Susan B. Sloane, BS, RPh, CDE, has been a registered pharmacist for more than 20 years and a Certified Diabetes Educator for more than 15 years. Her two sons were diagnosed with diabetes, and since then, she has been dedicated to promoting wellness and optimal outcomes as a patient advocate, information expert, educator, and corporate partner.

I know you’re probably thinking, “As if food wasn’t an issue for me and my diabetes already, now what?” But it is important to always consider food safety when you eat - even when it may not be in the forefront of your mind, like when you eat out.

People with diabetes need to pay special attention to some crucial food safety tips to avoid getting sick with pathogens such as salmonella. Diabetes can make the body more susceptible to these foodborne illnesses. As an example, if you have gastroparesis, food spends more time in the gastrointestinal tract, giving potentially harmful bacteria more opportunities to enter the blood stream and cause harm.

Diabetes can also weaken the immune system in some patients, which may make a foodborne illness more likely and more dangerous. Gastric acid secretion in the stomach can be altered in patients with diabetes. In addition, some prescription medications can cause gastric acid secretion to decrease. These factors make it important to follow good “food hygiene."

The foods that are most likely to contain harmful bacteria are uncooked, fresh fruits and vegetables and some animal products such as unpasteurized milk, raw meat, and lunch meats.

Remember that cold temperatures slow the growth of bacteria, so keeping a constant refrigerator temperature is very important (40 degrees F or below). The freezer should be zero degrees F or below. Refrigerate foods within two hours of cooking or purchasing; one hour if the outside temperature is 90 degrees or above. Never thaw food at room temperature, such as on the counter top. Thaw food in the fridge, in cold water or in the microwave.

When cooking beef and poultry, remember that the color of food is not a reliable indication of how well it has been cooked. A food thermometer is always best to assess if meat is done well enough to prevent bacteria growth. Ground beef should be cooked to at least 160 degrees, and ground poultry should be cooked to an internal temperature of 165 degrees. Always reheat fully cooked hams.

Cook eggs until the yolks and whites are firm; sunny-side up is not recommended. Raw lamb, beef, and pork should be cooked to an internal temperature of 145 degrees with a three-minute rest time after removal from heat. The U.S. Department of Agriculture also recommends that hot dogs and lunch meats get reheated until steaming hot.

The most common cause of bacterial food borne diarrhea in the United States is Campylobacter jejuni. This organism is transmitted mainly through food and water, not person to person. To give you perspective, it has been found in many studies that this type of bacteria is four times more common in people with diabetes than in those without diabetes.

Taking the proper precautions will make the food you eat safe to consume. Remember to wash hands, knives, and food preparation areas with soap and warm water after touching raw foods. Avoid unpasteurized products if possible and observe food expiration dates on grocery packaging. Make sure you rinse fruits and vegetables thoroughly before eating them.

For more detailed information on food safety, please visit this USDA webpage.