Type 2 Diabetes Diet: What to Eat and What to Avoid - EndocrineWeb

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A diagnosis of type 2 diabetes—or even prediabetes—usually comes with the suggestion that you make some changes to your diet or the diet of someone you care for. This is a good time to become wiser about how you are eating on a regular basis.

Fortunately, following a diabetes diet doesn’t mean giving up the joy of eating or avoiding your favorite foods and special family meals. You can still enjoy “pizza night,” celebrate birthdays and anniversaries, and partake in holiday meals and vacation dining. This is more about your routine daily food choices and meal planning.

How Can a Healthy Diet Help You Manage Type 2 Diabetes?

Eating to control and prevent diabetes is much more about making wise food adjustments than it is about denial and deprivation. A better way to look at a diet when you have diabetes is one that helps you establish a new normal when it comes to your eating habits and food choices.¹

In truth, a diet aimed at reducing the risks of diabetes is really nothing more than a nutritionally balanced meal plan aimed at helping maintain blood sugar levels within range and supporting a healthy weight.

For those with prediabetes or type 2 diabetes, the main focus of a diabetes-focused diet is being attentive to your weight. That said, a diabetic diet is simply an eating approach that works to keep you healthy, and so is not reserved only for people with diabetes. Your whole family can enjoy the same meals and snacks, regardless of whether others have diabetes or not.

Yes—there are a few food decisions that will matter more if you do have diabetes. We’ll provide you with some general guidelines to help you understand how much and how often to eat in order to maintain steady blood sugar levels.

Goals of a Type 2 Diabetes Diet

There are three main goals of a diabetes diet plan, according to the American Diabetes Association (ADA):

Goal 1: Achieve a Healthy Body Weight

Body mass index (BMI) uses your height and weight to determine how much body fat you carry. A BMI of 18.5 to 25 is considered to be a healthy weight range with a healthy amount of body fat.

Another measure, waist circumference, is considered by many to be a better indicator of excess abdominal body fat. A waist circumference greater than 40 inches for men and above 35 inches in women has been shown to increase the risk of developing health problems such as type 2 diabetes, heart disease, and high blood pressure.

The closer you are to a healthy body weight or at least an acceptable waist circumference, the more likely you will be able to control, prevent, and possibly reverse your risks of diabetes.

“Don’t get overwhelmed by thinking about how much total weight you have to lose,” advises Sandra Arevalo, MPH, RD, CDE, a diabetes expert and spokesperson with the Academy of Nutrition and Dietetics. “Studies have shown that losing just 5 to 10% of your body weight will significantly improve your blood sugar levels as well as your cardiovascular health, so set short-term goals of losing just 5 to 10 pounds to start.”

Goal 2: Attain Normal Lab Results

Your physician will work with you to establish individual goals for blood glucose, blood cholesterol, and blood pressure. Regular testing will help ensure that your diet plan, exercise strategies and medication, if necessary, are all working together to keep your blood sugar, lipids, blood pressure, and your body weight in healthy ranges.

Goal 3: Avoid Complications of Diabetes

Lifestyle changes, including adjustments to your diet and the addition of regular physical activity (even if only a 30 to 45 minute daily walk), can reduce your risk of developing heart disease, kidney disease, nerve damage, stroke, eye disease, and other long-term health problems that can commonly occur in people with diabetes.

Results of Following a Type 2 Diabetes Diet

It’s hard to overstate how much diet matters when it comes to diabetes. In fact, if you were recently diagnosed with type 2 diabetes, by decreasing your weight by about 10%, you may actually reverse your diabetes, putting it into remission. You are considered in remission from type 2 diabetes when you have had normal blood sugar levels for a year without medication.

In the case of prediabetes—in which your blood sugar levels are slightly above the normal range because your body is no longer responding to insulin effectively, but not yet high enough for a diagnosis of type 2 diabetes—by making adjustments to your current food patterns and increasing your level of physical activity, it is possible, even likely, that you can prevent or delay the progression to diabetes, as well as reduce your risk of heart disease and other complications associated with poorly controlled diabetes.²⁻⁴

How to Get Started With a Type 2 Diabetes Diet Plan

For many people, at least initially, following a diabetes diet may seem harder than it should be and that’s understandable; after all, it can seem very, very challenging to change current eating habits and find the right food rhythm to fit your lifestyle. It may ease your mind to know you will still be able to incorporate your favorite foods into a healthy diet while being mindful of your diabetes diet goals (e.g., healthy weight, steady blood glucose levels, good blood pressure).

