Millions—in fact, about 31 to 32 million—of Americans have type 2 diabetes, according to the Centers for Disease Control and Prevention (CDC). Most often, this chronic disease affects people older than age 45, but that doesn’t mean younger folks or even children can’t develop it. It’s more common in people who are overweight or obese.
When you have type 2 diabetes, the cells in your body don’t respond normally to insulin. As a result, glucose (sugar) from your food can’t enter your cells. (This is known as insulin resistance.) It builds up in the blood instead. Sensing high levels of sugar in your blood, your pancreas makes more insulin. But your cells still don’t respond to the insulin, and your blood sugar level continues to rise. When your blood sugar gets high enough, it’s considered type 2 diabetes.
How does type 2 diabetes affect nutrition?
Living with type 2 diabetes affects the way your body makes use of macronutrients. “Type 2 diabetes primarily impacts the way the body processes carbohydrates,” says Shannon Leininger, RD, a diabetes care and education specialist in Las Vegas.
With a healthy pancreas, the process goes like this: You eat foods with carbohydrates, which are broken down into sugar in the body. The sugar enters the bloodstream, and the body responds by releasing insulin. The insulin helps move the sugar out of the bloodstream and into the body’s cells to be used as fuel.
“In someone with diabetes, the body does not produce enough insulin—so the sugar stays in the bloodstream,” Leininger explains. “This is a problem because having too much sugar in the bloodstream is very damaging to the body.”
How does type 2 diabetes affect overall health?
Having type 2 diabetes puts you at risk for a multitude of other conditions, including heart disease, kidney disease, neuropathy, and vision loss. “Poor blood glucose control can also damage the heart, eyes, nerves, and organs—including sex organs,” says Jonathan Valdez, RDN, a diabetes care and education specialist and spokesperson for the New York State Academy of Nutrition and Dietetics. Yup, erectile dysfunction can, unfortunately, be a side effect of type 2 diabetes.
All of these related conditions occur because high blood sugar, over time, damages parts of the body, like the blood vessels and nerves.
In addition to medication, one of the best things you can do to manage your blood sugar levels is to follow a healthy diet.
What can I eat with type 2 diabetes?
When it comes to eating with type 2 diabetes, “the main goal is to maintain good blood sugar balance,” says Vandana Sheth, RDN, a diabetes care and education specialist and author of My Indian Table: Quick & Tasty Vegetarian Recipes. The good news: “You can enjoy your favorite foods and still manage your blood sugar,” she says.
There’s no one-size-fits-all type 2 diabetes diet. But here’s standard diabetes nutrition guidance: Pair carbohydrates with fiber, protein, and healthy fats to minimize quick spikes in blood sugar. And when possible, choose complex carbohydrates over refined carbs like white rice, white-flour pasta, and white bread.
Aim to add veggies to every meal; non-starchy foods like green beans and asparagus have fewer carbs than potatoes, carrots, or corn and therefore won’t raise your blood sugar as much. Drink plenty of water (dehydration can lead to higher blood sugar levels), and eat foods rich in omega-3 fats—salmon and sardines, for example—to boost your heart health.
Some people with diabetes find that frequent small meals (say, every three to five hours) help them control their blood sugar and maintain a healthy weight.
Monitor carbohydrate intake
This is of extreme importance: “Carbohydrates have the biggest and fastest effect on blood sugar,” says Sheth. “In general, I encourage my clients to enjoy around 30 grams carbs at meals and to try to limit carbs to 15 grams at snack time.”
The number of carbs you’ll eat per meal depends on factors such as your blood sugar goals, activity level, medications, age, and size. A doctor or registered dietitian can help you determine a number that’s best for you. Some people, for instance, eat as many as 60 grams of carbohydrate at mealtime, notes Erin Palinski-Wade, RD, author of 2 -Day Diabetes Diet: Diet Just Two Days a Week and Dodge Type 2 Diabetes.
Maintain a healthy weight
Being overweight or obese raises your risk for type 2 diabetes. Once you have the condition, overweight and obesity make it harder to manage. One way to keep your blood sugar in your goal range is to stick to a healthy weight. A registered dietitian can help you determine a meal plan that helps you drop pounds or maintain a reduced weight.
Diabetes-friendly plate sample
Sheth advises making this diabetes-friendly plate at mealtime:
- A half plate of non-starchy vegetables, like broccoli, brussels sprouts, and leafy greens
- A quarter of a plate (3 to 4 ounces) of lean protein, such as salmon, tofu, or chicken breast
- A quarter of a plate of whole grains or starchy vegetables, like brown rice, quinoa, whole-grain pasta, or sweet potato
- 1 to 2 teaspoons of heart-healthy oil (such as olive oil), a quarter avocado, 2 tablespoons nuts, or ¼ cup seeds
Best breakfast foods for type 2 diabetes
When it comes to breakfast with type 2 diabetes, don’t skimp on carbs. “I do recommend having a carbohydrate at each meal to help promote steady energy and blood sugar levels,” says Palinski-Wade. “Since insulin resistance can peak in the morning, make sure that the carbohydrates at breakfast are slowly digested and matched with a serving of protein and/or healthy fat.” This will lead to a smaller spike in blood sugar than refined grains or sugar-packed breakfast goods.
