If you were recently diagnosed with Type 2 diabetes or were diagnosed a while ago but are now ready to make diet changes, the prospect of giving up the foods you love may seem daunting. But you may be relieved to discover that a good diet for Type 2 diabetes isn’t as tricky as you fear, and that you can still find joy in food while managing this disease.
A healthy diet is a pillar of a successful diabetes management plan. Other pillars include taming stress, and exercising regularly.
How a Healthy Diet Can Help You Manage Type 2 Diabetes
Type 2 diabetes is characterised by a condition called insulin resistance, in which the body can’t effectively use the hormone insulin to ferry blood sugar, or glucose, to cells and muscles for energy. This causes glucose to accumulate in your blood at higher than normal levels, which can put your health in danger.
Eating a healthy diet is important for everyone, regardless of diabetes status. But for people with this disease, nourishing foods eaten in the right portions provide two key benefits:
Reduced blood sugar
Lowering blood sugar that is high can help reduce diabetes symptoms and lower the risk for health complications.
A healthier weight
Weight loss is associated with a better A1C result, a two- to three-month average of blood sugar levels.
What Is a Good Diet for Type 2 Diabetes?
A smart diabetes diet includes whole, minimally processed foods, with fibre-rich fruit and vegetables, complex carbohydrates in moderation, lean protein and healthy fats, and limited added sugars and refined grains.
“There is no ‘diabetic diet,’” says Erin Palinski-Wade, RD, CDCES, the author of 2 Day Diabetes Diet and Belly Fat Diet for Dummies, and based in Vernon, New Jersey. “The guidelines are basically the same for healthy eating for everyone, with or without diabetes,” she says.
According to the American Diabetes Association’s Nutrition Consensus Report in 2019, there are several healthful eating patterns you can follow to manage diabetes, including Mediterranean, low-carb, DASH, paleo, and vegetarian.
Work with your healthcare team to determine the right ratio of macronutrients and the best eating plan to accommodate your health risks and goals.
Top Diabetes-Friendly Foods to Eat
While no two diabetes diets will look the same, certain foods are considered staples for people with this disease because they support a healthy weight and blood sugar level. They include:
- Non-starchy vegetables, such as broccoli and high-fibre fruit like apples
- Lean sources of protein, such as boneless, skinless chicken, turkey, and fatty fish, like salmon
- Healthy fats, such as nuts, nut butter, and avocado
- Whole grains, like quinoa and barley
Foods to Limit or Avoid With Type 2 Diabetes
Likewise, certain foods are known to throw blood sugar levels out of whack and promote unhealthy weight gain. Foods that should be limited or avoided include:
- White bread and pasta
- Canned soups, which are high in sodium
- Microwaveable meals, which are usually high in sodium
- Sources of saturated fat, like bacon or fatty cuts of meat
A Diabetes Diet Sample Menu
When you’re getting started, it’s helpful to envision exactly what your plate should look like. The ADA has a Create Your Plate tool you can use. With enough practice, the best choices will become second nature. The ADA recommends filling half your plate with non-starchy vegetables (broccoli, spinach, tomatoes), one-quarter with grains (preferably whole) or starchy foods (sweet potato, plantain), and another quarter with lean protein (beans, seafood, skinless chicken).
Here are two days of diabetes-friendly meal ideas to get you started.
Breakfast:Veggie omelet (1 whole egg plus 2 egg whites), topped with reduced-fat cheese, plus fruit
Snack: Plain non-fat or lowfat Greek yogurt and berries
Lunch: Salad (dark lettuce or leafy greens) topped with chicken breast and chickpeas with olive oil and vinegar dressing
Snack: Celery and carrot sticks with nut butter
Dinner: Grilled salmon, steamed broccoli, and quinoa
Breakfast: Fruit smoothie made with low-fat milk; low-fat plain yogurt; and chia seeds (optional)
Snack: Unsalted almonds with a piece of fruit
Lunch: Turkey chili with reduced-fat cheese
Snack: Sliced vegetables and hummus
Dinner: Tofu and veggie stir-fry over brown rice
Snack: Fat-free or low-fat cottage cheese with a sliced peach
Dinner: Tray bake (all foods baked on the same tray) made with prawns and roasted vegetables
As you’ll see, a Type 2 diabetes diagnosis is not a sentence to eat boring, bland foods. You can eat the same food as your family, and even add special foods here and there, according to the American Diabetes Association.
What to Drink When You Have Diabetes
Your choice of drinks can make a difference in your blood sugar levels. Palinski-Wade recommends focusing on unsweetened beverages, such as water and seltzer. (To jazz it up, add a splash of 100 percent fruit juice, she says.)
If you like coffee or tea, you may notice that caffeine increases your blood sugar levels, so Palinski-Wade advises monitoring your glucose response after consuming these drinks to see where you stand.
