Prevention and Management of Type 2 Diabetes: Dietary Components and Nutritional Strategies

1. International Diabetes Federation. [accessed January 30, 2014];IDF Diabetes Atlas. (6). 2013 http://www.idf.org/diabetesatlas.

2. Hu FB. Globalization of diabetes: the role of diet, lifestyle, and genes. Diabetes Care. 2011;34(6):1249–57. [PMC free article] [PubMed] [Google Scholar]

3. Popkin BM, Adair LS, Ng SW. Global nutrition transition and the pandemic of obesity in developing countries. Nutr Rev. 2012;70(1):3–21. [PMC free article] [PubMed] [Google Scholar]

4. Ezzati M, Riboli E. Behavioral and dietary risk factors for noncommunicable diseases. N Engl J Med. 2013;369(10):954–64. [PubMed] [Google Scholar]

5. Hu FB. Obesity epidemiology. New York, New York: Oxford University Press; 2008. Metabolic consequences of obesity; pp. 149–73. [Google Scholar]

6. Hu FB, Manson JE, Stampfer MJ, et al. Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. N Engl J Med. 2001;345(11):790–7. [PubMed] [Google Scholar]

7. Vazquez G, Duval S, Jacobs DR, Jr, Silventoinen K. Comparison of body mass index, waist circumference, and waist/hip ratio in predicting incident diabetes: a meta-analysis. Epidemiol Rev. 2007;29:115–28. [PubMed] [Google Scholar]

8. Knowler WC, Barrett-Connor E, Fowler SE, et al. Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin. N Engl J Med. 2002;346(6):393–403. [PMC free article] [PubMed] [Google Scholar]

9. Tuomilehto J, Lindström J, Eriksson JG, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001;344(18):1343–50. [PubMed] [Google Scholar]

10. Pan XR, Li GW, Hu YH, et al. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and Diabetes Study. Diabetes Care. 1997;20(4):537–44. [PubMed] [Google Scholar]

11. Ramachandran A, Snehalatha C, Mary S, Mukesh B, Bhaskar AD, Vijay V. The Indian Diabetes Prevention Programme shows that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1) Diabetologia. 2006;49(2):289–97. [PubMed] [Google Scholar]

12. Risérus U, Willett WC, Hu FB. Dietary fats and prevention of type 2 diabetes. Prog Lipid Res. 2009;48(1):44–51. [PMC free article] [PubMed] [Google Scholar]

13. Hu FB, van Dam RM, Liu S. Diet and risk of type II diabetes: the role of types of fat and carbohydrate. Diabetologia. 2001;44(7):805–17. [PubMed] [Google Scholar]

14. Halton TL, Liu S, Manson JE, Hu FB. Low-carbohydrate-diet score and risk of type 2 diabetes in women. Am J Clin Nutr. 2008;87(2):339–46. [PMC free article] [PubMed] [Google Scholar]

15. Tinker LF, Bonds DE, Margolis KL, et al. Low-fat dietary pattern and risk of treated diabetes mellitus in postmenopausal women: the Women’s Health Initiative randomized controlled dietary modification trial. Arch Intern Med. 2008;168(14):1500–11. [PubMed] [Google Scholar]

16. Salmerón J, Hu FB, Manson JE, et al. Dietary fat intake and risk of type 2 diabetes in women. Am J Clin Nutr. 2001;73(6):1019–26. [PubMed] [Google Scholar]

17. Wu JH, Micha R, Imamura F, et al. Omega-3 fatty acids and incident type 2 diabetes: a systematic review and meta-analysis. Br J Nutr. 2012;107(Suppl 2):S214–S27. [PMC free article] [PubMed] [Google Scholar]

18. Hauner H, Bechthold A, Boeing H, et al. Evidence-based guideline of the German Nutrition Society: carbohydrate intake and prevention of nutrition-related diseases. Ann Nutr Metab. 2012;60(Suppl 1):1–58. [PubMed] [Google Scholar]

19. Schulze MB, Schulz M, Heidemann C, Schienkiewitz A, Hoffmann K, Boeing H. Fiber and magnesium intake and incidence of type 2 diabetes: a prospective study and meta-analysis. Arch Intern Med. 2007;167(9):956–65. [PubMed] [Google Scholar]

20. Bhupathiraju SN, Tobias DK, Malik VS, et al. Glycemic index, glycemic load, and risk of type 2 diabetes: results from 3 large US cohorts and an updated meta-analysis. Am J Clin Nutr. 2014 Under revision. [PMC free article] [PubMed] [Google Scholar]

