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Diabetes type 2 - meal planning. When you have type 2 diabetes, taking time to plan your meals goes a long way toward controlling your blood sugar and weight. Function. Your main focus is on keeping your blood sugar (glucose) level in your target range. To help manage your blood sugar, follow a meal plan that has: Food from all the food groups Fewer calories About the same amount of carbohydrates at each meal and snack Healthy fats. Along with healthy eating, you can help keep your blood sugar in target range by maintaining a healthy weight. People with type 2 diabetes are often overweight or obese. Losing even 10 pounds (4.5 kilograms) can help you manage your diabetes better. Eating healthy foods and staying active (for example, 60 total minutes of walking or other activity per day) can help you meet and maintain your weight loss goal. Activity lets your muscles use sugar from the blood without needing insulin to move the sugar into the muscle cells. HOW CARBOHYDRATES AFFECT BLOOD SUGAR. Carbohydrates in food give your body energy. You need to eat carbohydrates to maintain your energy. But carbohydrates also raise your blood sugar higher and faster than other kinds of food. The main kinds of carbohydrates are starches, sugars, and fiber. Learn which foods have carbohydrates. This will help with meal planning so that you can keep your blood sugar in your target range. Not all carbohydrates can be broken down and absorbed by your body. Foods with more non-digestible carbohydrates, or fiber, are less likely to increase your blood sugar out of your goal range. These include foods such as beans and whole grains. MEAL PLANNING FOR CHILDREN WITH TYPE 2 DIABETES. Meal plans should consider the amount of calories children need to grow. In general, three small meals and three snacks a day can help meet calorie needs. Many children with type 2 diabetes are overweight. The goal should be able to reach a healthy weight by eating healthy foods and getting more activity (150 minutes in a week). Work with a registered dietitian to design a meal plan for your child. A registered dietitian is an expert in food and nutrition. The following tips can help your child stay on track: No food is off-limits. Knowing how different foods affect your child's blood sugar helps you and your child keep blood sugar in target range. Help your child learn how much food is a healthy amount. This is called portion control. Have your family gradually switch from drinking soda and other sugary drinks, such as sports drinks and juices, to plain water or low-fat milk. Everyone has individual needs. Work with your health care provider, registered dietitian, or diabetes educator to develop a meal plan that works for you. When shopping, read food labels to make better food choices. A good way to make sure you get all the nutrients you need during meals is to use the plate method. This is a visual food guide that helps you choose the best types and right amounts of food to eat. It encourages larger portions of non-starchy vegetables (half the plate) and moderate portions of protein (one quarter of the plate) and starch (one quarter of the plate). EAT A VARIETY OF FOODS. Eating a wide variety of foods helps you stay healthy. Try to include foods from all the food groups at each meal. VEGETABLES (2½ to 3 cups or 450 to 550 grams a day) Choose fresh or frozen vegetables without added sauces, fats, or salt. Non-starchy vegetables include dark green and deep yellow vegetables, such as cucumber, spinach, broccoli, romaine lettuce, cabbage, chard, and bell peppers. Starchy vegetables include corn, green peas, lima beans, carrots, yams and taro. Note that potato should be considered a pure starch, like white bread or white rice, instead of a vegetable. FRUITS (1½ to 2 cups or 240 to 320 grams a day) Choose fresh, frozen, canned (without added sugar or syrup), or unsweetened dried fruits. Try apples, bananas, berries, cherries, fruit cocktail, grapes, melon, oranges, peaches, pears, papaya, pineapple, and raisins. Drink juices that are 100% fruit with no added sweeteners or syrups. GRAINS (3 to 4 ounces or 85 to 115 grams a day) There are 2 types of grains: Whole grains are unprocessed and have the entire grain kernel. Examples are whole-wheat flour, oatmeal, whole cornmeal, amaranth, barley, brown and wild rice, buckwheat, and quinoa. Refined grains have been processed (milled) to remove the bran and germ. Examples are white flour, de-germed cornmeal, white bread, and white rice. Grains have starch, a type of carbohydrate. Carbohydrates raise your blood sugar level. For healthy eating, make sure half of the grains you eat each day are whole grains. Whole grains have lots of fiber. Fiber in the diet keeps your blood sugar level from rising too fast. PROTEIN FOODS (5 to 6½ ounces or 140 to 184 grams a