A lot of breakfast foods are desserts in disguise (we see you, Pop Tarts and coffee cake), but there are plenty of foods that offer great nutritional benefits. Let’s look at a handful of them:
“These contain a specific type of soluble fiber called beta-glucan, which has been shown to be effective at reducing unhealthy [low-density lipoprotein] LDL cholesterol levels,” says Palinski-Wade. “This is beneficial for people with diabetes, who have a greater risk of heart disease. Lowering LDL cholesterol may lower heart disease risk. In addition, the soluble fiber in oats may have a positive impact on blood sugar.” Plus, oat intake has been found to significantly reduce A1C levels (average blood sugar level over two to three months) and fasting blood sugar levels, according to a 2015 study in Nutrients.
Some people with diabetes notice higher blood sugar after eating oatmeal, so be sure to test your levels to monitor your body’s reaction. If your number spikes, consider the ingredients in your oats. Many instant varieties are packed with sugar.
“Adding cinnamon to your next meal may benefit blood sugar,” says Palinski-Wade. “Cinnamon has been found to help improve insulin sensitivity while also slowing down the breakdown of carbs in the digestive tract. This may help slow the rise in blood sugar following a meal.” If you’re not a fan of cinnamon with food, stir it into your coffee or tea.
Keep in mind, though, that research on cinnamon’s effect is small, and many experts don’t consider it useful in managing blood sugar.
“To build a healthy plate for people with diabetes, choose healthy fats in small amounts,” says Toby Amidor, RD, author of The Create Your Plate Diabetes Cookbook: A Plate Method Approach to Simple, Complete Meals. “Avocados provide healthy fats that can help slow absorption of sugar into your bloodstream after eating. People with diabetes also have a higher risk of cardiovascular disease, and avocados provide heart-healthy monounsaturated fats.”
Some breakfast ideas:
- Smoothie: ¾ cup Greek yogurt, 1 cup frozen berries, and ½ avocado
- Omelet made with 2 eggs and 1 slice cheese, paired with 1 cup sauteed spinach and 1 slice whole-grain toast
- Greek yogurt parfait made with 6 ounces Greek yogurt, ¾ cup berries, and 2 tablespoons chopped nuts
Best lunch and dinner foods for type 2 diabetes
For lunch and dinner, diabetes experts recommend the same plate formula that you’ll follow for breakfast. “Try to balance each carb serving with a serving of a protein or a fat,” says Palinski-Wade.
And don’t forget those veggies! “Filling half your plate with non-starchy vegetables such as broccoli and peppers provides low-calorie options packed with nutrients,” says Heather Shasa, RDN, a diabetes care and education specialist who practices virtually. “Some of these include potassium and magnesium, which may help reduce blood pressure.”
If you’re using canned vegetables, rinse them with water to decrease the sodium content by about 40 percent, adds Wendy Kaplan RDN, a registered dietitian specializing in oncology, weight management, and diabetes in New York City.
When you have type 2 diabetes, many ingredients are particularly beneficial to include in meals:
“Eating fatty fish like salmon and tuna is great for people with diabetes,” says Lisa Young, RDN, author of Finally Full, Finally Slim: 30 Days to Permanent Weight Loss One Portion at a Time. “Not only are the omega 3-fatty acids found in fatty fish good for your heart, it turns out that salmon and other fatty fish may also help with glucose regulation. As a bonus, salmon is rich in protein, which helps stabilize blood sugar.”
“Olive oil has been shown to help improve A1C levels and fasting plasma glucose levels of people with diabetes,” says Andrea Goergen, RD, a registered dietitian in the Washington, D.C. area. In fact, a 2017 review study in Nutrition & Diabetes linked eating olive oil with lower A1C levels in people with type 2 diabetes and less risk of the condition in those without. “As a bonus, the healthy fat makes you feel fuller and more satisfied,” adds Goergen.
“These offer a quality source of protein and fiber,” says Mary Ellen Phipps, RD, author of The Easy Diabetes Cookbook: Simple, Delicious Recipes to Help You Balance Your Blood Sugars. “Protein and fiber both help you feel fuller longer and promote stable post-meal blood sugars. And you don’t have to just rely on dry or canned beans. So many shelf-stable products from pasta to chips are now made with everything from black beans to chickpeas!”