21. Dong J-Y, Xun P, He K, Qin L-Q. Magnesium intake and risk of type 2 diabetes: meta-analysis of prospective cohort studies. Diabetes Care. 2011;34(9):2116–22. [PMC free article] [PubMed] [Google Scholar]

22. Zhao Z, Li S, Liu G, et al. Body iron stores and heme-iron intake in relation to risk of type 2 diabetes: a systematic review and meta-analysis. PLoS ONE. 2012;7(7):e41641. [PMC free article] [PubMed] [Google Scholar]

23. Song Y, Wang L, Pittas AG, et al. Blood 25-hydroxy vitamin D levels and incident type 2 diabetes: a meta-analysis of prospective studies. Diabetes Care. 2013;36(5):1422–8. [PMC free article] [PubMed] [Google Scholar]

24. Mitri J, Muraru MD, Pittas AG. Vitamin D and type 2 diabetes: a systematic review. Eur J Clin Nutr. 2011;65(9):1005–15. [PMC free article] [PubMed] [Google Scholar]

25. Aune D, Norat T, Romundstad P, Vatten LJ. Whole grain and refined grain consumption and the risk of type 2 diabetes: a systematic review and dose–response meta-analysis of cohort studies. Eur J Epidemiol. 2013;28(11):845–58. [PubMed] [Google Scholar]

26. Hu EA, Pan A, Malik V, Sun Q. White rice consumption and risk of type 2 diabetes: meta-analysis and systematic review. BMJ. 2012:344. [PMC free article] [PubMed] [Google Scholar]

27. Pan A, Sun Q, Bernstein AM, et al. Red meat consumption and risk of type 2 diabetes: 3 cohorts of US adults and an updated meta-analysis. Am J Clin Nutr. 2011;94(4):1088–96. [PMC free article] [PubMed] [Google Scholar]

28. Carter P, Gray LJ, Troughton J, Khunti K, Davies MJ. Fruit and vegetable intake and incidence of type 2 diabetes mellitus: systematic review and meta-analysis. BMJ. 2010;341:c4229. [PMC free article] [PubMed] [Google Scholar]

29. Cooper AJ, Forouhi NG, Ye Z, et al. Fruit and vegetable intake and type 2 diabetes: EPIC-InterAct prospective study and meta-analysis. Eur J Clin Nutr. 2012;66(10):1082–92. [PMC free article] [PubMed] [Google Scholar]

30. Muraki I, Imamura F, Manson JE, et al. Fruit consumption and risk of type 2 diabetes: results from three prospective longitudinal cohort studies. BMJ. 2013:347. [PMC free article] [PubMed] [Google Scholar]

31. Tong X, Dong JY, Wu ZW, Li W, Qin LQ. Dairy consumption and risk of type 2 diabetes mellitus: a meta-analysis of cohort studies. Eur J Clin Nutr. 2011;65(9):1027–31. [PubMed] [Google Scholar]

32. Jiang R, Manson JE, Stampfer MJ, Liu S, Willett WC, Hu FB. Nut and peanut butter consumption and risk of type 2 diabetes in women. JAMA. 2002;288(20):2554–60. [PubMed] [Google Scholar]

33. Pan A, Sun Q, Manson JE, Willett WC, Hu FB. Walnut consumption is associated with lower risk of type 2 diabetes in women. J Nutr. 2013;143(4):512–8. [PMC free article] [PubMed] [Google Scholar]

34. Salas-Salvadó J, Bulló M, Babio N, et al. Reduction in the incidence of type 2 diabetes with the Mediterranean diet: results of the PREDIMED-Reus nutrition intervention randomized trial. Diabetes Care. 2011;34(1):14–9. [PMC free article] [PubMed] [Google Scholar]

35. Salas-Salvadó J, Bulló M, Estruch R, et al. Prevention of diabetes With Mediterranean diets: A subgroup analysis of a randomized trial. Ann Intern Med. 2014;160(1):1–10. [PubMed] [Google Scholar]

36. Malik VS, Popkin BM, Bray GA, Després J-P, Willett WC, Hu FB. Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a meta-analysis. Diabetes Care. 2010;33(11):2477–83. [PMC free article] [PubMed] [Google Scholar]