Artificially sweetened beverages, such as diet colas or lemonade, should go on the “proceed with caution” list. “Although these beverages are free of added sugars, consume these in moderation, since some research indicates some artificial sweeteners may impact gut health,” she says.
When it comes to alcohol, if you are someone who drinks, you may be able to do so moderately even with diabetes, according to the American Diabetes Association, but know that alcohol can lead to hypoglycaemia, especially if you are on certain medications. Mixing metformin with alcohol may contribute to a rare but serious condition called lactic acidosis.
If you’re a man, stick to two drinks maximum per day; if you’re a woman, drink no more than one per day. One drink equals a 5-ounce (oz) glass of wine, a 12 oz beer, or 1½ oz of 80-proof liquor.
Macronutrient Ratios for Type 2 Diabetes
You don’t need to worry about counting macros if you’re following a balanced diet rich in whole foods. But here are some basic guidelines to keep in mind.
You can find carbohydrates in whole grains, fruit, vegetables, legumes and beans, and dairy. These foods supply necessary vitamins, minerals, and fibre that everyone needs to be healthy.
That said, for people with type 2 diabetes, limiting carbs will help regulate blood sugar. “Although individual carbohydrate goals will vary based on age, activity level, medication, and individual insulin resistance levels,” says Palinski-Wade, “it’s imperative to avoid having too many carbohydrates in one sitting.”
If you have pre-diabetes or type 2 diabetes and don’t take medication, cap carbs to no more than 60 grams (g) per meal (four carbohydrate servings).
You can also use a diabetes exchange list, which tells you how foods compare in terms of their carbohydrate content. For instance, 1 apple and ½ cup applesauce both contain about 15 g of carbs. Good sources of carbs include:
- Whole grains, like whole-wheat pasta and bread, brown rice, oatmeal, and quinoa
- Non-starchy veggies, like peppers, eggplant, onion, and asparagus
- Starchy veggies, such as sweet potatoes and corn, are okay to eat in moderation, just mind the carbohydrate content
- Fresh, fibre-rich, whole fruit like raspberries, apricots, and pears
- Dairy such as unsweetened yogurt and cottage cheese
- Beans and legumes, like black beans, chickpeas, and lentils
Limit unhealthy carb sources, which include sugar and refined grains like white bread and pasta.
One-quarter of your plate should contain a source of lean protein, which includes meat, skinless poultry, fish, cheese, eggs, and vegetarian sources like beans and tofu.
Enjoy these diabetes-friendly options:
- Beans, including black or kidney beans
- Whole nuts and nut butter
- Fish, such as tuna, sardines, or salmon
- Skinless poultry
- Cottage cheese
- Cheese or regular cheese in small amounts
- Lean beef, like sirloin or tenderloin
Fat is not the enemy, even if you have diabetes! Learn to tell unhealthy fats from healthy fats and enjoy them in moderation, as all fats are high in calories.
Type matters more than amount: Aim to limit saturated fat to no more than 10 percent of total calories, Palinski-Wade advises.
Consider opting for these sources of healthy fat, per the American Diabetes Association (ADA):
- Nuts, such as almonds, peanuts, and walnuts
- Olive oil
- Seeds including sesame, pumpkin, and sunflower
Do I Need to Count Calories When Managing Type 2 Diabetes?
While it can be helpful, it’s not absolutely necessary to track how many calories you’re taking in daily. “Although tracking calories can be beneficial when it comes to weight reduction, you can lose weight and still have a poor nutritional quality to your diet,” Palinski-Wade points out.
Therefore, if you do count calories, make sure you’re also focused on healthy food choices. You can track your food intake, she says, which will let you “monitor portions as well as how certain foods and mealtimes impact blood glucose levels,” she says.
The National Institutes of Health (NIH) recommends the following calorie guidelines for people who are managing diabetes:
- About 1,200 to 1,600 calories a day for small women who are physically active, small or medium-size women interested in weight loss, or medium-size women who are not physically active
- About 1,600 to 2,000 calories a day for large women interested in weight loss, small men at a healthy weight, medium-size men who aren’t physically active, or medium-size or large men interested in weight loss
- About 2,000 to 2,400 calories a day for medium-size or large men who are physically active, large men at a healthy weight, or medium-size or large women who are very physically active
Can I Eat Sugar if I Have Type 2 Diabetes?
Yes, but eat no more than 10 percent of your total calories from added sugars, Palinski-Wade recommends. This is no different from the guidelines for everyone, meaning you can still enjoy a few bites of dessert if you’d like.
If you’re consuming 2,000 calories per day, 10 percent equates to 200 calories from added sugar or 50 grams per day. For reference, one scoop (½ cup) of vanilla ice cream contains 14 grams of total sugar, a 1 oz chocolate chip granola bar contains 8 grams of total sugar, and a 12oz strawberry banana smoothie made with low-fat yogurt contains 44 grams of total sugar.