“While the idea of changing your diet can be confusing and overwhelming at first, research shows that making healthy lifestyle choices can help you manage your blood sugar levels in the short term and may even prevent many of the long-term health complications associated with diabetes,” says Lori Zanini, RD, CDE, and author of The Diabetes Cookbook and Meal Plan for the Newly Diagnosed.

You don't have to go it alone: Seek advice from a registered dietitian (RD) or certified diabetes educator/certified diabetes care and education specialist (CDE or CDCES) who has the right training to help you come up with an individualized meal plan that will help you meet your self-management goals, get the nutrition you need, and show you how you can incorporate some of your favorite foods into your diet so that you continue to enjoy eating.

Hopefully, your doctor has someone on the team, but if not, call your health insurer to ask for the names of a few in-network RD/CDEs.

There are also virtual coaching programs that appear to be effective; this means you can get individualized dietary guidance at home or at work. Most health insurance companies will cover the cost of diabetes diet counseling, so ask your doctor for a prescription so cost doesn’t hold you back.

“An RD or CDE can look at your usual diet and help you identify where there’s room for improvement,” Arevalo says. “These diet experts can also help you create a diabetes diet plan tailored to your personal needs and food preferences.”

When you meet with a dietitian or CDE/CDCES, she will consider all of your health concerns, your weekday and weekend schedules, any cultural or religious preferences, and your likes and dislikes, as well as anyone else who usually eats with you. By taking into account all of these factors, you will have the best chance of establishing a workable new approach to eating that will support your ability to manage your diabetes with the least disruption possible.

Key Components of a Type 2 Diabetes Diet

Contrary to popular belief, a type 2 diabetes meal plan is not necessarily a low-carb diet, nor should it be a high-protein or very low-fat meal plan. In fact, the ADA recommends less emphasis on specific requirements for proteins, carbs, and fats, and more emphasis on eating a high-quality diet based around whole, unprocessed foods. The key components of a type 2 diabetes meal plan are:

The Right Calories and Portions

The food portions in a type 2 diabetes meal plan are geared toward meeting your energy needs but not consuming excess calories, which get stored as fat, leading to undesirable weight gain.

For people with diabetes, the exact number of calories to consume each day is based on the amount and timing of food that assures you can keep your blood sugar levels stable and your weight within a healthy range. That number can change, depending on your age, activity level, frame size, current versus preferred weight, and other factors.

“When the goal is a healthy weight and blood sugar control, a good starting point for a woman is 1,400 to 1,600 calories a day, with main meals containing up to 30 grams of fiber-rich carbohydrates and snacks containing 10 to 20 grams of fiber-rich carbohydrates,” Zanini advises. “For men and more physically active women who are already at a healthy weight, you may start with a 2,000 to 2,200 calorie meal plan, in which you may increase your carbs proportionately.”

Shifting most of your calorie intake to earlier in the day can also be helpful. Recent research suggests that by eating a big breakfast and a modest lunch, so you get most of your calories in by 3 p.m., you will find it easier to lose weight and achieve better blood sugar control.

Carbs that Keep Blood Sugar Steady

Our wide variety of food products contain different levels and types of carbohydrates, making it harder to eat wisely with diabetes. In general, you will want to choose carbs that have the least impact on your blood sugar. That means selecting items that are high-fiber (see next section) and low-sugar since these are absorbed more slowly and so have little impact on blood sugar changes. Think whole-grain breads and cereals, beans, fruits and vegetables, and dairy products without added sugar.

Combining Foods

Combining carbohydrates with either protein or some fat within each meal or snack is an important trick (maybe the most important trick) for controlling blood sugar and keeping it steady. “When meals are well-balanced (including some protein, fat, and fiber-rich carbs), they are generally more satisfying,” Zanini says, which means you won’t get hungry between meals and go looking for a quick fix that will cause your blood sugar to soar and your body to store those unneeded calories as fat.

