What is a healthy diet if you have diabetes?

People often think that diabetes means cutting out foods. Senior Dietitian Victoria Taylor explains how diabetes needn’t be restrictive.

Whether you have diabetes or are trying to prevent it, your diet is important. Making healthy choices can help you to manage your condition, as well as cutting your risk of heart and circulatory disease.

A spread of healthy food

Preventing diabetes with your diet

If you have been told by your doctor that you have pre-diabetes – sometimes called borderline diabetes, impaired fasting glucose (IFG), impaired glucose tolerance (IGT) or impaired glucose regulation (IGR) – this doesn’t mean that you have diabetes or that you will definitely get it.

It does mean that it’s time to make permanent changes to your lifestyle to help you prevent or delay developing type 2 diabetes. Eating healthily and being more physically active will help you to lower your weight and reduce your risk, so these are important changes to make.

Eating healthily and being more physically active will help you to lower your weight and reduce your risk [of diabetes]

Ways of eating to reduce your risk of diabetes are similar to those associated with preventing heart and circulatory diseases.

These include the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets, as well as well-balanced vegetarian and vegan diets, all of which include lots of fruit and vegetables, wholegrains, nuts, seeds and pulses, and are low in refined carbohydrates, and low in (or completely exclude) red and processed meat.

Find what works for you, bearing in mind you’ll need to stick to it long-term.

If you have diabetes

Having diabetes doesn’t mean you have to restrict your diet or exclude lots of foods – or that you can’t eat any sugar. Controlling your blood sugar is a priority and a healthy diet will help you to do this.

Making changes to your diet can also help you to lose weight if you are overweight. A five per cent reduction in body weight could improve your blood sugar levels, as well as lowering your risk of heart and circulatory diseases.

In a recent study of people who were overweight and had type 2 diabetes, almost nine out of 10 people in the study were able to put their diabetes into remission with a weight loss of 15kg.

...almost nine out of 10 people in the study were able to put their diabetes into remission with a weight loss of 15kg.

Make sure you eat enough fruit and vegetables by having plenty with every meal. Add them to soups, stews and curries to bulk out the portion and add colour, texture and flavour.

Some people worry about eating too much fruit but, if your blood sugars are frequently high, there are usually other sources of sugar to consider cutting first.

That said, juices and smoothies can increase your blood sugars because they contain several pieces of fruit in one portion, so try to stick to whole fruits and spread your portions out over the day rather than eating them all in one go.

A selection of colourful fruit

Go for healthy choices when it comes to carbohydrates. Choose wholegrain options like wholemeal bread, brown basmati rice or wholewheat pasta.

When you have potatoes, keep the skins on to increase the fibre content. Remember that foods like fruit, vegetables and pulses also contain carbohydrate.

Those foods that provide protein are also important – including beans, pulses, eggs, fish and lean meat, as well as dairy products (or non-dairy alternatives) like low-fat milk and yoghurt and reduced-fat cheese. You don’t need to have large amounts but these foods help to ensure you get enough iron and calcium in your diet, so eat some every day.

Foods that are high in sugar, fat and salt shouldn’t be everyday choices, so try making some healthier swaps. It’s a good idea to avoid sugary drinks, as the sugar these contain tends to be absorbed more quickly by the body. Switch saturated fats for unsaturated fats when cooking and spreading, too.

How much carbohydrate should I eat?

The right amount of carbohydrates will vary from person to person depending on how your diabetes is being managed, your levels of activity, weight and whether you are a man or a woman.

If you have type 1 diabetes treated with insulin, then you need to include some carbohydrate in your diet to reduce the risk of hypos. This is when your blood sugar levels drop too low.

There has been a growing interest in low-carbohydrate diets to help manage type 2 diabetes.

There has been a growing interest in low-carbohydrate diets to help manage type 2 diabetes. In the short term, low-carbohydrate diets have been found to be helpful in controlling blood sugar levels and lowering cholesterol.

If you are trying to eat less carbohydrate, you’ll find that this increases the proportion of fat and protein that you consume. Make sure that the fats are unsaturated and choose lean sources of protein such as beans, pulses, fish and skinless chicken or turkey.

When you have starchy carbohydrates, make sure these are wholegrain or high-fibre. While the short-term benefits of a low-carbohydrate diet do look positive, the longer term effects are less clear. If you want to try this approach to lose weight or help to manage your type 2 diabetes, talk to a dietitian who can help.

Getting support if you have diabetes

Whichever kind of diabetes you have, it’s important that you feel confident managing it.

There can be a lot to take in when you’re first diagnosed but, as time passes, it’s also important to keep up with the latest approaches to treatment and diet.

Education sessions are available for people with type 2 diabetes and those at risk of developing it. Your GP or diabetes team will be able to refer you to your local programme.

Even if you haven’t been diagnosed with diabetes, it’s important to know your risk. Many people have type 2 diabetes for a long time without knowing. To see if you might be at risk, take the Diabetes UK questionnaire.

Do I need diabetic products?

Since 2016 food manufacturers haven’t been allowed to label their foods as ‘suitable for diabetics’ or ‘diabetic’. However, they still offer chocolate, sweets and biscuits made using sweeteners (such as sorbitol or maltitol) instead of sugar.

It’s not good to eat a lot of these sweeteners because they have a laxative effect. These products usually still contain the same amount of saturated fat and calories as the standard products, which means they aren’t helpful if you are trying to reduce your weight and your risk of heart and circulatory diseases. They usually cost more too, so if you want a treat, it’s better to occasionally have a small amount of the standard food.

More useful information