day) Protein foods include meat, poultry, seafood, eggs, beans and peas, nuts, seeds, and processed soy foods. Eat fish and poultry more often. Remove the skin from chicken and turkey. Select lean cuts of beef, veal, pork, or wild game. Trim all visible fat from meat. Bake, roast, broil, grill, or boil instead of frying. When frying proteins, use healthy oils such as olive oil. DAIRY (3 cups or 245 grams a day) Choose low-fat dairy products. Be aware that milk, yogurt, and other dairy foods have natural sugar, even when they do not contain added sugar. Take this into account when planning meals to stay in your blood sugar target range. Some non-fat dairy products have a lot of added sugar. Be sure to read the label. OILS/FATS (no more than 7 teaspoons or 35 milliliters a day) Oils are not considered a food group. But they have nutrients that help your body stay healthy. Oils are different from fats in that oils remain liquid at room temperature. Fats remain solid at room temperature. Limit your intake of fatty foods, especially those high in saturated fat, such as hamburgers, deep-fried foods, bacon, and butter. Instead, choose foods that are high in polyunsaturated or monounsaturated fats. These include fish, nuts, and vegetable oils. Oils can raise your blood sugar, but not as fast as starch. Oils are also high in calories. Try to use no more than the recommended daily limit of 7 teaspoons (35 milliliters). WHAT ABOUT ALCOHOL AND SWEETS? If you choose to drink alcohol, limit the amount and have it with a meal. Check with your health care provider about how alcohol will affect your blood sugar and to determine a safe amount for you. Sweets are high in fat and sugar. Keep portion sizes small. Here are tips to help avoid eating too many sweets: Ask for extra spoons and forks and split your dessert with others. Eat sweets that are sugar-free. Always ask for the smallest serving size or children's size. YOUR DIABETES CARE TEAM IS THERE TO HELP YOU. In the beginning, meal planning may be overwhelming. But it will become easier as your knowledge grows about foods and their effects on your blood sugar. If you're having problems with meal planning, talk with your diabetes care team. They are there to help you.


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LIMITATIONS OF USE: It is not known if Qsymia changes your risk of heart problems or stroke or of death due to heart problems or stroke It is not known if Qsymia is safe and effective when taken with other prescription, over-the-counter, or herbal weight loss products. Important Safety Information. Do not take Qsymia if you are pregnant, planning to become pregnant, or become pregnant during Qsymia treatment; have glaucoma; have thyroid problems (hyperthyroidism); are taking certain medicines called monoamine oxidase inhibitors (MAOIs) or have taken MAOIs in the past 14 days; are allergic to topiramate, sympathomimetic amines such as phentermine, or any of the ingredients in Qsymia. See the end of the Medication Guide for a complete list of ingredients in Qsymia. QSYMIA CAN CAUSE SERIOUS SIDE EFFECTS, INCLUDING: Birth defects (cleft lip/cleft palate). If you take Qsymia during pregnancy, your baby has a higher risk for birth defects called cleft lip and cleft palate. These defects can begin early in pregnancy, even before you know you are pregnant. Patients who are pregnant must not take Qsymia. Patients who can become pregnant should have a pregnancy test before taking Qsymia and every month while taking Qsymia and use effective birth control (contraception) consistently while taking Qsymia. Talk to your healthcare provider about how to prevent pregnancy. If you become pregnant while taking Qsymia, stop taking Qsymia immediately, and tell your healthcare provider right away. Healthcare providers and patients should report all cases of pregnancy to FDA MedWatch at 1-800-FDA-1088, and the Qsymia Pregnancy Surveillance Program at 1-888-998-4887. Qsymia may slow the increase in height in children 12 years and older. Increases in heart rate. Qsymia can increase your heart rate at rest. Your healthcare provider should check your heart rate while you take Qsymia. Tell your healthcare provider if you experience, while at rest, a racing or pounding feeling in your chest lasting several minutes when taking Qsymia. Visual field defects (independent of elevated intraocular pressure) have been reported in clinical trials and in postmarketing experience in patients receiving topiramate. In clinical trials, most of these events were reversible after topiramate discontinuation. If visual problems occur at any time during treatment, consider discontinuing Qsymia. Suicidal thoughts or actions. Topiramate, an ingredient in Qsymia, may cause you to have suicidal thoughts or actions. Call your healthcare provider right away if you have any of these symptoms, especially if they are