37. The Inter Act Consortium. Consumption of sweet beverages and type 2 diabetes incidence in European adults: results from EPIC-InterAct. Diabetologia. 2013;56(7):1520–30. [PubMed] [Google Scholar]

38. Pan A, Malik VS, Schulze MB, Manson JE, Willett WC, Hu FB. Plain-water intake and risk of type 2 diabetes in young and middle-aged women. Am J Clin Nutr. 2012;95(6):1454–60. [PMC free article] [PubMed] [Google Scholar]

39. Baliunas DO, Taylor BJ, Irving H, et al. Alcohol as a risk factor for type 2 diabetes. Diabetes Care. 2009;32(11):2123–32. [PMC free article] [PubMed] [Google Scholar]

40. Joosten MM, Beulens JWJ, Kersten S, Hendriks HFJ. Moderate alcohol consumption increases insulin sensitivity and ADIPOQ expression in postmenopausal women: a randomised, crossover trial. Diabetologia. 2008;51(8):1375–81. [PMC free article] [PubMed] [Google Scholar]

41. Ding M, Bhupathiraju SN, Chen M, van Dam R, Hu FB. Caffeinated and decaffeinated coffee consumption and riskof type 2 diabetes: a systematic review and a dose-response meta-analysis. Diabetes Care. 2014;37(2):569–86. [PMC free article] [PubMed] [Google Scholar]

42. The Inter Act Consortium. Mediterranean diet and type 2 diabetes risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study: the InterAct project. Diabetes Care. 2011;34(9):1913–8. [PMC free article] [PubMed] [Google Scholar]

43. Esposito K, Maiorino MI, Ceriello A, Giugliano D. Prevention and control of type 2 diabetes by Mediterranean diet: a systematic review. Diabetes Res Clin Pract. 2010;89(2):97–102. [PubMed] [Google Scholar]

44. Chiuve SE, Fung TT, Rimm EB, et al. Alternative dietary indices both strongly predict risk of chronic disease. J Nutr. 2012;142(6):1009–18. [PMC free article] [PubMed] [Google Scholar]

45. Liese AD, Nichols M, Sun X, D’Agostino RB, Haffner SM. Adherence to the DASH Diet is inversely associated with incidence of type 2 diabetes: the insulin resistance atherosclerosis study. Diabetes Care. 2009;32(8):1434–6. [PMC free article] [PubMed] [Google Scholar]

46. de Koning L, Chiuve SE, Fung TT, Willett WC, Rimm EB, Hu FB. Diet-quality scores and the risk of type 2 diabetes in men. Diabetes Care. 2011;34(5):1150–6. [PMC free article] [PubMed] [Google Scholar]

47. Tonstad S, Stewart K, Oda K, Batech M, Herring RP, Fraser GE. Vegetarian diets and incidence of diabetes in the Adventist Health Study-2. Nutr Metab Cardiovasc Dis. 2013;23(4):292–9. [PMC free article] [PubMed] [Google Scholar]

48. Heidemann C, Hoffmann K, Spranger J, et al. A dietary pattern protective against type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition (EPIC)—Potsdam Study cohort. Diabetologia. 2005;48(6):1126–34. [PubMed] [Google Scholar]

49. Imamura F, Lichtenstein AH, Dallal GE, Meigs JB, Jacques PF. Generalizability of dietary patterns associated with incidence of type 2 diabetes mellitus. Am J Clin Nutr. 2009;90(4):1075–83. [PMC free article] [PubMed] [Google Scholar]

50. Liese AD, Weis KE, Schulz M, Tooze JA. Food intake patterns associated with incident type 2 diabetes: the Insulin Resistance Atherosclerosis Study. Diabetes Care. 2009;32(2):263–8. [PMC free article] [PubMed] [Google Scholar]

51. McNaughton SA, Mishra GD, Brunner EJ. Dietary patterns, insulin resistance, and incidence of type 2 diabetes in the Whitehall II Study. Diabetes Care. 2008;31(7):1343–8. [PMC free article] [PubMed] [Google Scholar]

52. Schulze MB, Hoffmann K, Manson JE, et al. Dietary pattern, inflammation, and incidence of type 2 diabetes in women. Am J Clin Nutr. 2005;82(3):675–84. [PMC free article] [PubMed] [Google Scholar]

53. Fung TT, Schulze M, Manson JE, Willett WC, Hu FB. DIetary patterns, meat intake, and the risk of type 2 diabetes in women. Arch Intern Med. 2004;164(20):2235–40. [PubMed] [Google Scholar]

