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Diabetes can be a difficult disease to manage, with poor diet only exacerbating that difficulty. In fact, a healthy diet is necessary to keep blood glucose levels within an optimal range, which is a critical requirement for people with diabetes. But what constitutes a healthy diet can be different for people with diabetes compared to those who simply want to shed a few pounds.
For our Best Diets of 2022 ranking, the Forbes Health editorial team created a panel of seven nutrition experts, who analyzed 19 diets across six metrics, including how effective the diet is for diabetes health. Read on for the diets with the highest average scores for our diabetes health category (but remember to always consult your doctor before beginning a new diet or eating plan).
With its focus on fresh fruits and vegetables, whole grains and moderate amounts of fish and dairy, this diet is not only great for managing diabetes, but it might even help prevent it. In fact, one study of 25,000 overweight, female health care providers found those who followed the Mediterranean diet had a 30% lower risk of developing diabetes 20 years later[1]. Other studies suggest this diet might improve fasting blood glucose and hemoglobin A1C levels in people with type 2 diabetes[2], result in a 83% lower chance of developing diabetes[3]and help prevent diabetes among those at high cardiovascular risk[4].
• Fresh fruits and vegetables
• Whole grains, nuts and legumes
• Fish
• Extra virgin olive oil
• Red meats
• Processed meats
• Sweets
With the DASH (Dietary Approaches to Stop Hypertension) diet’s low-sodium approach, its chief goal is to improve heart health, making it a great option for people with diabetes, who are prone to cardiovascular problems. In fact, those with diabetes have a higher risk of developing hypertension (two out of three people with diabetes have the condition)[5]. The DASH diet is known for promoting blood pressure control, and it’s rich in magnesium—which can help with insulin resistance and blood sugar control.
• Grains
• Lean meat, poultry and fish
• Fruits and vegetables
• Sweets and added sugars
• Foods high in saturated fats
This popular, plant-forward approach to eating has many different iterations—some include seafood, dairy and eggs, while others omit them—but regardless, emphasizing vegetables, whole grains and nuts and seeds offers many health benefits, particularly for those with diabetes. In fact, research has linked meat intake with a higher risk of developing diabetes, with one study finding that individuals who switched to a vegetarian diet after not being vegetarian had a 53% lower risk for developing diabetes than non-vegetarians[6].
• Fruits
• Vegetables
• Whole grains and legumes
• Nuts and seeds
• Meats
• Dairy
• Eggs
A more restrictive form of vegetarianism, the vegan diet bypasses animal-derived foods and focuses on fruits, vegetables, whole grains, legumes and nuts. As mentioned above, research links meat intake to an increased risk of developing diabetes, and the American Society for Nutrition reports that vegan diets may be effective for treating and managing type 2 diabetes, as they can improve glycemic control and body weight. Planning here is key, though, as vegan diets may require the supplementation of certain vitamins and minerals.
• Fruits and vegetables
• Soy
• Legumes and nuts
• Whole grains
• Any animal-derived products
Created by Dean Ornish, M.D., this diet is often associated with heart health, but its emphasis on plant-based foods including fruits, vegetables, whole grains and soy—as well as the addition of healthy lifestyle changes like regular exercise—can be particularly beneficial for diabetes management and prevention, too. The program has specific guidance for those with diabetes, including prioritizing protein, which can help control rising blood glucose levels when eaten with carbohydrates, and avoiding alcohol, which can raise triglyceride levels.
• Fruits and vegetables
• Whole grains and legumes
• Soy
• Refined carbs
• Sugar
• White flour and white rice
• Concentrated sweeteners
For our Best Diets for Diabetes 2022 ranking, the Forbes Health editorial team created a panel consisting of seven nutrition experts, who analyzed 19 diets across six metrics, including diabetes health. The diets with the highest average scores for our diabetes health category were named the winners.
Diabetes is a common—yet serious—disease in which your blood glucose, or blood sugar, is too high. When you eat, the bulk of your food (mainly carbohydrates) is broken down into glucose, which is then distributed into the bloodstream. Your blood sugar rising signals your pancreas to release insulin, which allows glucose into your cells to be used as energy.
But when a person has diabetes, their body doesn’t make enough insulin or can’t effectively utilize the insulin it does make. As a result, glucose remains in their bloodstream, causing their blood sugar to rise.
High blood glucose levels can lead to a plethora of health problems over the long term, including:
While there is no known cure for diabetes, it can be effectively managed with the right diet and proper maintenance.
In addition to gestational diabetes—a type of diabetes that can develop in pregnant people— there are two main types of diabetes: Type 1 diabetes and type 2 diabetes.
This type of diabetes is considered an autoimmune reaction in which your body attacks the cells in your pancreas that make insulin. Type 1 diabetes is typically diagnosed in children and young adults and requires the person to take supplemental insulin daily.
Type 2 diabetes typically develops in adults, although it can be diagnosed at any age. With this type of diabetes, your body simply doesn’t make or use insulin efficiently. Type 2 diabetes can typically be avoided with a healthy diet and active lifestyle, as obesity is the leading risk factor for type 2 diabetes. In fact, research has found that women who have a body mass index of 30 kg/m have a 28 times greater risk of developing type 2 diabetes than women of normal weight[7].