new, worse, or worry you: thoughts about suicide or dying; attempts to commit suicide; new or worse depression; new or worse anxiety; feeling agitated or restless; panic attacks; trouble sleeping (insomnia); new or worse irritability; acting aggressive, being angry, or violent; acting on dangerous impulses; an extreme increase in activity or talking (mania); other unusual changes in behavior or mood. Serious eye problems, which include any sudden decrease in vision, with or without eye pain and redness or a blockage of fluid in the eye causing increased pressure in the eye (secondary angle closure glaucoma). These problems can lead to permanent vision loss if not treated. Tell your healthcare provider right away if you have any new eye symptoms. Qsymia may cause a severe rash with blisters and peeling skin, especially around the mouth, nose, eyes, and genitals (Stevens-Johnson Syndrome). Qsymia may also cause a rash with blisters and peeling skin over much of the body that may be life threatening (Toxic Epidermal Necrolysis). Call your healthcare provider right away if you develop a skin rash or blisters. COMMON SIDE EFFECTS OF QSYMIA IN ADULTS INCLUDE: Numbness or tingling in the hands, arms, feet, or face (paraesthesia); dizziness; changes in the way foods taste or loss of taste (dysgeusia); trouble sleeping (insomnia); constipation; and dry mouth. COMMON SIDE EFFECTS OF QSYMIA IN CHILDREN 12 YEARS OLD AND OLDER INCLUDE: Depression, dizziness, joint pain, fever, flu, and ankle sprain. POSSIBLE SIDE EFFECTS OF QSYMIA INCLUDE: Mood changes and trouble sleeping. Qsymia may cause depression or mood problems, and trouble sleeping. Tell your healthcare provider if symptoms occur. Concentration, memory, and speech difficulties. Qsymia may affect how you think and cause confusion, problems with concentration, attention, memory or speech. Tell your healthcare provider if symptoms occur. Increases of acid in bloodstream (metabolic acidosis). If left untreated, metabolic acidosis can cause brittle or soft bones (osteoporosis, osteomalacia, osteopenia), kidney stones, can slow the rate of growth in children, and may possibly harm your baby if you are pregnant. Metabolic acidosis can happen with or without symptoms. Sometimes people with metabolic acidosis will: feel tired, not feel hungry (loss of appetite), feel changes in heartbeat, or have trouble thinking clearly. Your healthcare provider should do a blood test to measure the level of acid in your blood before and during your treatment with Qsymia. Low blood sugar (hypoglycemia) in people with type 2 diabetes mellitus who also take medicines used to treat type 2 diabetes mellitus. Weight loss can cause low blood sugar in people with type 2 diabetes mellitus who also take medicines used to treat type 2 diabetes mellitus (such as insulin or sulfonylureas). You should check your blood sugar before you start taking Qsymia and while you take Qsymia. High blood pressure medicines. If you are taking medicines for your blood pressure, your doctor may need to adjust these medicines while taking Qsymia. Central Nervous System (CNS) side effects. The use of prescription sleep aids, anxiety medicines, or drinking alcohol with Qsymia may cause an increase in CNS symptoms such as dizziness and light-headedness. Do not drink alcohol with Qsymia. Possible seizures if you stop taking Qsymia too fast. Seizures may happen in people who may or may not have had seizures in the past if you stop Qsymia too fast. Your healthcare provider will tell you how to stop taking Qsymia slowly. Kidney stones. Drink plenty of fluids when taking Qsymia to help decrease your chances of getting kidney stones. If you get severe side or back pain, and/or blood in your urine, call your healthcare provider. Decreased sweating and increased body temperature (fever). People should be watched for signs of decreased sweating and fever, especially in hot temperatures. Some people may need to be hospitalized for this condition. Qsymia capsules contain the inactive ingredient FD&C Yellow No. 5 (tartrazine) which can cause allergic-type reactions (including bronchial asthma) in certain people, especially people who also have an allergy to aspirin. Tell your healthcare provider if you have any side effect that bothers you or does not go away. These are not all of the possible side effects of Qsymia. For more information, ask your healthcare provider or pharmacist. Call your doctor for medical advice about side effects. You may report side effects to VIVUS LLC at 1-888-998-4887 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. The Q and Me® Patient Support Program is based on the LEARN® Program provided under copyright license (September 15, 2010). All rights reserved. 1. Qsymia Full Prescribing Information. Campbell, CA: VIVUS LLC; 2022. 2. Data on File. 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