measured restaurant meals exceeded the calorie requirement for a single meal. For 123 restaurants, the researchers found that a single meal exceeded the total calorie requirement for an entire day . This doesn’t even take into consideration beverages, appetizers, desserts and other add-ons.

4. Dessert: Just a little bit

It’s easy to think that living with diabetes means that you should avoid dessert during meals like this – you’ve likely encountered the “diabetes police,” well-meaning family and friends who question your food choices and make you feel self-conscious around sweets. And sure, nobody (living with diabetes or not) really needs dessert. However, total restriction can result in overindulgence later. If saying no to a bite of cake at the dinner table means that you’ll eat an entire sleeve of cookies later that night, the cake may be the better choice – you know your body, and your diabetes. Just like you’ve done during the rest of the meal, you should make sure to be intentional about dessert.

As mentioned before, I’m a chocoholic, which means that my dessert of choice on Valentine’s Day (and during basically every other special occasion meal) is a flourless chocolate cake, often called a chocolate lava cake. I order these without the fruit garnish and/or ice cream and with a small dessert spoon. I then allow myself three to four small spoonfuls. The remainder of the dessert goes to my partner, Rich – a system that protects me from a spike in blood sugar (and makes Rich pretty happy, too).

To be sure, this system of moderation only works because my partner holds me accountable. Moderation may not work for some – Adam Brown confesses that he’s terrible with moderation, and prefers to avoid his Landmine foods completely. (Read more on that here.)

Some people with diabetes will react poorly to even this much sugar, but my CGM indicates that I personally do not (I stay below 140 mg/dl with a few spoonfuls of dessert). One thing that really helps me in cases like this is choosing a dessert that is high in dark chocolate and relatively low in sugar. I’ve experimented with other desserts (a flour-based chocolate cake, for example) and found that it simply doesn’t work. My blood sugar will hit 140-180 mg/dl after one hour, which is too high for me. (Don’t be alarmed if you are in this range, which is still considered normal for someone with diabetes. It simply makes me feel a bit icky.)

5. Can you live without it?

As I mentioned above, having a bit of dessert can help stave off future cravings and binges – however, if the dessert isn’t exactly what you want, consider skipping it. A suboptimal dessert isn’t worth the high blood sugars and future complications.

Valentine’s Day is about love, not stress – and hopefully, these tips will help you show your body love by managing your diabetes well.

Headed to a less formal meal out? Check out some more tips from Adam Brown on eating at restaurants with diabetes here .

Great pragmatic advice for a Valentine’s Day meal out. Also applies to any meal eaten out.

I knew about this in general but didn’t realize that the effect has been measured and so effective.

I live in San Francisco and find the restaurants here offer better food choices than say the Midwest cities.
I also prefer a reasturant with a view or activity so you just don’t sit and look at food.

Favorite main course, sea food: mussels, fish, Ciopino ( a fish stew, delicious and with lots of clams, mussels, crab, fish, it takes a while to eat through it)

Most restaurants have menus on line now, so make your food choices from home, change if you wish in the restaurant, but I find my choices are better when I have thought through them before you sit down Plus most of my friends try to make sure I have appropriate choices.

Desert, Only in very small portions and only on very special occasions (like my parents 70th wedding anniversary).
Usually a cup of good tea. No sweetener fake or real.

Typically when’d I get home my BG is in the 90’s, which makes me a lot happier than 140.

If my numbers are good, I also try to thank the person that picked the restaurant, and let them know it worked out well for me.

FYI I do diet and exercise only so I can’t adjust a mistake with insulin.


When I go out to eat, I want to ENJOY my meal, so I don’t avoid the bread, pizza, or other fun things. I just don’t do it too often. Moderation allows me to enjoy some meals, knowing I don’t make a foolish habit of eating poorly all the time.

The one thing I wish I could bring myself to order is a CHOCOLATE MILKSHAKE. They usually run about 80-90 carbs. Sooo good, but oh, sooo bad. I do have my limits on “cheating”.

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Happy Valentine’s Day!! My husband and I will celebrate our 50th next year. I am celebrating
my 60th yr living with type 1 this year. We seldom eat out because we
eat only low fat plant foods which means no oil of any kind.

My husband is my biggest Valentine gift and supporter.

Today he is making one of my favorite dishes. He does the cooking and eats the way I choose to. He is my valentine’s gift and I couldn’t be more grateful.:heart:

Once in a blue moon we eat out, but we try to keep it vegan and somewhat low fat.


I am a T2 (responding to a T2 post)
I enjoy all my meal choices, but if i had pizza, bread. etc as you suggested as a treat in order to control my BG I would have to use insulin. Those choices wouldput my BG in the 200. Currently I prefer to limit my food choices rather than use insulin FYI my first A1c was12.0 now down to under 6.0 for more than 7 years.
With my LCHF way of eating.

When needed I would have no issues with using insulin, but for now I prefer to manage on diet and exercise only.

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Agreed, Tom, T2 rules aren’t the same as for T1’s!!

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Except I would assume a well controlled A1c less than 6.0 is a common goal.

Mine is 5.4 currently.

5,7 here, I have not quite made it to your level yet. Good control!

I don’t think this is a common goal for most people outside of a few individuals. Only a small minority of people with Type 1, even on sites like this one where the level of control is far above average, ever manage to get an A1c below 6.0%. I’ve been trying for decades and have not managed to do it yet, even when eating low carb.

We each have our own goals, for A1c My goal is below 6.0, I first achieved it in 2011, Which also means that 5.9 works as well as 5.6 or even in the low 6’sI I would say the majority of the T1’s and T2’s I know aim for less than 7.0

I also don’t need to worry much about going lower than that, since my numbers generally tend to float up slightly., except when I am running.

Since I was diagnosed as a clueless T2 with an A1c of 12.0, I feel very fortunate to be able to only to use diet and exercise and have tight control.

Of course that is not an option for T1’s

All you have to do is leave out the second “only” and then it can be applied to a T1, along with, of course, some insulin. That’s how I can stay below 6.

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That Ciopino sounds so good!