54. Evert AB, Boucher JL, Cypress M, et al. Nutrition therapy recommendations for the management of adults with diabetes. Diabetes Care. 2014;37(Supplement 1):S120–S43. [PubMed] [Google Scholar]

55. Canadian Diabetes Assocaition Clinical Practice Guidelines Expert Committee. Clinical Practice Guidelines: Nutrition Therapy. Can J Diabetes. 2013;37:S45–S55. [PubMed] [Google Scholar]

56. Mann JI, De Leeuw I, Hermansen K, et al. Evidence-based nutritional approaches to the treatment and prevention of diabetes mellitus. Nutr Metab Cardiovasc Dis. 2004;14(6):373–94. [PubMed] [Google Scholar]

57. Dyson PA, Kelly T, Deakin T, et al. Diabetes UK evidence-based nutrition guidelines for the prevention and management of diabetes. Diabet Med. 2011;28(11):1282–8. [PubMed] [Google Scholar]

58. The Look AHEAD Research Group. Reduction in weight and cardiovascular disease risk factors in individuals with type 2 diabetes: one-year results of the look AHEAD trial. Diabetes Care. 2007;30(6):1374–83. [PMC free article] [PubMed] [Google Scholar]

59. The Look AHEAD Research Group. Cardiovascular Effects of Intensive Lifestyle Intervention in Type 2 Diabetes. N Engl J Med. 2013;369(2):145–54. [PMC free article] [PubMed] [Google Scholar]

60. Faulconbridge LF, Wadden TA, Rubin RR, et al. One-year changes in symptoms of depression and weight in overweight/obese individuals with type 2 diabetes in the Look AHEAD study. Obesity. 2012;20(4):783–93. [PMC free article] [PubMed] [Google Scholar]

61. Foster GD, Borradaile KE, Sanders MH, et al. A randomized study on the effect of weight loss on obstructive sleep apnea among obese patients with type 2 diabetes: The sleep ahead study. Arch Intern Med. 2009;169(17):1619–26. [PMC free article] [PubMed] [Google Scholar]

62. Phelan S, Kanaya AM, Subak LL, et al. Weight loss prevents urinary incontinence in women with type 2 diabetes: results from the Look AHEAD trial. J Urol. 2012;187(3):939–44. [PMC free article] [PubMed] [Google Scholar]

63. Williamson DA, Rejeski J, Lang W, et al. Impact of a weight management program on health-related quality of life in overweight adults with type 2 diabetes. Arch Intern Med. 2009;169(2):163–71. [PMC free article] [PubMed] [Google Scholar]

64. Gerstein HC. Do lifestyle changes reduce serious outcomes in diabetes? N Engl J Med. 2013;369(2):189–90. [PubMed] [Google Scholar]

65. Martínez-González MA, Salas-Salvadó J, Estruch R. Intensive Lifestyle Intervention in Type 2 Diabetes. N Engl J Med. 2013;369(24):2357. [PubMed] [Google Scholar]

66. American Diabetes Association. Standards of medical care in diabetes—2014. Diabetes Care. 2014;37(Supplement 1):S14–S80. [PubMed] [Google Scholar]

67. Gloy VL, Briel M, Bhatt DL, et al. Bariatric surgery versus non-surgical treatment for obesity: a systematic review and meta-analysis of randomised controlled trials. BMJ. 2013;347 [PMC free article] [PubMed] [Google Scholar]

68. Sjöström L, Peltonen M, Jacobson P, et al. Bariatric surgery and long-term cardiovascular events. JAMA. 2012;307(1):56–65. [PubMed] [Google Scholar]

69. Thomas DE, Elliott EJ. The use of low-glycaemic index diets in diabetes control. Br J Nutr. 2010;104(06):797–802. [PubMed] [Google Scholar]

70. Silva FM, Kramer CK, de Almeida JC, Steemburgo T, Gross JL, Azevedo MJ. Fiber intake and glycemic control in patients with type 2 diabetes mellitus: a systematic review with meta-analysis of randomized controlled trials. Nutr Rev. 2013;71(12):790–801. [PubMed] [Google Scholar]

71. Stanhope KL, Schwarz JM, Keim NL, et al. Consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans. J Clin Invest. 2009;119(5):1322–34. [PMC free article] [PubMed] [Google Scholar]

