Barbie Cervoni MS, RD, CDCES, CDN, is a registered dietitian and certified diabetes care and education specialist.
Do-Eun Lee, MD, has been practicing medicine for more than 20 years, and specializes in diabetes, thyroid issues and general endocrinology. She currently has a private practice in Lafayette, CA.
Because certain foods, such as carbohydrates, directly impact your blood sugars, your diet is one of the most important factors in managing diabetes. Carbohydrates are found in foods such as grains, fruit, dairy, legumes, and sweets.
When metabolized carbohydrates turn into sugar (glucose), which is the body's primary source of energy, insulin, a hormone produced by the pancreas, takes glucose from the bloodstream to the cells to use for energy.
When you have diabetes, managing blood sugar can be difficult either because your pancreas isn’t making enough insulin or the insulin it makes isn’t being used efficiently. Learning how to eat a balanced, modified carbohydrate diet can help you lose weight if you need to and better manage your blood sugars. Use a glucometer to monitor your blood sugar at home.
A balanced carbohydrate diet can mean reducing carbohydrate intake, counting carbohydrates, or eating a consistent carbohydrate diet. There are many types of meal plans that can help you lose weight. Spend some time understanding some of the best ways to eat for diabetes to get you jump started.
Educate yourself as much as you can about nutrition. Learn about what foods you can eat, what foods you should limit, when you should eat, and how to portion control your food.
Please note that exact portions differ from person to person based on calorie needs, weight, etc. Here are some great ways to get started.
The plate method is an easy way to portion control your food without having to directly count your carbohydrates. Its emphasis is on increasing non-starchy vegetables, whole grains, and lean protein.
The plate method can help you increase fiber intake. Fiber-rich foods can help slow down how quickly your blood sugars rise. Eating a high-fiber diet may also help you to lose weight because high-fiber foods are metabolized at a slower pace, which helps you to feel full.
Feeling full more quickly can help to reduce your calorie intake and aid in weight loss. High-fiber foods are also often rich in vitamins and minerals, which boosts your nutrition.
To practice the plate method, simply divide your plate into three. Make half your plate non-starchy vegetables, such as salad, broccoli, string beans, cauliflower, tomatoes, etc.
Dedicate a quarter of your plate to lean protein, such as roasted chicken, grilled or baked fish, or lean meat like sirloin steak. Your portion of protein should be about 3 to 4 ounces (the size of a deck of cards, or the palm of your hand).
Lastly, make a quarter of your plate a complex carbohydrate, such as whole grains like quinoa, brown rice, barley, a starchy vegetable like baked sweet potato, or a legume like chickpeas, or black beans. Your portion should be about 1 cup or about a fist full.
You can add some healthy fat to your meal, such as a serving of avocado or olive oil when cooking. A serving of oil is about 1 teaspoon and a portion of avocado is about a quarter of an avocado.
Depending upon your calorie needs, you may be able to increase your intake of fats, too. If you are still hungry after this meal, have another helping of non-starchy vegetables. Be sure to eat slowly and enjoy your food.
When you have diabetes, you must manage your carbohydrate intake because carbohydrates are the types of foods that impact blood sugar the most. A consistent carbohydrate diet means that you eat about the same amount of carbohydrates at the same time daily.
This doesn't mean you have to eat the same foods daily, but that you aim to eat the same amount of carbohydrates for each meal. For example, if you are instructed to eat 45g of carbohydrates for breakfast and lunch, 15g of carbohydrates for a snack, and 60g of carbohydrates for dinner, you want to try to stick to that daily.
Eating a consistent carbohydrate diet can help to keep your blood sugars steady and prevent fluctuations. For example, if you eat a small amount of carbohydrates for breakfast one day and then have a heavy carbohydrate meal for breakfast the next day, your blood sugars will likely spike. Being consistent helps to keep your blood sugars steady.
If you follow this type of diet, you’ll need to be carbohydrate savvy. You’ll have to be a good carbohydrate counter, know where hidden carbohydrates reside, and have some good carbohydrate counting tools.
Limiting certain types of food applies to all people who have diabetes. And quite honestly, even if you don't have diabetes, limiting these types of foods is part of healthy eating. Certain types of refined, processed carbohydrates, like white bread, pasta, juice, sweets, cake, and candy, can increase blood sugars rapidly. In addition, they contain very little nutrition and are rich in calories that can cause weight gain.
While many people with diabetes believe they can’t eat fruit, fresh, whole fruit, such as berries, can be part of a diabetes diet. The portion of fruit and how you eat fruit should be carefully considered.
Aim to avoid fruit juice altogether unless your blood sugar is low. Try to keep your fruit servings to about 2-3 per day and consider avoiding certain types of fruit like dried fruit and grapes, which can raise blood sugars quickly.
Replace white bread, pasta, and bagels for whole grains such as whole-grain bread or whole-grain pasta. These changes can help to regulate your blood sugar, increase your fiber intake, and boost your nutrition. K
eep in mind that, although you've swapped refined carbohydrates for whole grains, portions still matter. For example, if you swap your sugary cereal for oatmeal in the morning, that doesn't mean you can eat unlimited amounts. The portion of carbohydrates still matters both for calorie control and blood sugar control.