“You don't necessarily have to follow a strict food regimen and avoid all kinds of foods when you’re diagnosed with diabetes or prediabetes,” Arevalo says. “You just have to learn how to combine different types of foods in the same meal and measure those foods so you eat appropriate amounts.”

Eating Less Prepared and Processed Food

The ADA recommends minimizing the intake of processed, refined, prepared, and fast foods in favor of whole, unprocessed foods…which generally means making more of your own food and eating at home. Moving toward eating more home-cooked meals may seem daunting, but it just takes a little planning. Resources like the ADA's Diabetes Food Hub can be a big help.

Fiber

Dietary fiber is the basis of a healthy diet, as well as the key to a diabetes diet plan or any good diet for weight loss.

In fact, the one factor that separates healthy carbs from all other carbs is the presence or absence of dietary fiber. Only plant foods contain fiber. Those with the most fiber include dried beans, peas, and lentils, fruits, vegetables, whole grains, nuts, and seeds.

A high-fiber diet—meaning one that contains at least 25 to 35 grams of dietary fiber a day—is essential for good health. And it is key for people with diabetes because fiber helps slow down the absorption of all sugars in your bloodstream—both those that are naturally forming, like in fruits and starches, as well as any refined sugars you consume.

Heart-Healthy Fats

When you have diabetes, you are at higher risk of developing other chronic health problems, such as heart disease, high blood pressure, and kidney disease. That’s why it’s important to watch your intake of saturated fat, which can contribute to heart disease and numerous other conditions, and aim instead for unsaturated fats that are good for your heart. Good sources of healthy fat include avocado, fatty fish (e.g., sockeye salmon, mackerel, herring, lake trout), nuts and seeds, olive oil, and oils made from nuts (e.g., walnut oil, peanut oil).

Protein Choices That Are Low in Saturated Fat

People who eat animal-derived foods can get high-quality protein from lean meats, poultry, seafood, low-fat dairy, and eggs. Vegetarians, vegans, and non-vegetarians alike should look to plant sources for some or all of their protein needs. Plant foods like soy-based tofu and tempeh are excellent sources of non-animal proteins and fit quite well into a diabetes meal plan because they are also low in carbs.

The same can be said for nuts and legumes such as black beans, chickpeas, lentils, and edamame, as well as some whole-grain foods such as quinoa, kamut, and teff. Even couscous and wild rice contain some protein.

Foods to Eat With Type 2 Diabetes

Although you can include most foods in a diabetes diet, you do need to pay most attention to particularly to the types of carbohydrates you choose in order to control and prevent spikes, or unhealthy increases, in your blood sugar. The glycemic index ranks foods based on the effect they have on blood sugar levels: low glycemic foods (near the “1” on a range from 1 to 100) have less effect than high glycemic foods like white rice, breakfast cereals and cereal bars, and sweetened dairy products.

Foods high in simple carbohydrates—mostly from added sugars (i.e., cane sugar, brown sugar, maple syrup, honey) and refined grains (especially white flour and white rice)—are high on the glycemic index, meaning they will cause your blood sugar levels to rise more quickly than foods that contain fiber, such as 100% whole wheat and oats, which have a lower glycemic index.

Examples of healthy lifestyle-promoting carb choices for people with diabetes include:

• Whole-grain breads and cereals and foods made with 100% whole wheat, oats, quinoa, brown rice, corn and cornmeal

• Dried beans, lentils, and peas

• Fresh (or frozen) fruits like berries, apples, pears, and oranges

• Vegetables. Both starchy and non-starchy vegetables are healthy carbs that have less (glycemic) effect on your blood sugar

• Dairy products including yogurt, milk, and cheese. The best yogurt is Greek-style or strained yogurt since these contain triple the level of protein. (Avoid yogurts labeled “fruit-sweetened,” which are mostly added sugar. Instead stir in some fresh or frozen berries, banana, or your favorite seasonal fruit to plain yogurt; you might even add some granola or chopped walnuts.)