72. Gardner C, Wylie-Rosett J, Gidding SS, et al. Nonnutritive sweeteners: current use and health perspectives: a scientific statement from the American Heart Association and the American Diabetes Association. Circulation. 2012;126(4):509–19. [PubMed] [Google Scholar]

73. Pan Y, Guo LL, Jin HM. Low-protein diet for diabetic nephropathy: a meta-analysis of randomized controlled trials. Am J Clin Nutr. 2008;88(3):660–6. [PubMed] [Google Scholar]

74. Estruch R, Ros E, Salas-Salvadó J, et al. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2013;368(14):1279–90. [PubMed] [Google Scholar]

75. Tanasescu M, Cho E, Manson JE, Hu FB. Dietary fat and cholesterol and the risk of cardiovascular disease among women with type 2 diabetes. Am J Clin Nutr. 2004;79(6):999–1005. [PubMed] [Google Scholar]

76. Hu FB, Cho E, Rexrode KM, Albert CM, Manson JE. Fish and long-chain omega-3 fatty acid intake and risk of coronary heart disease and total mortality in diabetic women. Circulation. 2003;107(14):1852–7. [PubMed] [Google Scholar]

77. Rizos EC, Ntzani EE, Bika E, Kostapanos MS, Elisaf MS. Association between omega-3 fatty acid supplementation and risk of major cardiovascular disease events: A systematic review and meta-analysis. JAMA. 2012;308(10):1024–33. [PubMed] [Google Scholar]

78. ORIGIN Trial Investigators. Bosch J, Gerstein HC, et al. n-3 fatty acids and cardiovascular outcomes in patients with dysglycemia. N Engl J Med. 2012;367(4):309–18. [PubMed] [Google Scholar]

79. Schwingshackl L, Strasser B, Hoffmann G. Effects of monounsaturated fatty acids on cardiovascular risk factors: a systematic review and meta-analysis. Ann Nutr Metab. 2011;59(2–4):176–86. [PubMed] [Google Scholar]

80. Shai I, Schwarzfuchs D, Henkin Y, et al. Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. N Engl J Med. 2008;359(3):229–41. [PubMed] [Google Scholar]

81. Esposito K, Maiorino MI, Ciotola M, et al. Effects of a Mediterranean-style diet on the need for antihyperglycemic drug therapy in patients with newly diagnosed type 2 diabetes: a randomized trial. Ann Intern Med. 2009;151(5):306–14. [PubMed] [Google Scholar]

82. Appel LJ, Moore TJ, Obarzanek E, et al. A clinical trial of the effects of dietary patterns on blood pressure. N Engl J Med. 1997;336(16):1117–24. [PubMed] [Google Scholar]

83. Sacks FM, Svetkey LP, Vollmer WM, et al. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. N Engl J Med. 2001;344(1):3–10. [PubMed] [Google Scholar]

84. Azadbakht L, Fard NRP, Karimi M, et al. Effects of the Dietary Approaches to Stop Hypertension (DASH) eating plan on cardiovascular risks among type 2 diabetic patients: a randomized crossover clinical trial. Diabetes Care. 2011;34(1):55–7. [PMC free article] [PubMed] [Google Scholar]

85. Azadbakht L, Surkan PJ, Esmaillzadeh A, Willett WC. The Dietary Approaches to Stop Hypertension eating plan affects C-reactive protein, coagulation abnormalities, and hepatic function tests among type 2 diabetic patients. J Nutr. 2011;141(6):1083–8. [PMC free article] [PubMed] [Google Scholar]

86. Ekinci EI, Clarke S, Thomas MC, et al. Dietary salt intake and mortality in patients with type 2 diabetes. Diabetes Care. 2011;34(3):703–9. [PMC free article] [PubMed] [Google Scholar]

87. Ajala O, English P, Pinkney J. Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes. Am J Clin Nutr. 2013;97(3):505–16. [PubMed] [Google Scholar]

88. Barnard ND, Cohen J, Jenkins DJ, et al. A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: a randomized, controlled, 74-wk clinical trial. Am J Clin Nutr. 2009;89(5):1588S–96S. [PMC free article] [PubMed] [Google Scholar]

89. Koppes LLJ, Dekker JM, Hendriks HFJ, Bouter LM, Heine RJ. Meta-analysis of the relationship between alcohol consumption and coronary heart disease and mortality in type 2 diabetic patients. Diabetologia. 2006;49(4):648–52. [PubMed] [Google Scholar]

