How To Follow a Diabetic Diet
We know how upsetting a new diagnosis can be and how difficult it is to find trustworthy advice online about what to eat with diabetes. We created this Type 2 Diabetes Playbook to simplify the diabetic diet, provide answers to your questions, and give you endless recipe inspiration to help you enjoy eating balanced and delicious meals.
We are always updating our playbook with new information. Leave us comments below if you have questions that this guide didn’t answer!
Part One: What Can I Eat?
Let’s dive right in.
You’ve recently been diagnosed with Diabetes and your doctor hands you a list of foods that you can and cannot eat, tells you to cut the soda, potatoes and white bread, and encourages you to exercise more.
You’re left feeling like your whole life needs to change with zero guidance on where to start.
Hopefully, your doctor referred you to a Registered Dietitian who is trained to help you understand how to eat well with diabetes. We know that referrals don’t always happen though. And sometimes you need continual guidance outside of the number of sessions your insurance will pay for so we hope that you can use this resource as needed to help you better understand how to eat to better manage your blood sugars.
The Foods List from your Doctor
This list is helpful for identifying foods that have a more favorable effect on your blood sugar. For example, vegetables, proteins and healthy fats don’t spike your blood sugars, while certain carbohydrates like desserts, sweetened beverages, white rice and potatoes typically do.
You may have noticed that individual foods spike your sugars but it’s important to remember that we typically eat meals, not individual foods, and a combination of different foods has a very different effect on your blood sugas. Fruit by itself for example, may spike your sugar higher than eating fruit with nuts. This is because nuts contain protein, fat, and additional fiber that slow down digestion and release sugar into your blood more slowly, preventing those drastic spikes in blood sugar.
Here’s a guide with food lists that help you put meals together.
The Diabetes Plate
You may have seen some version of this plate before.
Remember it. Print it out and hang it on your fridge. Take a screenshot of it and save it in your phone. Use this plate when deciding what to eat and you’ll be well on your way to better managing your blood sugar.
To break it down simply, split your plate in half and fill half of it with non-starchy vegetables; then split the other half into a quarter of complex carbohydrates and a quarter of lean protein. You also want to work in a small number of healthy fats which you can see examples of below.
By choosing foods from a variety of food groups, you get a combination of nutrients that help to slow digestion down, resulting in lower blood sugar readings. We’ll put this into action shortly.
How Many Carbs Can I Have?
The American Diabetes Association recommends eating 45-60 grams of carbohydrates per meal. This is a general recommendation and may be too high for some people. Consider 30-45 grams per meal another option. Use the graphic above as your cheat sheet when building meals and deciding your portions of foods with carbohydrates. The serving sizes listed above (1/3 cup rice or pasta, 1/2 cup fresh fruit, 2 tablespoons dried fruit, etc.) all provide roughly 15 grams of carbohydrate. If you allot yourself 45 grams per meal, you can have three of those servings. Not bad, right?
Because everyone has a different degree of insulin resistance it is helpful to track your blood sugars in relation to your meals so you can see patterns and determine what portion sizes work best for you. For example, if you spike high after eating 1.5 cups of sweet potatoes, you may do better with 3/4 cup. Don’t completely cut foods out because chances are you can tolerate small amounts of them. Not only will cutting these foods out of your diet reduce the variety of vitamins and minerals in your diet, it can also deprive you of foods you really enjoy eating and make your diabetes journey more stressful than it already is.
Here are a couple example meals that follow this plate method:
This method gives you the flexibility to swap foods out to modify meals and recipes to your liking.
For example, let’s say you can’t stand zucchini and corn and would rather have something else on that salad.
Zucchini falls into the non-starchy category so what other non-starchy vegetables could you replace the zucchini with? Asparagus would be good. So would mushrooms or green beans
And what about the corn? Since you already have the chickpeas, a source of complex carbohydrates, you could choose a larger portion of these instead of the corn. Or you could leave the chickpeas alone, and replace the corn with a small serving of fruit on the side or mixed in with the salad. Imagine if you added some spice to that asparagus and shrimp; a small amount of diced pineapple would be a great contrast of flavors.