One of the best changes anyone with diabetes can make is to switch from white food products—white bread, white potatoes in any form, and white rice—that can also cause notable spikes in blood sugar to similar products made from whole grains, like multigrain sourdough bread, shredded wheat or sweet potatoes, and roasted red potatoes that still have the skin on.

For breakfast, you can learn to prepare your favorite pancakes or waffles with oat flour or almond flour. Check out our handy More or Less guide to help you make healthy swaps and promote balanced blood sugar management.

The Top Diabetes-Friendly Foods

Although a type 2 diabetes diet can accommodate many foods, the American Diabetes Association recommends certain “superstars.” Think of these as the items that should form the cornerstones of your diabetes diet (provided you like eating them):

• Beans, including kidney, pinto, navy and black

• Dark green, leafy vegetables like spinach and kale

• Citrus fruit

• Berries

• Tomatoes

• Fish high in omega-3s: salmon, albacore tuna, herring, sardines, mackerel, and trout

• Nuts and seeds

• Whole grains

• Milk and yogurt (watch the sugar content of yogurts)

Foods to Avoid With Type 2 Diabetes

Flour and sugar represent two ingredients most likely to wreak havoc for people with diabetes because they typically add unnecessary calories and end up leading to a boost in blood sugar and your weight; a double whammy. While you don’t have to avoid white flour (a.k.a. refined flour, all-purpose white flour) and sugar altogether, be aware that foods made with them—including sugar-sweetened cookies, cakes, doughnuts, and other baked goods and sugar-sweetened drinks—have little nutritional value and are likely to send your blood sugar soaring.

It’s also important to steer clear of processed foods when possible. The more a food has been mechanically handled, and refined, the greater the likelihood that its nutritional value will decrease, and such foods are often high in sugar, refined flour, or saturated fats. By eating foods considered highly refined (i.e., empty calories), you are filling up on foods that will make it harder to manage your weight and your blood sugar levels.

While a diabetes diet is more about avoiding certain types of foods—i.e., empty carbs and foods with little nutritional value—than cutting out any single “bad” food, there are some clear items to avoid or minimize:

• White breads and pastries

• Pasta made from white flour

• Processed foods made with added sugar or high-fructose corn syrup

• Foods high in saturated fat (fatty meats, butter, sausage, bacon, cured meats, cheese, and ice cream)

• Candy and soft drinks that contain sugar and high fructose corn syrup

A Cautionary Word About Salt

Some people are sensitive to salt, which causes higher blood pressure when too much sodium is consumed. Since we have no way of testing who is salt-sensitive and who isn’t, the best precaution is to limit salt and avoid sodium-containing foods if you may be at risk for high blood pressure.

Simply put, the excess salt in most people’s diets comes from processed foods, so check the package for sodium content. By adopting a diabetes diet that contains mostly whole foods, this issue will no longer present a problem. Also, foods that are flash frozen are as good as fresh.

Canned vegetables usually have added salt as a preservative. Your best bet when buying is to check the food labels for sodium content. You’ll want to stay well below the upper recommended limit of 2,300 mg/day, and you can certainly look for low-sodium varieties of canned, and processed, prepackaged food products.

Diabetes-Safe Drinks (and Those to Avoid)

Sugars are important to look out for in drinks as well. Your best bets for liquids include:

• Water. Plain or fizzy is great—just watch out for any added sugars or sweeteners.

• Tea, including green and herbal. Opt for lemon to give it a boost instead of sugar or honey.

• Unsweetened coffee.

• Low-fat or non-dairy milk (unsweetened).

• Vegetable juice.

If you have low blood sugar, sipping on orange, apple, or grape juice is OK, just be sure to look for 100% real fruit juices—no “fruit drinks,” “cocktails” or unpronounceable ingredients on food labels—and drink in moderation.

Same for alcoholic drinks—they can be enjoyed in moderation, and ideally with food.

Watch out for drinks that use sugar substitutes, such as sugar-free (“diet”) sodas or energy drinks, as they are not necessarily “good” for people with diabetes.