90. Bantle AE, Thomas W, Bantle JP. Metabolic effects of alcohol in the form of wine in persons with type 2 diabetes mellitus. Metabolism. 2008;57(2):241–5. [PMC free article] [PubMed] [Google Scholar]

Carbohydrates, Fiber, Salt, and Fat

Written by WebMD Editorial Contributors

• Carbs
• Fiber
• Fat
• Salt
• Low-Salt Cooking Tips
• Which Seasonings Can Replace Salt?
• How Much Can You Eat?
• What Is the TLC Diet for Diabetes?
• Can You Have Sugar?
• Other Sweeteners
• What About Alcohol?
• More

What you eat makes a big difference when you have diabetes. The right foods can be an ally in your fight to keep your blood sugar levels in check. When you build your diet, four key things to focus on are carbs, fiber, fat, and salt. Here’s what you should know about each of them.

Carbs give you fuel. They affect your blood sugar faster than fats or protein. You’ll mainly get them from:

• Fruit
• Milk and yogurt
• Bread, cereal, rice, and pasta
• Starchy vegetables like potatoes, corn, and beans

Some carbs are simple, like sugar. Other carbs are complex, like those found in beans, nuts, vegetables, and whole grains.

Complex carbohydrates are better for you because they take longer for your body to digest. They give you steady energy and fiber.

You may have heard of “carbohydrate counting.” That means you keep track of the carbs (sugar and starch) you eat each day. Counting grams of carbohydrate, and splitting them evenly between meals, will help you control your blood sugar.

Talk to your doctor, a registered dietitian, or a diabetes educator about how to keep track of how many carbs you eat. They may recommend that you use the glycemic index. It ranks how different foods raise your blood sugar. The higher the index, the more it raises your levels.

If you eat more carbohydrates than your insulin supply can handle, your blood sugar level goes up. If you eat too few, your blood sugar level may fall too low. You can manage these shifts by knowing how to count carbs.

One carbohydrate serving equals 15 grams of carbohydrates.

A registered dietitian can help you figure out a carbohydrate counting plan that meets your specific needs. For adults, a typical plan includes two to four carb servings at each meal, and one to two as snacks.

You can pick almost any food product off the shelf, read the label, and use the information about grams of carbohydrates to fit the food into your type 2 diabetes meal plan.

Anyone can use carb counting. It’s most useful for people who take more than one daily shot of insulin, use an insulin pump, or want more flexibility and variety in their food choices.
 

You get fiber from plant foods — fruits, vegetables, whole grains, nuts, beans, and legumes. It helps with digestion and blood sugar control. You feel fuller, so you eat less, which is a plus if you need to lose weight.

People who eat high-fiber diets tend to be less likely to get high blood pressure and heart disease.

Most Americans don’t eat enough fiber. So focus on these foods:

• Fresh fruits and vegetables
• Cooked dried beans and peas
• Whole-grain breads, cereals, and crackers
• Brown rice
• Bran foods

It’s best to get fiber from food. But if you can’t get enough, taking fiber supplements can help. Examples include psyllium, methylcellulose, wheat dextrin, and calcium polycarbophil. If you take a fiber supplement, increase the amount you take slowly. This can help prevent gas and cramping. It’s also important to drink enough liquids when you increase your fiber intake.
 

Diabetes makes you more likely to get heart disease. So you’ll want to limit unhealthy fat such as saturated fats and trans fats.

The main sources of saturated fats are cheese, beef, milk, and baked items.

Avoid trans fats, which are bad for your heart. Check the ingredients list for “partially hydrogenated” oils. Also, know that if a product says “0 grams trans fat,” it may actually have up to half a gram of trans fat per serving.

For a healthy diet:

• Choose lean cuts of meat.
• Don’t fry foods. Instead, you can bake, broil, grill, roast, or boil.
• Choose low-fat or fat-free dairy foods. Include them in your daily carbohydrate count.
• Use vegetable cooking spray or cholesterol-lowering margarine that has stanols or sterols.
• Pick liquid vegetable oils instead of animal fat.

A registered dietitian can give you more information on how to prepare and choose the right fats for you.