The quantity of carbohydrates is just as important as the quality of carbohydrates when it comes to managing diabetes. The amount of carbohydrates you need per day can be determined based on your weight, activity level, calorie needs, and how your body responds to carbohydrates.
Discuss with your diabetes educator how many carbohydrates you need per day, so that you can portion control your grams of carbohydrates throughout the day. If you are not interested in carbohydrate counting or you find it too complicated, aim to practice the plate method.
One serving of carbohydrates is about 15g. That doesn't mean you are limited to 15g per meal, but we use 15g as a reference point. Most people can have about 45g of carbohydrates per meal. Some people benefit from eating less carbohydrates, while others may need more if they are more active or require a higher calorie intake.
Depending on whether you are using the exchange method (an older method for carbohydrate counting) or counting carbohydrates in total grams, your diabetes educator can teach you how to count portions of carbohydrates or total grams.
Eating a balanced diet also means controlling your portions of foods that do not contain carbohydrates, especially if you are trying to lose weight. If you reduce your carbohydrate intake and start to eat endless amounts of cheese (because it is low-carb), odds are you won't lose weight.
Here are some portions:
The American Diabetes Association suggests that people with diabetes receive individualized meal plans based on their likes/dislikes, culture, lifestyle, weight, education level, etc.
Meeting with a registered dietitian or certified diabetes educator is a great way to help you understand carbohydrates and a healthy diabetes diet. They can provide you with an individualized meal plan and the tools you need to get you started on making good food choices. If you are unable to meet with someone, approach your new way of eating in small steps.
If you are feeling overwhelmed with all this information, start small. Head to the food store and pick up some healthy items. If you don’t have healthy foods in the house, you won’t be able to put together healthy meals.
Secondly, get rid of your temptations. You can't control what surrounds you on the outside, but you can control what is in your home. Toss the cookies, cake, juice, and chips. If it's not there, you can't have it.
If you want to indulge from time-to-time, make it an outing. Go out for ice cream after a walk. You'll appreciate it more. You'll be surprised at how much you will enjoy your new way of eating and how surprised you'll be at the way you used to eat. Be patient, though. It takes time to create new habits.
Remember that any change you can make is worth your effort. Even the smallest change can help to improve your energy and blood sugar. Make realistic goals for yourself. For example, if you are used to eating a doughnut and sugary coffee for breakfast, switch to whole-wheat English muffin with peanut butter and reduce the sugar in your coffee.
The next week, focus on lunch—add vegetables to your sandwich or pack a small baggy of cut-up vegetables. After another week or so, decide to make dinner two nights per week and practice the plate method. Once you start to feel better, you'll want to continue to make changes.
Think about it: What you eat is a major part of your everyday life. We are constantly being tested to make healthy choices. Whether you decide to follow a consistent carbohydrate diet, practice the plate method, or simply reduce your portions of carbohydrates and make better food choices, you must decide that your new mantra is to eat healthfully.
A diabetes “diet” is not a temporary thing. By making small, realistic goals for yourself, you can be successful in losing weight and reducing your blood sugars, cholesterol, and blood pressure. Adjusting to a new way of eating takes some time, and you may slip once in a while. It’s OK. Allow yourself to make some mistakes and move on.
As with anything new, sometimes we need help. Don’t hesitate to contact your certified diabetes educator or registered dietitian if you need help. They are the experts and they are there to help you. You can also use online resources, such as Verywell for inspiration, tips, and more education.
If you are looking for more information, consider finding someone else who has diabetes for motivation and inspiration. You can always look to the American Diabetes Association for help or dLife.com for an online way to meet others with diabetes.
Eating a healthy diet is one of the most important ways to manage diabetes. While it may seem difficult, it is controllable. And today we are not only bombarded with unhealthy food preferences, but we are also inundated with healthy ones. America has jumped on the healthy eating bandwagon. Utilize all the resources you have at hand. Set small, tangible goals, and embrace all your wins. You can eat healthy and enjoy it too.
There are no off-limit foods for people with diabetes. However, carbohydrates have an impact on blood sugar, and people with diabetes usually need to watch their carbohydrate intake.
Yes. In fact, people with diabetes need fast-acting sugar to treat hypoglycemia. Sugar quickly raises blood glucose levels. However, when blood sugar is not low, people with diabetes should limit their sugar intake.
A balanced, portion-controlled diet with a focus on non-starchy vegetables, lean protein, whole grains, and healthy fats is recommended for people with type 2 diabetes.
American Diabetes Association. Key takeaways from ADA's Nutrition Consensus Report.
American Diabetes Association. Get to know carbs.
American Diabetes Association. What is the Diabetes Plate Method?
Barbie Cervoni MS, RD, CDCES, CDN, is a registered dietitian and certified diabetes care and education specialist.
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