Now that you know what foods are better if you have diabetes, putting the right foods on your plate is a matter of portions. The key to a balanced diet is planning meals using the diabetes plate method—divide the plate into quarters: ¼ protein or meat, ¼ carbs, and ½ vegetable and fruit. If you want to lose weight, use 9-inch dinner plates and bowls so you aren’t piling the food on to a large dinner plate.

For example, fill half the plate with non-starchy veggies such as salad greens or steamed broccoli, and fill the remaining half of the plate with equal portions of a grain or starchy vegetable like mashed sweet potato and a heart-healthy protein such as broiled salmon.

Here are some sample dinner menus to give you an idea of reasonable portion sizes that make up a healthy meal for someone with diabetes (or anyone, for that matter!). These menus will also give you an idea of the variety of delicious and balanced meals that can fit into a diabetes meal plan. In addition, the infographic above features a week’s worth of breakfast, lunch, and dinner ideas consistent with a diabetes diet plan.

Sample Dinner Menu 1

• 5 or 6 ounces roasted chicken (skin removed)

• ½ cup multigrain pasta (or Banza chickpea pasta), cooked, tossed with 2 tablespoons olive oil and a teaspoon of grated Parmesan cheese

• 2 cups sautéed zucchini and/or summer squash and sliced mushrooms

Sample Dinner Menu 2

• 6-ounce salmon fillet, broiled with lemon

• ½ cup lightly steamed broccoli and ½

  cup halved cherry tomatoes

• 1 cup baby kale and spinach, lightly sautéed in olive oil with chopped garlic and onion

Sample Dinner Menu 3

• 6 ounces (about 1 ½ cups) sauteed tofu seasoned with Chinese Five Spice powder

• ⅓ cup quinoa

• ¼ avocado, sliced and topped with sesame seeds and a squeeze of lime

• 1 cup cucumber, snow pea pods, arugula, and radish salad dressed with vinegar and light soy sauce

Best and Worst Diet Plans for Type 2 Diabetes

According to the ADA, a Mediterranean-style diet, a plant-based diet, and a diet known as Dietary Approaches to Stop Hypertension (DASH) are all good starting points for a type 2 diabetes meal plan that can be modified to accommodate your personal eating preferences.

These diet approaches have two important factors in common: mostly whole foods and meals built around vegetables and fruit. The ADA also now recommends low-carb diets as an option for people with type 2 diabetes.

If you like following a formal diet plan, you can talk with your doctor or diabetes educator about which plan or combination of plans might make sense for you. Here is more information on the plans mentioned above (Mediterranean diet etc.) as well as other popular diet plans that have been studied for the prevention or treatment of T2D.

(Diets are in alphabetical order.)

DASH Diet

Designed to help lower blood pressure, the DASH diet (short of Dietary Approaches to Stop Hypertension) is a well-rounded eating plan that focuses on fruits, vegetables, whole grains, fish, nuts, low-fat or nonfat dairy products, seafood, and poultry and is low in saturated fat, sodium, and sugar. In addition to reducing high blood pressure, which is a risk factor for type 2 diabetes, following the DASH eating plan has been shown to improve insulin sensitivity⁹, improve cholesterol levels, and promote weight loss, all important for managing type 2 diabetes.

800 Calorie Diet

In a 2018 study in The Lancet, called the DiRECT trial (Diabetes Remission Clinical Trial), U.K. researchers found that adults with type 2 diabetes who followed a medically supervised 800-calorie-a-day diet plan for 3 to 5 months were more likely to achieve substantial weight loss than those who got standard diabetes care. And nearly half the participants in the 800-calorie-diet group (46%) saw their blood sugars return to normal during the study, compared to 4% of the control group.

The benefits were maintained for at least a year and in some people were still present at the two-year mark. The study included 298 adults who had been diagnosed with diabetes in the past six years, were overweight or obese, and were not taking insulin.

A British physician markets a do-it-yourself version of the 800-calorie diet, called The Fast 800, that’s essentially a hybrid of the DiRECT diet and intermittent fasting and is designed to produce quick weight loss and get blood sugars out of the diabetes range. For the first two weeks you consume 800 calories a day, then you switch to a “5:2” regimen where you eat normally (but healthfully) five days of the week and eat 800 calories on the other days.