Diabetes raises your risk of getting high blood pressure. Too much salt can add to that risk. Your doctor or dietitian may ask you to limit or avoid:

• Salt and seasoned salt (or salt seasonings)
• Boxed mixes of potatoes, rice, and pasta
• Canned meats
• Canned soups and vegetables with salt
• Cured or processed foods
• Ketchup, mustard, salad dressings, other spreads, and canned sauces
• Packaged soups, gravies, and sauces
• Pickled foods
• Processed meats: lunch meat, sausage, bacon, and ham
• Olives
• Salty snack foods
• Monosodium glutamate (MSG)
• Soy and steak sauces

• Use fresh ingredients and foods with no salt added.
• For favorite recipes, you may need to use other ingredients and cut out or use less salt.
• Try orange or pineapple juice as a base for meat marinades.
• Check the sodium on food labels.
• Choose frozen entrees that have 600 milligrams or less of sodium. Limit yourself to one of these frozen entrees per day.
• Use fresh, frozen, or no-added-salt canned vegetables. Rinse them first.
• If you buy canned soup, look for low-sodium ones.
• Avoid mixed seasonings and spice blends that include salt, such as garlic salt.

Herbs and spices improve the natural flavors in food without using salt. Make these mixtures to use for meats, poultry, fish, vegetables, soups, and salads.

Spicy blend

• 2 tablespoons dried savory, crumbled
• ¼ teaspoon freshly ground white pepper
• 1 tablespoon dry mustard
• ¼ teaspoon ground cumin
• 2½ teaspoons onion powder
• ½ teaspoon garlic powder
• ¼ teaspoon curry powder

Saltless surprise

• 2 teaspoons garlic powder
• 1 teaspoon basil
• 1 teaspoon oregano
• 1 teaspoon powdered lemon rind or dehydrated lemon juice

Herb seasoning

• 2 tablespoons dried dill weed or basil leaves, crumbled
• 1 teaspoon celery seed
• 2 tablespoons onion powder
• ¼ teaspoon dried oregano leaves, crumbled
• A pinch of freshly ground pepper

Spicy seasoning

• 1 teaspoon cloves
• 1 teaspoon pepper
• 2 teaspoons paprika
• 1 teaspoon coriander seed (crushed)
• 1 tablespoon rosemary

Check the serving sizes on nutrition labels. Servings may be smaller than you think. Eat only the amount of food in your diabetes meal plan. Extra calories lead to extra fat and pounds.
 

Don’t skip meals, though. Eat them, and snacks, at regular times every day.

If you also have high cholesterol, your doctor probably will recommend something called the TLC (therapeutic lifestyle changes) plan.

The goal is to lower your cholesterol level, drop extra weight, and get more active. That helps prevent heart disease, which is more common when you have diabetes.

On the TLC diet, you will:

• Limit fat to 25%-35% of your total daily calories.
• Get no more than 7% of your daily calories from saturated fat, 10% or less from polyunsaturated fats, and up to 20% from monounsaturated fats (like plant oils or nuts).
• Keep carbs to 50%-60% of your daily calories.
• Aim for 20-30 grams of fiber each day.
• Allow 15%-20% of your daily calories for protein.
• Cap cholesterol at 200 milligrams per day.

You’ll also need to get more exercise and keep up with your medical treatment.

You might have heard that people with diabetes shouldn’t have any table sugar. While some doctors say that, others take a more forgiving view.

Most now say that small amounts of the sweet stuff are fine, as long as they’re part of an overall healthy meal plan. Table sugar doesn’t raise your blood sugar any more than starches.

Remember, though, that sugar is a carb. So when you eat sweet foods like cookies, cake, or candy, don’t eat another carb or starch (for example, potatoes) that you would’ve eaten that day.

In other words, substitute, don’t add. Ultimately, the total grams matter more than the source of the sugar.

Account for any food swaps in your carbohydrate budget for the day. Adjust your medications if you add sugars to your meals. If you take insulin, tweak your dose to account for the added carbs so you can keep your blood sugar under control as much as possible. Check your glucose after eating sugary foods.

Read food labels so you know how much sugar or carbs are in the things you eat and drink. Also, check how many calories and how much fat are in each serving.

You can add artificial ones to your food and drinks. Many have carbs, though, so check the label carefully. If necessary, adjust the other foods in your meal or your medication to keep your blood sugar under control.

Certain sweeteners called sugar alcohols have some calories and can slightly raise your glucose levels. If you eat too much of them, you can get gas and diarrhea. Examples include:

• Xylitol
• Mannitol
• Sorbitol

You can also use stevia to make things sweet. It’s a natural product with no calories.