Some lunch and dinner ideas:
- Sandwich on 2 slices of whole-grain bread with 2 ounces chicken breast, sliced non-starchy veggies, and 1 tablespoon pesto sauce
- 3-4 ounces chicken breast, ½ cup baked sweet potato, and 1-2 cups sauteed zucchini
- 1 cup tofu with 2/3 cup brown rice and 2 cups stir-fried veggies
- 3-4 ounces salmon with 1 cup whole-wheat pasta and 1 cup roasted broccoli
Best snack foods for type 2 diabetes
When you have diabetes, it’s not a good idea to snack on just a handful of crackers. As with meals, you’ll want to pair whole grain sources of carbohydrates with protein or healthy fat. This helps promote a slow release of sugar into the bloodstream for steady blood sugar as well as sustained energy throughout the day, says Palinski-Wade.
“These make a terrific snack choice for people with diabetes, since they are rich in plant-based protein, along with healthy unsaturated fat and fiber,” says Palinski-Wade. “You get a trio of nutrients to help you stay feeling satisfied, without adding additional carbohydrates to your meal.”
She points to research published in PLoS One, which found a link between eating tree nuts (walnuts, almonds, pistachios, etc.) with improvements in blood sugar for people with diabetes. Eating an average of 2 ounces of nuts daily reduced fasting blood sugar levels, along with A1C levels.
Nuts also help protect against heart disease, which people with type 2 diabetes are at a greater risk of, adds Lacy Ngo, RDN, author of The Nourishing Meal Builder: How to Create Meals That Promote Health, Happiness & Healing.
“Raspberries are lower in sugar than many other fruits and are a good source of fiber,” says Palinski-Wade.
A randomized, controlled trial published in the journal Obesity found that when 32 adults with prediabetes ate 2 cups of red raspberries along with a high-carb meal, their post-meal insulin and blood sugar levels were significantly lower than it was in those who ate the high-carb meal without raspberries.
“Studies have shown that black tea containing the antioxidant polyphenol can decrease blood sugar following a meal,” says Kara Lydon, RD, a Boston-based registered dietitian. “And experimental studies have shown that tea may improve insulin resistance.”
Early research suggests drinking black tea may help lower inflammation in the body (which contributes to diabetes), as researchers reported in a review study in the journal Antioxidants. “Although the mechanism behind this is unclear, some studies suggest that the extracts of black tea may interfere with carbohydrate absorption,” adds Lydon.
While black tea’s effect on diabetes is still only experimental and requires further research, there’s another benefit to the drink. It’s a good alternative to sugary juices and sodas that can increase blood sugar and lead to weight gain.
Some snack ideas:
- 1 small apple with 2 tablespoons walnuts
- 6 whole-grain crackers with 1 slice of cheese
- ½ homemade healthy energy bar
- ¾ cup baby carrots with 2 tablespoons hummus
Best dessert foods for type 2 diabetes
The very, very good news: You can still eat dessert if you have diabetes! “However, the more you reduce added sugars in the diet, the better it is for blood glucose management,” says Palinski-Wade. “When making dessert, try incorporating healthy swaps that can improve glucose response after the meal, such as using pureed fruit in replacement of added sugar and using whole-grain flour over refined flour.”
Some dessert ideas:
- 1 serving nice cream made with frozen banana and unsweetened cocoa powder
- 1 avocado brownie made with prunes
- 1 chocolate almond butter protein ball
- ½ portion chocolate chip vegan cookie dough
Foods to limit with type 2 diabetes
Also good news: Not too many foods are off-limits when you have diabetes. “There aren’t too many foods I would recommend completely avoiding,” says Leininger. “Certainly, there are foods that have more nutrients that I would suggest including more of. But in a healthy eating plan for type 2 diabetes, all foods can fit.”
Balance is the name of the game. If tonight’s dessert is higher in carbs, cook a lower-carb dinner.
The only foods to completely avoid: ones with trans fats. You can tell a food contains trans fats if an ingredient label lists partially hydrogenated oils. Trans fats are detrimental to health.
Limit foods with added sugars. These include candy, cookies, and ice cream. “Beyond the more obvious culprits, look for sugars that may be lurking in your foods by reading food labels,” says Caroline Thomason, RD, a diabetes care and education specialist in Warrenton, Virginia. “The added sugar content will be listed underneath ‘total carbohydrate.'”
According to the Dietary Guidelines, aim to get no more than 10 percent of your total daily calories from sugar. For the average person, this is equivalent to about 10 to 15 grams per meal, most.
You should also limit alcohol to one drink per day for women and two drinks per day for men. In addition to lowering the risk of high blood pressure and cancer, per the CDC, capping alcohol consumption at this amount is a good idea because alcohol consumption may cause delayed low blood sugar in people taking insulin, says Valdez.
Foods high in fat
Other foods to limit include ones high in fat, like French fries, foods high in saturated fat like beef and lamb, and processed red meat. Saturated fat plays a role in cardiovascular disease, which people with diabetes are at greater risk of developing.
Look for ways to replace these items with healthier alternatives. If you’re craving traditional bacon, for example, salmon bacon is a much heart-healthier choice.