Symptoms of diabetes include the following, according to the Centers for Disease Control and Prevention (CDC):
Additionally, symptoms of type 1 diabetes—which can form over weeks or months and typically appear in children—include nausea, vomiting and stomach pains, as noted by the CDC. Type 1 diabetes, however, can occur at any age. Meanwhile, symptoms of type 2 diabetes can be slow to develop over the course of several years, and can be hard to spot.
What you eat has a direct impact on your glucose levels, making diet an incredibly important part of managing—or even preventing—diabetes. A healthy diet, which includes what you eat, how much you eat and when you eat, can keep your blood sugar levels within a healthy range.
In fact, studies show that while insulin or oral medications are often required to treat diabetes, good blood glucose level control is unlikely to occur with medicine alone and requires a healthy diet[8].
While there are no “forbidden foods,” certain foods that are high in sugar can clearly raise your blood sugar levels and should be limited, says Ruth S. Horowitz, M.D., an endocrinologist at the Greater Baltimore Medical Center in Towson, Maryland.
“Limiting the quantity of foods that have high glycemic content that raise glucose levels quickly, such as pasta, white rice, white potatoes, corn and large amounts of breads, will help keep glucose levels in control,” says Dr. Horowitz.
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Dr. Horowitz applauds many of the diets featured in this ranking for their inclusion of complex carbohydrates (in the form of vegetables, fruits, whole grains, legumes and low-fat milk), lean proteins, healthy fats and dietary fiber, as well as their restriction of sweetened drinks and simple carbohydrates.
When it comes to keeping blood sugar levels within a healthy range—a key to successful diabetes management—Dr. Horowitz recommends higher fiber foods because they’re slower to digest and take longer to affect glucose levels while also improving satiety.
“The key to keeping glucose levels from rising is balance,” she says. “Having more of the meal composed of complex carbs—and also eating a consistent amount of carbohydrates from meal to meal and avoiding meals that have too much at any one time—[as well as] including lean protein in the meal will help with satiety and prevent overeating.”
Not all diets are created equal, and some of the more restrictive diets (which also happen to be increasingly trendy) should be approached with caution.
“Highly carbohydrate-restricted diets, such as the extreme forms of keto diets, should be assessed carefully,” says Dr. Horowitz. “Though many people do very well with lower carbohydrate diets, and modified keto diets are often beneficial, diets that eliminate entire food groups are not balanced and may lead to deficiencies of macronutrients. They are also difficult to maintain.”
In general, foods and drinks that people with diabetes should limit include:
If you have diabetes, starting a new diet might sound daunting. However, it can be easier than it seems. The key is planning ahead to ensure healthy meals that will keep your blood sugar levels in check.
The CDC also recommends taking the following steps when developing an eating plan (but details will vary based on your specific diet):
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People with diabetes can eat a variety of healthy foods from all food groups, as well as foods with heart-healthy fats like olive oil, nuts and seeds, fish like salmon, tuna and mackerel, and avocado. Focus on adding whole foods to your plate, as they are digested more slowly, which helps with blood sugar control. Additionally, consider combining carbohydrates with a lean protein or healthy fat to help keep your blood sugar stable. Swap out butter, cream, shortening, lard or margarine with oils for cooking.
The best snacks for people with diabetes include lean protein and complex carbohydrates, such as nuts and vegetables. Meanwhile, snacks to avoid include those high in salt, as well as high carbohydrate foods like chips.
There are a few differences between what a healthy diet might look like for a person with type 1 diabetes versus type 2.
“Since patients with type 1 diabetes are taking insulin with each meal, understanding how to calculate the amount of carbohydrates one is going to consume and then adjusting insulin dosing for that meal to prevent both hyperglycemia and hypoglycemia is key to optimal control,” says Dr. Horowitz.
“However, many people with type 2 diabetes are also on multiple daily injections of insulin and use carbohydrate counting to adjust their insulin dosing. Those individuals usually require higher doses of insulin, as they are more insulin resistant,” she adds. “For type 2 patients who are not on insulin, it’s critical that they are more careful in not consuming quantities of carbohydrates that will lead to hyperglycemia since they are not utilizing a medication that can be adjusted for those higher calorie meals.”
The amount of carbohydrates you should aim to consume per day should be determined by your doctor or registered dietitian. However, the CDC recommends people with diabetes aim to get about half of their daily calories from carbs, and consume around the same amount of carbs per meal in order to keep blood sugar levels stable.
People with diabetes should opt for fruits that do not have added sugars, according to the American Diabetes Association. The association states that most fruits have a low glycemic index (GI) (meaning they don’t cause as big of swings in blood sugar levels) due to their fructose and fiber content, but notes that melons, pineapples and some dried fruits have a medium GI.
If left untreated, diabetes can lead to serious health complications including kidney failure, vision loss and heart disease, among others.
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Sarah is an experienced writer and editor enthusiastic about helping readers live their healthiest and happiest lives. Before joining Forbes Health, Sarah worked as a writer for various digital publications including LendingTree, theSkimm, CNBC and Bankrate. When she isn’t writing or editing, you can find Sarah with her nose in a book or enjoying the outdoors with her French bulldog, Honey.
Jessica is a writer and editor with over a decade of experience in both lifestyle and clinical health topics. Before Forbes Health, Jessica was an editor for Healthline Media, WW and PopSugar, as well as numerous health-related startups. When she isn’t writing or editing, Jessica can be found at the gym, listening to a health or true prime podcast, or spending time outside. She also really enjoys bread (even though she’s not supposed to eat it).