Note that the 800-calorie diet in the DiRECT study was done under medical supervision, with nutritionally balanced meal-replacement products provided by the study. Don’t undertake any plan of extreme calorie restriction on your own without consulting your doctor first.

High Fiber Diet

Eating a high fiber diet is undoubtedly good for people with type 2 diabetes, since fiber helps slow down the absorption of sugars in your bloodstream. Plus it helps you feel full and satisfied. Only plant foods contain fiber. So if your eating plan includes plenty of plant foods like fruits, vegetables, legumes, whole grains, and nuts and seeds—as the Mediterranean, DASH, and plant-based vegetarian/vegan diets all do—then you’re likely getting lots of fiber. People with type 2 diabetes (and everyone) should aim for 25 to 35 grams of dietary fiber a day.

Intermittent Fasting

Intermittent fasting (IF) is an umbrella term for various eating protocols in which you abstain from all food and caloric beverages or substantially reduce your calorie intake for some set period of time. Popular methods of IF include 5:2 fasting, in which you restrict caloric intake to only 500 or 600 calories on two non-consecutive days of the week and eat normally on the other days, and time-restricted feeding, in which you limit caloric intake to a certain time window each day and consume only water during the other hours.

Studies show that IF can help reduce some symptoms of type 2 diabetes and address its underlying causes such as insulin resistance. But the practice can be risky for some people; in particular, fasting can lead to hypoglycemia (low blood sugar). If you are interested in trying intermittent fasting, consult your doctor about whether this is a safe choice for you.

Keto Diet

Keto is a very-low-carb diet plan that focuses on eating foods that are high in fat. In a standard keto diet, about 55-70% of your daily calories come from fat, 25-35% come from protein, and 5-10% (or 50 grams per day in a 2000 kcal per day diet) come from carbohydrates, including carbs from veggies and fruits. The goal is to get you into “ketosis,” a metabolic state in which your body is burning fat (instead of carbs) for energy. There are variations of the keto diet that tweak the amount of allowed carbs.

There’s good evidence that keto diets can be beneficial to people with type 2 diabetes and prediabetes (as well as type 1 diabetes), with benefits including improved glycemic control, greater insulin sensitivity, and possibly less need for medication. However, keto-style eating can also lead to a rare complication called diabetic ketoacidosis, so it’s important to work closely with your doctor and monitor yourself for adverse effects.

Read More About Diabetes and the Ketogenic Diet 

Low-Carb Diet

In an updated consensus statement released in 2018¹⁰, the ADA and the European Association for the Study of Diabetes (EASD) included low-carbohydrate diets along with DASH, Mediterranean, and vegetarian (plant-based) diets among its recommended lifestyle management interventions for people with type 2 diabetes. There are different definitions of what constitutes a low-carb diet; in one study¹¹ cited in the consensus statement, the low-carb regimen was defined as providing no more than 25% of daily energy (calories) from carbs.

Mediterranean Diet

Named the overall best diet for 2022 by US News & World Report¹², the Mediterranean diet isn’t really a diet but rather an eating pattern that emphasizes fruits, vegetables, seafood, healthy fats (especially olive oil), and whole grains. As the name suggests, this style of eating is rooted in the olive-rich southern European countries that border the Mediterranean sea, such as Greece and Italy.

An abundance of research supports numerous health benefits of the Mediterranean eating pattern, including a reduced risk of heart disease, stroke, and premature death. The Mediterranean diet may benefit type 2 diabetes specifically through its high content of fiber (via legumes, produce, and whole grains, for example), which can improve blood sugar levels by slowing digestion, thus reducing spikes.

Read More About the Mediterranean Diet 

Paleo (Caveman) Diet

The Paleo Diet (as in “Paleolithic”) is based on the idea that by returning to our caveperson roots of eating a simple, unprocessed diet, we can avoid or reverse many health ills that are prevalent in modern-day society, including heart disease, cancer, and type 2 diabetes. The diet consists mainly of lean meats, seafood, vegetables, fruits, and nuts and eschews grains, dairy, legumes (like beans and peanuts), and processed foods, along with added sugars and artificial sweeteners—basically anything cavemen didn’t eat.