Tips for Getting Started With a Diabetes Diet
Rather than trying a complete overhaul all at once, create lasting good habits by focusing on small, simple, and maintainable changes, Palinski-Wade says. Otherwise, you may feel overwhelmed and revert to any previous unhealthy eating habits. “Being consistent with change, no matter how small, is the key to long-term weight loss success,” she adds. Here are some of the basic rules for building – and then sticking with – a diabetes meal plan.
Consult the experts
Connect with your primary doctor and a registered dietitian nutritionist (RDN) who is also a certified diabetes care and education specialist (CDCES) to figure out how many carbohydrates you should eat per meal based on your individual needs as well as the optimal eating approach for your preferences and health goals.
Add in one extra serving of non-starchy vegetables at dinner. Consider adding vegetables to snack time too.
Sweeten things up with fruit
To satisfy your sweet tooth, opt for fruit in moderation. Previous research shows that eating berries, apples, and pears is associated with weight loss.
Diabetes-friendly fruit tend to be especially fibre-rich choices. All other fruits count, too – just be sure to factor them into your carbohydrate servings.
Beware of sauces and dressings
Sugar hides in many condiments, like tomato sauce, barbecue sauce, and marinades. Always read the label, and choose the lower-sugar option that best fits your diet and goals.
Don’t skip breakfast
Breakfast is one habit of long-term weight-losers.
Plain yogurt with fruit; nuts and fruit; or scrambled eggs and whole-grain toast are all diabetes-friendly breakfasts that will set up your daily blood sugar management for success.
Instead of reaching for sweetened drinks, opt for water (sparkling without added sugar also counts!), unsweetened tea, and coffee.
Cut back on salt
Aim for less than 2,300 milligrams (mg) of sodium per day (and less than 1,500 mg daily if you have heart disease) as a way to help manage blood pressure and heart disease risk – a common diabetes complication.
Try seasoning foods with dried herbs and spices instead. They’re sodium- and calorie-free!
Don’t fear grains
They’re a great source of heart-healthy fibre. Aim to make at least half of your grain intake whole grains when you’re managing type 2 diabetes. Diabetes-friendly options include brown rice, quinoa, 100 percent whole-wheat bread, whole-grain pasta, and barley.
Add fibre to your diet
Fibre isn’t digested by the human body, so fiber-rich foods with carbohydrates do not raise blood sugar levels as quickly because they are processed more slowly. Fibre-rich foods can also help you feel fuller for longer, possibly aiding weight loss.
Unfortunately, most adults don’t eat enough fibre.
Regardless of diabetes status, women should get at least 25 g of fibre per day, while men need at least 38 g per day, Palinski-Wade says.
Choose dairy mindfully
Opt for nonat or low-fat (1 percent) with milk, cottage cheese, and plain yogurt. Also, remember that while these sources offer protein, they are also another source of carbs, so you need to factor them into your carb allotment. Unsweetened non-dairy milk, such as soy and almond milk, are also diabetes-friendly.
Dining Out When Managing Type 2 Diabetes
It can seem tough to navigate a menu when you’re eating out, but it’s not impossible. Enjoy your time with friends and eat delicious food with these guidelines from Palinski-Wade.
Have an appetiser before you leave
It’s tempting to “save up” calories throughout the day to help plan for a night out, but that approach can backfire. You’ll be famished by the time you get there and less likely to make a healthy choice when you order. Eat a small, healthy snack before you go, like some nuts or a low-fat plain yogurt. “This can help decrease hunger and prevent overeating,” she says.
Visualise your plate
Ideally, your plate should look very similar to the way it does at home – with a couple of small tweaks: ½ non-starchy vegetables (steamed if possible), ¼ lean protein, and ¼ whole grains. “You want to be careful not to eat too many carbs at one sitting, and avoid meals packed with saturated fat,” says Palinski-Wade.
Alcohol stokes your appetite, so if you do have alcohol (make sure to talk to your doctor first if you’re on medication), do so near the end of the meal and limit it to one glass.
Low-Carb Dieting for Type 2 Diabetes
If you are interested in going low-carb to better manage type 2 diabetes, there is some evidence that this type of diet plan is effective. For instance, a preliminary research review in 2017 found that a low-carb plan helped adults with diabetes lower their triglyceride levels and boost “good” HDL cholesterol. It may also have mind-body benefits, as people said they were less stressed and happier between meals.
Another review concluded that low-carb diets drop blood glucose levels and allow people to use less medication or eliminate it completely. The authors recommend it as a first-line treatment for diabetes.
While the benefits are exciting, if you do go low-carb, be aware of the risks, which include nutrient deficiencies. You may also not get enough fibre if you’re not eating enough non-starchy vegetables. Too much protein may also compromise kidney health, though research on the matter is mixed.
