Elizabeth Woolley is a patient advocate and writer who was diagnosed with type 2 diabetes.
Dr. Danielle Weiss is double board-certified in internal medicine and endocrinology. She is the founder of the Center for Hormonal Health and Well-Being in San Diego, California.
Managing diabetes means managing multiple meals and snacks throughout the day, ideally by planning ahead and eating as much homemade food as possible to control calories, carbs, and sugar. This can be a challenge if you have diabetes, given that you must eat regularly in order to keep blood sugar levels under control: Real life simply doesn’t allow for every meal and snack to be made from scratch at home.
This means that sometimes fast food is the only option—but it's not necessarily a bad option despite having the reputation for being heavy on carbs, saturated fat, and added sugar. If you do your homework and choose wisely, you easily can include these convenient offerings in your overall diabetes eating plan.
Unless you’ve been newly diagnosed with diabetes, chances are you’re already incorporating these standard rules for managing what you eat throughout the day to control your blood sugar levels and, if you need to, lose weight. If not, they’ll help you make smart fast food choices; if so, they’re always worth reviewing.
Whether you have a hankering for Tex Mex takeout, a yen for sushi, crave a burger, or are forced to grab something from the nearest convenience store at snack time, having a sense of the best and worst options can help you stick to your diabetes diet plan, keep your blood sugar levels from zigzagging, and contribute to an overall healthy diet.
Supersized burgers, fries, and milkshakes are the mainstays of popular spots like Wendy's, McDonald's, and Burger King. None are ideal choices if you have diabetes, but most fast food chains now offer items that are healthier and will fit nicely into a diabetes eating plan.
Regular or junior sized burger or grilled chicken sandwich on whole-grain bun (if available)
Burger/sandwich add-ons such as vegetables (lettuce, tomato, onion) and condiments including mustard, salsa, hot sauce, ketchup (be aware of added sugar)
Side salad (light dressing, no croutons)
Diet soda, lightly sweetened lemonade, unsweetened iced tea, water
Main dish salad (greens and other fresh veggies, nuts, beans, grilled chicken, light no-sugar-added dressing)
Oatmeal with fruit
Yogurt parfait with fruit

Large or multi-patty burger or crispy chicken sandwich on white bun
Cheese, bacon, mayo, special sauces
French fries or other fried potato side
Milkshake or other frozen dairy beverage or dessert
Salad mix-ins such as fried tortilla strips, croutons, cheese, and heavy dressing containing added sugar
Macaroni, potato, or other salads containing mayo or dressing
Egg sandwiches on English muffin, biscuit, or other bread
One advantage with restaurants like Subway and Quiznos is that you have the option to build your own sandwich, making it easier to select ingredients that are diabetes-friendly and to your liking.
Six-inch grilled chicken, turkey breast, or lean cold cut sub
Sandwich add-ons: lettuce, tomato, onions, pickles, guacamole
Apple or other fresh fruit
Diet soda, unsweetened tea, low-sugar lemonade, water
Subs featuring cheesesteak, meatballs, or other high-fat protein
Mayonnaise, ranch dressing, and rich (potentially sugar-added) sauces
Chips and other fried snacks
Regular soda, sweet iced tea, sweetened fruit drinks
Cookies
In general, poultry is a smart choice while following a diabetes-friendly diet—except when it's breaded or dipped in flour and fried. This version adds not just carbs but saturated fat and calories as well to menu items at restaurants like KFC (Kentucky Fried Chicken) and Popeyes.
Skinless grilled chicken
Green beans
Cole slaw
Fried chicken
Mashed potatoes, mac and cheese
Biscuits
White rice is a staple of Asian cuisines, but it’s a heavy source of carbs. When visiting American Chinese establishments such as Panda Express, focus on vegetables and non-breaded proteins.
Stir fries featuring lean, unbreaded protein and vegetables
Steamed broccoli
Brown rice (small portion)
Deep-fried meats
Egg rolls, fried wontons, dumplings
White rice
Noodles
Tex-Mex fast food has a reputation for featuring deep-fried tortillas with cheesy, greasy ingredients. However, the two most popular restaurants in this category, Taco Bell and Chipotle, offer plenty of diabetes-friendly alternatives. One option: Bowls containing ingredients that would otherwise be folded into a tortilla.
Corn or whole-grain tortillas
Grilled beef, pork, chicken, or fish
Cooked whole beans
Brown rice
Guacamole/avocado
Lettuce, tomato, fresh salsa or pico de gallo

Deep-fried taco shells or double taco shells
Fried meat, poultry, or fish fillings
Refried beans
White rice
Cheese or cheesy sauces
Starbucks, Dunkin', and an array of similar coffee and pastry chains serve a range of items that don't sync up with eating (or drinking) well for those with diabetes: sugary coffee drinks and carb-laden pastries abound. But most also offer options that are safe for people watching their carbs and fat intake.
Regular or decaf coffee, hot or iced, unsweetened or flavored with spices or low-sugar syrup
Breakfast sandwich in a whole-wheat wrap
Sous vide egg bites
"Protein" boxes

Coffee and tea drinks made with sugar or flavored syrup
Bagels
Breakfast sandwiches with biscuits, English muffins, or other bread
Doughnuts and other pastries
This popular lunch and breakfast spot is unique in the breadth of its breakfast and lunch menus—not to mention its bakery items—that are generally off-limits for people with diabetes. But Panera also offers plenty of diabetes-appropriate options.
Mediterranean egg white wrap

Ten vegetable soup, chicken noodle soup
Seasonal greens salad
Mediterranean veggie sandwich (half; remove top slice of bread to reduce carbs further)
Lentil quinoa broth bowl
Spinach and bacon egg souffle
New England clam chowder, broccoli cheddar soup
Toasted Tuscan grilled chicken sandwich
Soba noodle broth bowls
Diabetes Meal Planning. Centers for Disease Control and Prevention.
Ward EM. Happier meals for kids at the drive-thru. EatRight.
Breads,Toppings & Extras. Subway.
Healthy Eating Plate. Asiandiabetesprevention.org.
Santiago-Torres M, Kratz M, Lampe JW, et al. Metabolic responses to a traditional Mexican diet compared with a commonly consumed US diet in women of Mexican descent: a randomized crossover feeding trial. Am J Clin Nutr. 2016;103(2):366-74. doi:10.3945/ajcn.115.119016
DDSMART®. Dunkin'.
Eat Well, Your Way. Panera Bread.
American Diabetes Association. What Can I Eat? Fast Food Tips.
National Institute of Diabetes and Digestive and Kidney Diseases. Carbohydrate Counting & Diabetes.
Pan A, Malik VS, Hu FB. Exporting diabetes mellitus to Asia: the impact of Western-style fast food. Circulation. 2012;126(2):163–165. doi:10.1161/CIRCULATIONAHA.112.115923
University of Michigan Comprehensive Diabetes Center. Diabetes: Tips for Fast Food.
By Elizabeth Woolley
Elizabeth Woolley is a patient advocate and writer who was diagnosed with type 2 diabetes.

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