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Diabetes and Nutrition

Last Updated January 2024 | This article was created by familydoctor.org editorial staff and reviewed by Robert "Chuck" Rich, Jr., MD, FAAFP

People who have diabetes have too much sugar in their blood. Managing diabetes means managing your blood sugar level. What you eat is closely connected to the amount of sugar in your blood. The right food choices will help you control your blood sugar level.

Path to improved health

Eating well is one of the primary things you can do to help control diabetes.

Do I have to follow a special diet?

There isn’t one specific diabetes diet. Your doctor can work with you to design a meal plan. A meal plan is a guide that tells you what kinds of food to eat at meals and for snacks. The plan also tells you how much food to have. For most people who have diabetes (and those without), a healthy diet consists of:

  • 40% to 60% of calories from carbohydrates
  • 20% calories from protein
  • 30% or fewer calories from fat

Your diet should also be low in cholesterol, low in salt, and low in added sugar.

Can I eat any sugar?

Yes. In recent years, doctors have learned that eating some sugar doesn’t usually cause problems for most people who have diabetes—if it is part of a balanced diet. Just be careful about how much sugar you eat and try not to add sugar to foods.

What kinds of foods can I eat?

In general, at each meal you may have:

  • 2 to 5 choices (or up to 60 grams) of carbohydrates
  • 1 choice of protein
  • A certain amount of fat

Talk to your doctor or dietitian for specific advice.

Carbohydrates are found in fruits, vegetables, beans, dairy foods, and starchy foods such as breads. Try to have fresh fruits rather than canned fruits, fruit juices, or dried fruit. You may eat fresh vegetables and frozen or canned vegetables. Condiments such as nonfat mayonnaise, ketchup, and mustard are also carbohydrates.

Protein is found in meat, poultry, fish, dairy products, beans, and some vegetables. Try to eat poultry and fish more often than red meat. Don’t eat poultry skin. Also, trim extra fat from all meat. Choose nonfat or reduced-fat options when you eat dairy, such as cheeses and yogurts.

Not all fats are bad. It is important to know the differences between fats. Unsaturated fats are the “good” fats (nuts, fish, olive oil, canola oil, seeds, etc.). Saturated fats are less healthy. You should limit these in your diet. They include red meats, butter, lard, full-fat dairy products, dark-meat poultry, etc. Trans fats are the worst fats for you. These fats can be found in processed foods like crackers, snack foods, and most fast foods. To identify trans fats, check food labels for the words “partially hydrogenated.”

Your doctor or dietitian will tell you how many grams of fat you may eat each day. When eating fat-free versions of foods (such as mayonnaise and butter), check the label to see how many grams of carbohydrates they contain. Keep in mind that these products often have added sugar.

What is the exchange list?

The exchange list is a tool to help you plan healthy meals and snacks. To add variety to your diet, you can substitute certain foods for other foods in the same group. Some examples are listed here.

Food group You can have… Or exchange it for…
Fruit (each serving contains about 15 grams carbohydrates) 1 small or medium piece of fresh fruit 1/2 cup fruit juice, or canned or chopped fruit
Vegetable (each serving contains about 5 grams carbohydrates) 1 cup raw vegetables 1/2 cup cooked vegetables or vegetable juice
Starch (each serving contains about 15 grams carbohydrates) 1 slice or ounce bread 1/2 cup pasta, cereal, starchy vegetable
Sugar, honey, molasses 1 teaspoon 4 grams carbohydrates
Milk (does not include cream, yogurt or cheese) 1 cup of cow’s milk (lowfat) 12 grams carbohydrates and 8 grams protein
Meat 1 ounce meat, fish, poultry, cheese or yogurt 1/2 cup dried beans
Fat (includes nuts, seeds and small amounts of bacon and peanut butter) 1 teaspoon oil, butter or margarine 5 grams fat

Things to consider

If you don’t manage your diabetes, you are putting yourself at risk for many other health problems. The best way to manage diabetes is through diet, exercise, and sometimes medication. Poor diabetes management over time can lead to kidney disease and heart disease. It also can damage your eyes and nerves. It can cause skin tissue problems, especially on your feet and legs.

An important part of managing your diabetes is monitoring your blood sugar level. It’s easy to do this yourself either through a blood glucose monitor or a continuous glucose monitoring system. Your doctor can help you decide which method is best for you.

If you are unable to control your blood sugar through diet and exercise, talk to your doctor. It may mean that you need medication to help in your diabetes management. Some signs of uncontrolled high blood sugar include:

  • Blurry vision
  • Unquenchable thirst
  • Unexplained weight loss
  • Dizziness or being light-headed
  • Nausea
  • Being more fatigued than normal for no obvious reasons

Questions to ask your doctor

  • If I have type 2 diabetes, can I manage it with diet and exercise alone?
  • If I take medicine to control my blood sugar, do I really need to diet and exercise?
  • Can I still go out to eat when I have diabetes?
  • Am I healthy enough to begin an exercise routine?
  • What kinds of exercises should I do?
  • If I exercise, can I have more high-fat foods?
  • Where can I learn more about eating right?

Resources

American Diabetes Association: Nutrition

American Heart Association: Healthy for Good

Centers for Disease Control and Prevention: Diabetes

 

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