Diabetic diet: what to eat and avoid with type 1 and 2 diabetes

A diabetic diet is an important part of managing both type 1 and type 2 diabetes.
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  • Diabetes is a serious condition which affects more than 4.9 million people in the UK, according to Diabetes UK. It is caused by a person’s blood glucose (sugar) levels being too high. This is due to the body either being unable to produce the hormone insulin or producing not enough or ineffective insulin. While symptoms of diabetes can be treated by medication, a diabetic diet is also an important part of managing the condition.

    There are a number of different types of diabetes, but the most common are types 1 and 2. While the symptoms are the same for both, including extreme thirst, urinating more frequently and feeling very tired, they are caused by different things. Jump down to our section on the difference between type 1 and type 2 diabetes for more information.

    How to manage diabetes with a diabetic diet

    While many people with type 1 and 2 diabetes take medication for their condition, a diabetic diet also helps. This is because it keeps blood sugar levels stable and helps to avoid overeating. However, because diabetes is different for everyone, there is no one-size-fits-all diabetic diet. It is all about choosing a balanced diet.

    A diabetic diet is basically an eating plan which focuses on healthy nutrients, such as fruit, vegetables and wholegrains. It also aims to reduce the amount of bad fats and ‘free sugars’, which manufacturers add to food and drinks. This is because when you eat extra calories they cause a rise in blood glucose levels.

    Registered dietitian Ellouise Simpson, from City Dietitians, says: “There is no special diet for someone living with diabetes, it is more about introducing a healthy diet and lifestyle coupled with understanding how certain foods impact blood glucose (sugar) control.”

    Another important factor in following a diabetic diet is to eat meals at regular meal times. This helps you to better use the insulin your body produces or gets through medication.

    There are a number of factors which can increase your chances of getting diabetes, including family history, age and ethnicity. However, researchers have found that dietary habits and a sedentary lifestyle are the major factors for rising cases of type 2 diabetes in developing countries. So, like the Mediterranean diet, a diabetic diet should be full of healthy carbohydrates, fibre-rich foods, fish and “good” fats.

    Tamara Willner, a registered nutritionist from Second Nature, an NHS-backed healthy eating plan, says: “For those individuals living with type 2 diabetes, the focus should be on making healthy changes that last. If we go on a healthy diet and achieve remission but then return to our old ways, type 2 diabetes will return.

    “It’s about making changes you know you can stick to, and for many of us, that’s a less restrictive, lower carb approach. This is because it helps us stay fuller for longer and we’re not punishing ourselves, but rather changing our way of life and still enjoying food.”

    If you intend to lose weight by following the diabetic diet, you should also consider incorporating some exercise into your daily routine such as the Couch to 5k training plan.

    What can I eat with type 1 diabetes?

    It may surprise some people to learn that you can basically eat anything with type 1 diabetes. However, health experts recommend that you make healthier food choices that are lower in saturated fat, sugar and salt. Doing this will help to control your blood fats and maintain a healthy weight. So opt for healthy carbohydrates over refined ones and natural sugars, like fruit, over ‘free sugars’ like cakes and chocolate.

    With type 1 diabetes you can calculate the amount of carbohydrates in your meal and adjust your insulin dose accordingly. This is important to keep your blood sugar levels steady.

    Registered dietitian Ellouise Simpson says: “It is important for someone living with type 1 diabetes to have an understanding of what foods contain carbohydrates, as this will have an impact on their insulin therapy. Additionally, following a healthy balanced diet is the goal for overall health.”

    People with type 1 diabetes should also be careful with sugary drinks. This is because they can put blood glucose levels up very high, very quickly. If you are thirsty it is better to opt for water or sugar-free drinks.

    This US study found that diet quality of children with type 1 diabetes improved when their families were given 18 months of support to understand the importance of fruits, vegetables, and wholegrains in their diet.

    What can I eat with type 2 diabetes?

    When thinking about what you can eat with type 2 diabetes, you should be aiming for a diet that is full of healthy carbohydrates, fibre-rich foods, fish and “good” fats. This will ensure that your blood levels stay stable and may even help to reverse the condition for some people.

    Registered dietitian Ellouise Simpson explains: “Remission for type 2 diabetes is a complex topic as age, length of time living with diabetes, medication requirements and motivation all impact the success of achieving remission. Remission is a possibility for many, however, it is so important to seek support from a specialist diabetes dietitian and your GP. This is because you will need to be closely monitored by your healthcare team for safe and sustainable success.”