Check with your physician or RDN for guidance on the optimal amount of carbs and protein for your diet.
Best and Worst Diet Plans for Diabetes
Adherence to a popular diet plan is not required to manage diabetes, but you may like the direction it offers. A professional who is an RDN and CDCES can help you follow one of these approaches safely.
Best Diet Plans for Managing Type 2 Diabetes
The two that are suggested for people with diabetes time and again are the Mediterranean diet and the DASH (Dietary Approaches to Stop Hypertension) diet. Unlike so-called “diets” (many of which are designed only for the short term), these eating approaches aim to set the foundation for building and maintaining lifelong habits.
Palinski-Wade favours the Mediterranean diet because “it’s been researched for decades and has been shown to be beneficial at reducing the risk of heart disease,” she says. That’s important, because people with diabetes are up to four times more likely to die from heart disease compared to adults without diabetes.
On the Mediterranean diet, you’ll focus on whole foods in the form of fruits and vegetables, whole grains, olive oil, legumes, nuts, poultry and fish, while limiting red meat.
The DASH diet has been found to be beneficial at reducing blood pressure levels, a key risk factor for heart disease and kidney disease. Because both of these disease risks are elevated with diabetes, this style of eating may promote a reduction in the risk of comorbid conditions associated with diabetes,” Palinski-Wade explains.
Similar to the Mediterranean diet, the DASH diet promotes fruit and vegetables, whole grains, fish and poultry, beans, nuts, and fat-free or low-fat dairy. You’ll also cap sodium to 2,300 mg per day (1,500 mg if advised by a doctor).
Diet Plans to Discuss With Your Healthcare Team
While it’s best to talk to your doctor before you start any diet plan, it’s especially important to talk to them if you’re interested in the following:
You’ll eat very few carbs on this plan (20 to 50 g a day) to achieve a state of ketosis, where your body burns fat for fuel instead of carbs. “There is some research that suggests ketogenic diets may help to reduce insulin resistance and improve blood glucose levels,” says Palinski-Wade. Indeed, one study of adults with Type 2 diabetes who followed a ketogenic diet for 10 weeks improved glycaemic control and helped patients lower their dosage of medication.
Still, it’s a controversial diet, so make sure to weigh the pros and cons with your physician.
Intermittent fasting (IF)
IF requires you to limit the time period in which you eat to a certain number of hours per day, or to eat a very low number of calories on certain days. Some research (small studies and animal trials) has shown benefits from IF to fasting glucose and weight. That said, skipping meals may hinder blood sugar control or cause low blood sugar (hypoglycaemia), especially if you’re on insulin or a sulfonylurea, so talk to your doctor about the risks and benefits before you attempt it.
The premise of the paleo diet is to eat like our hunter-gatherer ancestors, focusing on fruit, vegetables, nuts, lean meat, and certain fats. (It eliminates grains, legumes, and most dairy.) One small study in 2015 found that both paleo diets and the guidelines from the ADA improved glucose control in patients with Type 2 diabetes.
Diet Plans to Avoid
Any diet that is gimmicky, not backed by research, is too restrictive, or makes too-good-to-be-true promises (like losing x amount of weight in a certain amount of time) is one to skip.
Results of Following a Diabetes-Friendly Diet
Your specific results depend on where you started before embarking on your diabetes-friendly diet journey. But Palinski-Wade notes that there are short and long-term results you can expect.
Pretty quickly, you should see benefits to your blood sugar at the outset. “You will start to see your daily blood glucose readings improve within a few days,” she says. Then you’ll notice your A1C start to get better in three to six months. “These are a measurement of your blood sugar levels on average over the past three months, so consistent improvement for at least three months needs to happen to see this number decrease,” Palinski-Wade adds.
If your doctor advises you to lose weight, making these diet changes along with increasing your activity level can help you lose weight and shed body fat. Be careful about monitoring the scale too closely in the early days. “It’s important to note that if your blood sugar levels were uncontrolled and weight loss resulted from this, you may notice an initial weight gain as blood sugar comes back to a normal level. Do not be discouraged. Generally, this weight gain is minimal, and once blood sugar stabilises, weight stabilises as well,” she says.
Your diet is one of the main tenets of good diabetes management. “What you eat can help or hinder insulin resistance,” says Palinski-Wade.
While it seems like there is a lot to remember, the basic tenets boil down to simple, nutritious eating.
In the end, you can cut through the noise by considering a few things when you sit down to eat: Aim for “a well-balanced diet limited in simple sugars and rich in whole plant-based foods, such as vegetables and fruit, along with lean proteins, whole grains, and healthy, plant-based fats,” she says.
Remember that and you don’t need to follow a ton of rules – even when you have type 2 diabetes.