Diabetes is one of the most commonly occurring long-term medical conditions in the world.
According to the World Health Organization, as of 2014, over 422 million people worldwide have diabetes. Diabetes complications can include blindness, kidney problems, and heart disease.
Similar to many long-term diseases, complications may be prevented with proper management of the condition.
“Diet is one of the key elements in managing diabetes,” Amparo Gonzalez, RN, CDE, of the Johnson and Johnson Diabetes Institute. “People with diabetes need to manage the amounts of carbohydrates, fat, and overall calories they eat daily.”
“When it comes to diet, it’s also important to remember moderation and portion control are essential.”
The basics of diabetes
The two major types of diabetes are type 1 diabetes and type 2 diabetes.
Making the right food choices is important for both type 1 and type 2 diabetes.
Type 1 diabetes often develops early in life, and the cause is not fully understood. Type 1 diabetes occurs when the immune system damages the cells that make a hormone called insulin. The result is insufficient insulin production.
Type 2 diabetes is associated with a sedentary lifestyle and being overweight. It can develop in both children and adults. People with type 2 diabetes do not produce enough insulin, or the insulin they do produce is not used efficiently.
Fortunately, both types of diabetes can be managed through medication and lifestyle choices, such as healthy eating. Making healthy food choices and limiting unsuitable foods is a large part of a diabetes treatment plan.
Important goals for managing diabetes through diet include controlling blood sugar levels and maintaining a healthy weight.
The role of diet in diabetes
After eating, food breaks down into glucose. Glucose is a type of sugar and a major source of energy for the body.
In response to an increase in glucose levels, the body releases insulin. Insulin is an essential hormone because it allows the cells in the body to absorb glucose. It also plays a role in helping the body store protein and fat.
In people who have diabetes, their body may stop making insulin, not make sufficient levels of insulin, or may not use insulin efficiently. Without proper insulin production and use, glucose may not be absorbed by the cells. Instead, glucose levels rise in the bloodstream.
There are a couple of problems when blood sugar levels in the bloodstream become high. The cells don’t get the energy they need, and fatigue can occur.
High blood sugar levels over time can also damage blood vessels in the body. When the blood vessels become damaged, various complications can occur, such as kidney and heart disease, and vision loss.
The good news is that by making the right choices, people can manage their diabetes more effectively, keep glucose levels steady, and lower the risk of possible complications.
How does food affect blood sugar levels?
Different foods affect blood sugar levels differently. The three macronutrients the body uses are fat, protein, and carbohydrates. Carbohydrates affect glucose levels the most. When eaten alone, protein and fat do not have a significant impact on glucose levels.
It’s important to remember that many foods contain a combination of carbohydrates, protein, and fat. Since food can have a significant impact on blood sugar levels, it’s essential to make good food choices and monitor carbohydrate intake.
There is no “one-size-fits-all” diet for people with diabetes. Several individual factors play a role in dietary choices, including whether a person is overweight, has kidney disease, and whether they have type 1 diabetes or type 2 diabetes.
It’s always best to get nutritional advice from a registered dietitian. The guide below provides some general dietary guidelines to help manage diabetes.
Suitable food choices for people with diabetes
It’s difficult to state recommendations for an exact number of grams of nutrients, such as carbohydrates, a person with diabetes should eat.
Fresh fruits, vegetables, and whole grains are good choices for people with diabetes.
According to dietary guidelines released by the American Diabetic Association (ADA), there is no conclusive evidence supporting an ideal amount of carbohydrates or other nutrients for people with diabetes.
Instead, an emphasis is placed on choosing healthy foods, including:
Complex carbohydrates differ from simple carbohydrates. Complex carbohydrates are broken down slowly. They also often contain fiber, and they do not affect blood sugar levels as significantly as simple carbohydrates.
Foods containing complex carbohydrates include:
- Whole grains
- Sweet potatoes
The ADA guidelines do not provide a specific protein intake recommendation for blood sugar control. Again, the focus is on healthy choices.
People with diabetes should keep in mind that some sources of protein can be high in fat, which can contribute to weight gain.
The ADA recommend lean sources of protein including:
- Fish (herring, sardines, salmon, tuna)
- Nuts (cashews, peanuts, soy nuts)
Fat is an essential nutrient. Certain types of fat, such as monounsaturated and polyunsaturated fat are considered healthy fats. More important than the quantity of fat is the type of fat eaten, however.
Suitable fat choices include:
- Sesame seeds
- Olive oil
Unsuitable food choices for people with diabetes
People with diabetes should also be aware of food choices that can cause spikes in blood sugar and contribute to being overweight. When choosing foods, it’s helpful to limit those listed below.
People with diabetes should limit refined carbohydrates and foods containing hidden sugars.
Refined carbohydrates may include foods containing processed sugar or refined grains. Most refined carbohydrates have their fiber removed and have limited nutritional value. They also lead to rapid spikes in blood sugar levels.
Refined carbohydrates to be limited include:
- White bread
- White rice
- Cereal with added sugar
Trans fat and saturated fat
Excessive amounts of saturated fats and any amount of trans fats are unhealthy for everyone. They can raise “bad” cholesterol and contribute to heart disease.
Foods that are high in trans fat and saturated fat include:
- Fried food
- Commercially baked cookies and cakes
- Vegetable shortening
- Food containing partially hydrogenated oil
People with diabetes should also be aware of foods with hidden sugar. Some foods may look healthy but have a high sugar content on closer inspection.
Always check food labels to determine the sugar and carbohydrate content.
Foods that often contain hidden sugar include:
- Canned fruit packed in syrup
- Canned pasta sauce
- Frozen dinners
- Bottled condiments
Daily and weekly menu planning tips
People with diabetes may benefit from daily and weekly meal planning. Meal planning can help someone choose foods that keep glucose levels steady and help them maintain a healthy weight. Meal planning should also include keeping track of what is eaten.
There are three main ways for people to track what they eat: carbohydrate counting, glycemic index, and the plate method.
Plate method: Divide the plate into three categories. Half the plate should consist of non-starchy vegetables. One-fourth should consist of whole grains and complex starchy food. The remaining fourth of the plate should contain lean protein.
Carb counting: Carbohydrate counting involves planning how many grams of carbohydrates are eaten with each meal and snack.
Glycemic index: The glycemic index categorizes food by how much it increases blood sugar. Foods that have a high glycemic index raise blood sugar more than foods with a low glycemic index. Meal planning using the glycemic index involves choosing foods that are low or medium on the glycemic index.
Whether planning daily or weekly menus, it’s also important for people with diabetes to keep the following in mind:
- Eating at regularly set times
- Avoiding skipping meals as it can affect blood sugar levels
- Spacing meals and snacks out to prevent large changes in blood sugar levels
- Eating a wide range of foods
- Thinking about the size of servings
- Avoiding carbohydrate-only meals that can cause higher blood sugar spikes