Your second mission is to experiment with this plate. This isn’t something you will have to reference forever because it will soon become second nature to you and seamlessly weave itself into your food decisions. But you have to consistently put this into practice before you get to that point.
So moving forward, be intentional about balancing your plate. Whenever you eat, include a non-starchy vegetable, a complex carbohydrate, a protein, and a healthy fat.
A Word on Breakfast
Insulin responses are generally better in the morning so you may be able to tolerate a larger amount of carbs at breakfast (up to 60 grams). But like I’ve said, everyone is different so start small and monitor your blood sugar to see what works best for you.
If you’re like most of us and don’t eat vegetables for breakfast, here’s a healthy breakfast plate with examples.
Want More Recipe Ideas?
Check out our recipe archive; we add new recipes every week so sign up for our mailing list and we’ll email them to you every week!
Part Two: Blood Sugar Basics
Understanding how your body turns food into sugar will give you a better sense of direction when it comes time to make food decisions.
Carbohydrates: immediately raise blood sugar
Proteins and Fats: no immediate effect on blood sugar
How your body turns food into blood sugar
Whenever we eat a carbohydrate-rich food, our digestive system breaks it down into the smallest version of a sugar molecule so that it can be passed through the walls of our intestines, into our blood, and delivered to our cells for energy. This smallest version of a sugar molecule is called glucose.
Because high levels of glucose in our blood can be damaging to our blood vessels and organs, our body has a mechanism in place to get that glucose out of our blood and into our cells.
How? Our pancreas. The beta cells of the pancreas to be exact. In response to high blood glucose, our beta cells secrete the hormone insulin which acts as the key to move glucose out of our blood and into our cells, leaving us with normal levels of blood glucose again.
This process of clearing the sugar out of your blood can take anywhere from 1-2 hours which is why your doctor or nurse told you to measure your blood sugar 1 and 2 hours after your meal.
However, if the sugar can’t enter your cells (like in diabetes), it is left to float around in your bloodstream and can cause harm to your blood vessels and organs. The longer your high blood sugar is left untreated (with either medication or diet and exercise) the greater your risk for developing serious complications like kidney failure, blindness, and wounds that can’t heal, leading to amputation.
If you have diabetes, there may be two reasons why it’s difficult for you to manage your blood sugar:
- Your beta cells are not producing enough insulin so some glucose is left to float around in your blood
- Your cells have become resistant to insulin so glucose can’t even get into your cells, and it’s left to float around in the blood
- Or a combination of both
This is why there are different medications available and why sometimes it takes a while to figure out which medications work best for you.
Your Blood Sugar on Carbohydrates
Remember, carbohydrate-rich foods have an immediate effect on your blood sugar. You don’t have to completely cut them out, just scale back on the portion size a bit and choose the right kind of carbohydrates.
It’s important to remember that not all carbs are created equal. Complex carbohydrates (like the ones listed in the diabetes plate graphic) have fiber which slows the absorption of sugar into the blood, causing less drastic spikes in blood sugars.
Fiber is your friend here. This is why sweet potatoes may not spike your sugars as high as white potatoes. And why a meal with pasta, protein AND vegetables may not spike your sugar as high as just pasta and red sauce alone. That fiber from the vegetables slows things down; even more so if you choose whole wheat pasta over white.
Fiber also promotes the growth of healthy gut bacteria which are crucial for reducing inflammation caused by high blood sugars. There is some interesting research to suggest that gut bacteria strongly influences the way our blood sugar responds to different foods and that what raises someone else’s blood sugar may not raise yours (because you have different gut bacteria). Keeping a food and blood sugar journal will help you understand what foods work best for you.