    This study suggests that rather than specifying how many calories a person with diabetes should consume, it is more important to provide a person-centred healthy eating plan to control the condition.

    In order to be healthy and balanced, a diabetic diet should include the following:

    Healthy carbs

    • Wholegrains – Wholegrain bread, brown rice, wholewheat pasta, quinoa, bulgar wheat, whole oats
    • Fruits – Strawberries, blueberries, raspberries, grapes, apples, oranges, melon, pomegranate
    • Vegetables – Peppers, aubergines, courgettes, tomatoes, spinach, kale, beans, broccoli, carrots
    • Pulses – Chickpeas, beans, lentils
    • Dairy – Unsweetened yoghurt, milk

    These foods take longer to be digested as they release the sugar more slowly into the bloodstream, so you don’t get a sugar spike. Researchers have also linked them to a reduced risk of type 2 diabetes.

    Registered nutritionist Tamara Willner, says: “Eating a diet that’s lower in carbohydrates can help individuals with type 2 diabetes manage their blood sugar levels and lose or maintain weight in the long term.”

    High Fibre foods

    • Vegetables – Especially produce like Brussels sprouts, peas, artichokes, carrots, broccoli and green leafy vegetables like spinach
    • Fruit – Especially produce like avocados and berries
    • Nuts and seeds – especially chia seeds and flaxseeds

    High fibre foods are an important part of the diabetic diet as they slow the absorption of sugar, helping to stabilise blood sugar levels.

    Oily fish

    • Sardines
    • Mackerel
    • Anchovies
    • Salmon
    • Herring

    Studies have shown two or three portions of oily fish a week can reduce the chances of diseases associated with diabetes.

    Protein

    • Fish
    • Lean meat
    • Beans
    • Lentils
    • Eggs

    Protein in the diet helps to control blood sugar and insulin metabolism.

    Healthy fats

    • Avocados
    • Coconut oil and olive oil
    • Nuts

    Healthy fats help to control blood sugar and insulin metabolism.

    Registered dietitian Ellouise Simpson says: “Diet can play a massive part in the treatment plan for someone living with type 2 diabetes. Depending on the person’s personal goal, for example, remission, and reduced medication, will have an impact on their dietary recommendation. In many cases weight loss can support the management of type 2 diabetes therefore adjusting your food intake to achieve weight loss would be recommended. However, many people live with type 2 diabetes and weight loss isn’t a recommendation. Therefore the dietary focus may be focusing on achieving balanced meals to support stable blood sugar levels.”

    Foods to avoid with type 2 diabetes

    1. Refined carbs

    There are a couple of reasons why refined carbs are best avoided with type 2 diabetes. Firstly, researchers have linked refined carbs with an increased risk of type 2 diabetes. Secondly, refined carbs are more likely to give you a sugar spike. Replacing refined carbs like white bread, pasta and rice, for whole grain alternatives, such as wholemeal bread, brown rice, buckwheat or quinoa, which are fibre-rich and keep your blood levels more steady.

    2. Red and processed meat

    Studies show that a diet high in red and processed meat increases the risk of developing diabetes. Eating too much-saturated fat can cause high levels of ‘bad cholesterol’, which increases the risk of cardiovascular disease.  According to Diabetes UK, diabetics are already at an increased risk of developing this, making it more important they make healthier choices. Opt for healthy fat alternatives such as those found in oily fish and avocados.

    3. Salty foods

    Scientists have found that more salt in a diet can lead to type 2 diabetes. So it is important that you try and cut down on the amount in your diet. One of the easiest ways to do this is by eating less processed food, which often contains high amounts.

    This study also found that people who were adding salt to a prepared meal when there was not enough, or almost every time without tasting, were associated with a higher risk of type 2 diabetes. So it is worth finding ways to replace salt when cooking or seasoning, for example, you could try using herbs instead.

    4. High sugar food

    Added sugar, or ‘free sugar’ as it is often called, can cause problems for people with diabetes as it can cause blood levels to spike suddenly. This is especially true when drinking sugary drinks. It is, therefore, better to eat naturally occurring sugar, such as that found in fruit.

    This study found that the excessive intake of sugar, along with other refined carbohydrates, is a major factor driving the epidemics of type 2 diabetes among the Asian Indian population.

    Registered nutritionist Tamara Willner says: “For those individuals living with type 2 diabetes, the focus should be on making healthy changes that last. If we go on a healthy diet and achieve remission but then return to our old ways, type 2 diabetes will return.