Paleo tends to be high in protein, low in carbs, and provides many beneficial vitamins and minerals—as does any eating plan that’s based on whole foods and rich in fruits and vegetables.

Whether Paleo-style eating is beneficial for diabetes is controversial. Certain principles of the plan, like cutting out processed foods and added sugar, are clearly helpful for weight loss and may have beneficial effects on blood sugar, insulin sensitivity, and other variables. But you don’t have to be a Paleo devotee to avoid such foods. And sticking to a diet totally free of cereal, bread, beans, and anything processed can be challenging in modern times to say the least, especially if you are vegetarian or vegan.

Plant-Based Diet

A plant-based diet emphasizes legumes, fruits, vegetables, and whole grains and either excludes or strictly limits animal-derived products. This category includes both vegetarian diets, in which some people still consume eggs and dairy, and vegan diets, in which all animal products are off-limits. Consuming a plant-based diet reduces the risk of developing type 2 diabetes as well as helps treat it, according to a review of the evidence published in 2021 in Advances in Nutrition¹³, in part by improving blood glucose concentrations, body weight, plasma lipid concentrations, and blood pressure.

Vegan Diet

See Plant-Based Diet.

Vegetarian Diet

See Plant-Based Diet.

Tips for When Temptation Strikes

In diabetes diet terms, temptation translates to foods you “shouldn’t” eat because they are loaded with sugar and empty carbs that will send your blood sugar skyrocketing. That piece of cake, cinnamon bun, brownie, or bag of chips usually contain more than just carbs, they usually contribute unhealthy fats, too.

The less often you eat these sugary, fatty desserts and snacks, the less you will come to want them. For some people, you may do better allowing yourself to satisfy an occasional craving. Striking the right balance will depend upon your goals and urgency.

By skipping these calorie-laden artery cloggers, you are voting for long-term health in place of serious medical complications. But you know that already.

Here’s the thing: This word of caution is not just for people with diabetes who need to watch their sugar and fat intake; in truth, it is a red flag for anyone who wants to stay healthy and avoid chronic diseases. That’s why the whole family benefits from eating healthy foods and saving small indulgences for special occasions.

Participating in Celebrations With Type 2 Diabetes

Parties, events, and holidays can be challenging to navigate with type 2 diabetes, with their frequent emphasis on and abundance of high-calorie food, alcohol, and sweets. Thankfully, there are things you can do to get through these events without feeling completely deprived. First, you can make sure you have been eating balanced meals earlier in the day, so you arrive at the event with a stabilized blood sugar and not starving.

Additionally, allow yourself some of the treats. “You don’t have to stop eating sweets in order to control your blood sugar, and in fact, if you add these ‘extras’ strategically, you’ll improve your chances of long-term success,” says Lori Zanini, RD, CDE, author of The Diabetes Cookbook and Meal Plan for the Newly Diagnosed. “Giving yourself permission to enjoy an occasional sweet may empower you to self-manage diabetes in a way that suits your individual needs.”

So, rather than trying to prohibit chips, cupcakes, or holiday pie, think of them as occasional indulgences that have a place in your diet on special occasions…and enjoy.

Type 2 Diabetes and Exercise

Lifestyle management of diabetes isn’t just about what you eat. Physical activity also plays an important role. The best type of exercise for managing type 2 diabetes is a combination of cardio (aerobic) exercise, like brisk walking, and strength training. Aim for at least 150 minutes per week of moderate intensity activity. A variety of activities count toward your goal¹⁴; in addition to brisk walking, examples of moderately intense exercise include dancing, mowing the lawn, swimming, biking, dancing, and doing housework, according to the CDC. Most important is to find activities you enjoy doing, which makes exercise easier to stick with.

Type 2 Diabetes Diet FAQs

Does following a type 2 diabetes diet mean I won’t need to take insulin?

It might. For people with type 2 diabetes, your pancreas produces plenty of insulin that is not sensed by the cells, so your body is unable to properly use the insulin you make. Usually, type 2 diabetes can be controlled well with lifestyle changes—particularly shifting from processed carbs to high fiber foods and walking daily—with the addition of medication as needed.