Your Blood Sugar on Protein and Fat
Protein and fat do not have an immediate effect on your blood sugar and may actually help to slow the rise in blood sugar after a meal since they slow digestion and absorption.
However, too much fat (like 35g or higher in one meal) may worsen insulin resistance. The exact mechanism isn’t known but research shows that diets high in fat are associated with insulin resistance.
Refresher: insulin resistance is when your cells are unaffected by the action of insulin so that blood sugar can’t get into the cells and out of the blood. Thinking back, if insulin acts as the key to move sugar out of the blood and into cells, insulin resistance would be like the key no longer fits the lock and can’t open the door anymore. If you have diabetes, you likely already have some amount of insulin resistance and it’s helpful to eat less of those fatty cuts of meat and fried foods.
Research also shows that the type of fat matters. This study showed that people who replaced saturated fats (from animal products) with monounsaturated and polyunsaturated fats (from plant foods) had the greatest reductions in A1C. The fat sources listed on your diabetes plate graphic contain examples of these healthy fats. Try to work small amounts of them into each meal.
What Should my Numbers be?
The American Diabetes Association recommends the following blood sugar targets:
- Before Meals: 70 to 130 mg/dl
- One to two hours after a meal: less than 180 mg/dl
Your nurse or doctor will likely give you a recommended target range in which to keep your blood sugar levels. In this case, follow your medical team’s advice. If you are having trouble achieving your recommended targets, visit your doctor and dietitian to modify your plan. Sometimes medication dosages need to be changed, or maybe you need a fresh perspective on diet changes that you haven’t yet considered.
Your Hemoglobin A1C is a number that indicates your average blood sugar levels over 3 months and is a more accurate picture of how well your blood sugar is managed. Your doctor may want you to go back and get new lab work every three-to-six months to see if you’ve been able to reduce your A1C.
|Normal||below 5.7 percent|
|Prediabetes||5.7 to 6.4 percent|
|Diabetes||6.5 percent or above|
*National Institutes of Diabetes and Digestive and Kidney Diseases
If you have not yet been put on medications, focus really hard these next few months to make some lifestyle changes that can help you get that A1C down and keep it down. It is possible to avoid medications and control this thing with diet and exercise.
Part Three: Move Your Body
Since this guide is about eating, I won’t go into detail about exercise but I do want to leave you with these two golden nuggets:
- Exercise makes your cells more sensitive to insulin and makes it easier to clear sugar from your blood, giving you better blood sugar readings. It’s powerful stuff. This is why your doctor recommends that you exercise.
- Find an exercise that you actually enjoy and find your “why” for doing it. When you do an exercise you actually enjoy, you will be more likely to stick with it long term and it won’t feel so much like a chore. People spend lots of money on gym memberships, workout clothes, and running shoes because they think it will make them exercise more; but if you hate going to the gym, there’s no workout apparel that can fix that. There are plenty of enjoyable ways to exercise; take a brisk walk around the neighborhood or on your lunch break, take a dance class, swim, play with your kids or grandkids in the yard. If your job keeps you up and moving most of the day – this is great too! The point is to reduce your sitting time and add more movement – any movement – to your day. Your “why” is what motivates you to get moving every day. Find your motivation and hold on to it.
Join Our Free Live Cooking Program
Cooking your meals at home is the best way to ensure that you’re eating nutritious foods in the appropriate amounts. Every week on our Facebook page we have four live cooking shows where you can join us in your kitchen and cook along with us to learn a new healthy recipe and tips for managing your blood sugars. Since the cooking shows are live, you can ask our Registered Dietitians whatever nutrition questions you have.
Cook With Me TV is founded and supported by a network of Registered Dietitian Nutritionists. The materials and content contained on this site (CookWithMe.TV) are for general educational purposes only and are not intended to be a substitute for professional medical advice, diagnosis or treatment. Always consult with your physician and dietitian before beginning or modifying any diet, exercise or lifestyle program. The use of any information provided on this site is solely at your own risk.