    “It’s about making changes you know you can stick to, and for many of us, that’s a less restrictive, lower carb approach. This is because it helps us stay fuller for longer and we’re not punishing ourselves, but rather changing our way of life and still enjoying food.”

    How do carbohydrates affect blood sugar levels?

    Carbohydrates are important to our bodies as they are one of our main sources of energy. When we eat carbohydrates our bodies break them down into glucose relatively quickly and can therefore affect our blood sugar levels. The amount and type of carbohydrates eaten by people with diabetes each day is therefore important for keeping their condition under control.

    Registered dietitian Ellouise Simpson explains: “When we eat carbohydrates they are digested and converted into glucose (sugar).

    “However, the process has many influential factors such as portion size, the type of carbohydrates we choose, for example, ultra-processed or whole grain and if they are paired with other foods such as fat and protein. Pairing food groups may slow down the release of glucose from the carbohydrate and reduce how quickly and how much your blood sugar level rises.”

    Many of the foods we eat contain carbohydrates. These include:

    • Starchy foods – Rice, pasta and foods containing flour such as bread, pastry and dough-based foods
    • Fruit and vegetables (Carbohydrates are generally found in all fruits and vegetables. However some have a higher amount of carbs) – Potatoes, root vegetables such as parsnips and beetroot, mangoes, bananas and pears
    • Sugar – Chocolate, cakes, biscuits, sweets

    There are different types of carbohydrates which are broken down quickly or less quickly because of their chemical structure. Simple carbohydrates are sugars and are broken down quickly by the body and therefore raise blood sugar levels quickly. Meanwhile, complex carbohydrates are starches and broken down more slowly than simple carbs and will raise sugar levels more slowly.

    It is important that people following a diabetic diet keep track of the amount of carbohydrates they are eating. This is because type 1 diabetes it will affect the amount of insulin medication they take.

    For those with type 2 diabetes, generally, the higher the amount of carbohydrates eaten, the more likely it is that the body will struggle to produce enough insulin. As a result, people with type 2 diabetes on a relatively high carbohydrate diet are more likely either to have too high blood glucose levels or to need larger doses of stronger diabetes medication.

    So the main way to reduce your body’s need to produce insulin is by lowering your calorie intake, including the amount of carbohydrate eaten, and by exercising. This is why many people with type 2 diabetes follow a low-carb diet.

    Registered nutritionist Tamara Willner says: “Carbohydrates cause greater spikes in our blood sugar compared with proteins or healthy fats. Particularly with refined carbohydrates, this can lead to great troughs later on and increase cravings, impact our mood, and make us feel hungrier later.”

    Breakfast ideas for diabetes

    For breakfast, try to aim for food which will release energy slowly and keep you filled up until lunchtime. Think oats, wholegrain toast and unsweetened yoghurt with berries. Here are some ideas:

    Lunch ideas for diabetes

    Remember to avoid processed meats like ham and bacon and use wholemeal bread for sandwiches. Try to include lots of green leafy veg, such as spinach, kale, watercress and rocket into salads, as research has associated them with reducing the risk of diabetes.
    Here are some quick and easy diabetic diet-friendly lunches:

    Dinner ideas for diabetes

    If possible try to avoid red meat such as beef, lamb and pork, which researchers have associated with an increased risk of diabetes. Instead opt for chicken and fish. Try to eat at least one portion of oily fish and one portion of white fish a week.

    Snack ideas for diabetes

    When thinking about snack ideas for diabetes, try to avoid food with high sugar and salt contents, like chocolate bars and crisps. Instead opt for fruit, seeds and nuts. Produce like apples, grapes and berries have been associated with reducing the risk of diabetes.

    • A portion of fruit – Apple, banana, orange, pear, two plums, two kiwis, seven strawberries, 14 cherries, half a grapefruit, one slice of melon, one slice of pineapple
    • Dried fruit (about 30g) –  Raisins, sultanas, prunes, dried banana chips, mixed fruit
    • Unsalted nuts – Cashews, hazelnuts, Brazil nuts, walnuts, pistachios
    • Seeds – Pumpkin, sunflower
    • Unsweetened yoghurts

    What to drink and avoid when you have diabetes

    When considering what to drink and avoid when you have diabetes, you should think about sugar content. For example, drinks like milk, water and coffee are fine to drink. Whereas, drinks like fruit juices and smoothies should be taken in moderation. This is because these drinks have most of the roughage removed or already broken down. So it is very easy to drink large quantities in a short amount of time. Diabetes UK says that 150ml of fruit juice provides about 15g of carbohydrates and ‘free sugar’.