“Some people with type 2 diabetes may also need to begin taking insulin at some point,” says Sandra Arevalo, MPH, RD, CDE, a diabetes expert and spokesperson with the Academy of Nutrition and Dietetics. “It can depend on your age and your individual ability to control your blood sugar with diet and exercise.”

However, when type 2 diabetes is found early enough and weight loss is achieved, in most cases, insulin is never needed.

Can I eat sugar substitutes with type 2 diabetes?

The current belief is that people who need to follow a diabetes diet should avoid added sweeteners of all kinds, including sugar substitutes and artificial sweeteners. Researchers have found that people who consume foods with any form of sweetener typically crave more of these foods and end up gaining weight.

Your best bet is to begin using fruit to get your sweet fix. By adding fruit to foods, you totally avoid the added sugars and sugar alcohols and get the added benefit of dietary fiber, which is better for blood glucose control.

If you want to use a non-caloric sweetener, “of all the alternative sweeteners, stevia is the one I recommend most often,” says Lori Zanini, RD, CDE, author of The Diabetes Cookbook and Meal Plan for the Newly Diagnosed. “It’s a great natural and zero-calorie option for blood sugar control when added to beverages, hot cereals, and other foods.” You’ll have to experiment with stevia, she adds, because it works better with some foods than with others.

Can I drink diet soda with type 2 diabetes?

There are better choices. Although these beverages don’t provide calories, consuming sweet-tasting foods and drinks may lead you to crave additional sweet items (see previous question), even if they’re not sweetened with sugar. And diet soda provides no nutritional value. Better to drink water, tea, coffee, or milk, or have a small amount of fruit juice (make sure it’s 100% juice with no added sweeteners).

Can I follow a vegetarian or vegan diet with type 2 diabetes?

Yes, definitely, and in fact plant-based diets can be especially beneficial for people with diabetes by providing lots of dietary fiber (which is only naturally found in plant foods, not foods from animals). Vegetarian and vegan are not necessarily synonymous with nutritious; you could eat a vegetarian or vegan diet filled with highly processed junk, like chips and candy. (After all, sugar and white flour are plant foods!) So make sure your plant-based plan contains plenty of healthy items like fruits, vegetables, legumes, whole grains, nuts, and seeds and is relatively low in added sugar and processed fare.

How may a fiber-rich diet lower the risk for type 2 diabetes?

Fiber helps slow digestion, keeping you feeling full longer, which can aid in weight loss or prevent weight gain. And it helps slow the absorption of sugars in your bloodstream, which can help keep your blood sugar steady and prevent “spikes.” Some high-fiber foods include dried beans, fruits, lentils, nuts, peas, seeds, vegetables, and whole grains. Aim for 25 to 35 grams of dietary fiber a day.

1. American Diabetes Association Position Statement: Lifestyle Management: Standards of Medical Care in Diabetes, 2018. Diabetes Care. 2018;41:S38-S50.
2. Asif M. The prevention and control of type 2 diabetes by changing lifestyle and dietary pattern. J Educ Health Promot. 2014; 3: 1
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Notes: This article was originally published October 29, 2018 and most recently updated May 10, 2022.

Gila Lyons writes about health and mental health for The New York Times, Oprah Magazine, Vice, Cosmopolitan, Salon, Health Magazine, The Huffington Post, and other publications. 

Registered Dietitian

Susan McQuillan, MS, RDN, CDN, has contributed diet, nutrition, lifestyle, and general health articles to web sites such as QualityHealth.com, PsychologyToday.com blogs, CalorieLab.com and to magazines such as Parent & Child, A&P Supermarket’s Easy Solutions, Natural Health, Sante for Restaurant Professionals, ADDitude, Woman’s Day, Prevention, Family Circle, Cooking Light, Fitness, McCalls, Women’s Sports & Fitness, Fit Pregnancy, Living Fit, BabyTalk, Shape Cooks and Country Cooking magazines. Her original recipes and special-diet meal plans can be found in books published by Reader’s Digest, Weight Watchers and Rodale Press. Her latest book is a family cookbook from Sesame Street titled "Let's Cook!"

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