    The best things to dink on a diabetes diet:

    • Water
    • Milk
    • Tea and coffee (with no sugar)
    • Diet/low-calorie soft drinks (in moderation)

    Avoid where possible/drink in moderation:

    • Fruit juices
    • Smoothies
    • Fizzy drinks
    • Energy drinks
    • Low-sugar beers and cider
    • Low-alcohol wines

    Registered dietitian Ellouise Simpson says:  “Drinks laden with added sugar will not help with the management of diabetes as the main goal we are trying to achieve with diabetes is to reduce the amount of glucose in the blood. When you drink a sugary drink the sugar is quickly digested and released into the bloodstream. This raises your blood sugar levels like a rocket heading for the moon. Therefore, if you are wanting a drink with flavour swap drinks with added sugar for a sugar-free version.”

    You can still drink alcohol when you have diabetes. However, you should be aware that it can increase the risk of hypos because alcohol interferes with blood sugar levels.

    You should try to avoid low-sugar beers and cider, which have higher levels of alcohol in them. Plus you should avoid low-alcohol wines that often contain more sugar than normal ones. Spirits, dry wines and prosecco usually have fewer carbs and you should opt for diet or sugar-free mixers with spirits.

    Tamara: “Sugary juices, fizzy drinks, and certain alcoholic beverages all contain a lot of sugar, so swapping things like coca-cola, apple juices, and cocktails for herbal teas, milk, or sparkling water flavoured with fruit should help control blood sugar levels. It’s not necessary to eliminate alcohol, but we could consider alternating alcoholic beverages with lower sugar soft drinks, as alcohol impacts our blood sugar and can also have indirect effects on our weight if we binge drink.”

    Are bananas good for diabetics?

    A question that is often asked is whether bananas are good for people with diabetes? The short answer is yes. Although bananas contain natural sugars, they also have important nutrients. So it is better to reduce your intake of things like chocolate and sugary drinks.

    Some people may think that the sugar content of fruit means that they should not eat it. However, sugar in fruit is not the same as ‘free sugar’ in things like cakes and biscuits.

    Tamara says: “It’s easier to build healthy habits if we consider ‘how can I build a balanced plate’ rather than marking foods as ‘good’ or ‘bad’. Bananas are packed with nutrients and vitamins and so shouldn’t be off-limits. However, they are higher in sugar compared with other foods so eating them in moderation is key. Individuals with diabetes could also consider eating a banana with a protein or fat source, such as Greek yoghurt or a teaspoon of peanut butter. This slows down digestion and mitigates the effect on our blood sugar.”

    Difference between type 1 and type 2 diabetes

    Type 1 diabetes is a genetic condition. It is caused when the cells that produce insulin in the pancreas are attacked by the body’s immune system. This means that although the body can still break down carbohydrates from food and drink and turn it into glucose, when it enters the bloodstream there is no insulin to allow it into the body’s cells. Glucose then builds up in the bloodstream, leading to high blood sugar levels.

    Over time this could lead to damage to other areas of the body, such as the heart, eyes, feet and kidneys. There is currently no known cure for type 1 diabetes, but it can be managed through a variety of different measures, including a healthy, balanced diet.

    In contrast, type 2 diabetes, which around 90% of people with diabetes in the UK have, is mainly lifestyle-related and develops over time. This is because with type 2 diabetes the body can still produce insulin, it just doesn’t produce enough or produces ineffective insulin. So the body’s blood glucose levels keep rising. This can lead to hyperglycaemia (hypers), which can make people feel sick and cause headaches and blurred vision.

    Natasha Marsland, Senior Clinical Advisor at Diabetes UK, explains: “Type 2 diabetes means either that not enough insulin is produced in the pancreas, or that the pancreas isn’t working effectively. Essentially, it’s too much sugar in the blood, and diet is key.”

    In the long term, type 2 diabetes can also lead to complications with the heart, eyes and feet. However, while some people have to take medication to keep their blood sugar levels stable, others are able to achieve this through a diabetic diet. Studies have also shown that by losing weight it is possible for some people to put type 2 diabetes into remission.

    Where to go for more support

    If you need to adopt a diabetic diet, more support is available from Diabetes UK and via your GP.

    If you need help to create a healthy eating plan to manage your diabetes contact a registered nutritionist or dietitian.

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