Ask your doctor if it’s OK for you to drink booze. If they say yes, do it only occasionally, when your blood sugar level is well-controlled. Most wine and mixed drinks have sugar, and alcohol also has a lot of calories.

Top Picks

Diet for type 1 and type 2 diabetes – menus, allowed foods, basic nutrition

According to WHO, more than 420 million people in the world suffer from diabetes mellitus (DM). One of the important methods of treatment of this disease is diet. Its goal is to prevent or delay the occurrence of complications and prolong a person’s life. Diet for diabetes is the topic of our article today.

Classification of the disease and the role of nutrition

Since 1965, the WHO has periodically updated and revised the classification of diabetes mellitus. In Russia, today the option proposed in 1999 with additions.

The type of nutrition in diabetes is selected individually in such a way as to optimize the level of sugar in the blood to the maximum acceptable value. It depends on the mechanism of development of pathology.

Degrees of disease

Diabetes is distinguished:

type 1. Previously, it was called insulin-dependent, youthful or children’s. Today under SD 1 Art. imply immune-mediated, idiopathic. With this pathology, an insufficient amount of insulin is produced in the human body, the deficiency of which is replenished through daily injections. Today, medicine does not know exactly what provokes type 1 diabetes, so it is not possible to develop preventive measures.

Clinically, the pathology is manifested by excessive urination (polyuria), thirst (polydipsia), overwhelming hunger, weight loss, visual disturbances and fatigue. Perhaps the sudden appearance of the listed symptoms

type 2. Previously, it was called non-insulin dependent or adult diabetes. In this case, the production of insulin is not disturbed, but a failure occurs in its effective use. According to WHO, 95% of people with diabetes are diagnosed with type 2. The most common cause of pathology is overweight and lack of physical activity. The clinical presentation is similar to type 1 diabetes, but usually not as pronounced. Because of this, as a rule, there are some difficulties in the early diagnosis of the disease. In many people, pathology is detected only when complications are already developing. And this process can take more than one year. A few years ago, type 2 diabetes was diagnosed only in the adult population, today it has become increasingly common in children.

Gestational. It is manifested by an increase in the level of glucose in the blood, but the indicators do not exceed the normal values ​​so that diabetes can be diagnosed. The gestational form develops in pregnant women, which increases the risk of complications during gestation and the birth itself. In the future, both the woman and the child can develop type 2 diabetes.

In most cases, this pathology is detected not during the collection of anamnesis and conversation with the patient, but during prenatal screening.

Other specific types. They are diagnosed with genetic defects in the function of β-cells and insulin action, diseases of the exocrine pancreas, endocrinopathy, infectious processes, and a number of other pathological conditions.

Types of diets for diabetes

There are quite a lot of them: carbohydrate-free, protein, low-carb and others. At the same time, a physiological, in all respects, balanced diet is considered the most preferable. Experts also note that it should be individualized, taking into account the patient’s eating habits and nutrition stereotype.

To account for carbohydrate-containing products, it is recommended to use a simple system of bread units (XE) that is perfectly suitable for real life. It helps a person with type 1 and type 2 diabetes maintain a varied diet: replace some carbohydrate-containing meals with others, but at the same time avoid serious fluctuations in blood sugar. One bread unit of the product contains 10-12 g of carbohydrates. The XE system is convenient in that a person does not need to use the scale every time to find out the carbohydrate content to the nearest 1 g. He can make a visual assessment using simple units of measurement: a piece, a glass, a piece, an st. l. etc.

Basic nutritional guidelines for type 1 diabetes mellitus

The main treatment for people with this diagnosis is insulin replacement therapy. Here, the diet for diabetes is used adjunctively. Since the injected insulin “cannot know” at what time and how much a person will eat, the diabetic himself must ensure that the effect of the drug is consistent with his diet. To do this, you need to know which foods can increase blood sugar levels in blood plasma.

Proteins and fats do not have a sugar-increasing effect. Therefore, people with type 1 diabetes can consume them in the same amount as without this diagnosis, provided that their body weight is normal and there are no other medical contraindications.

Carbohydrates, on the other hand, have a real sugar-increasing effect. But this does not mean that they should be limited. If the patient does not have problems with being overweight, carbohydrates should only be taken into account in order to correctly calculate the dose of the drug with insulin.

Conventional diet therapy for type 1 diabetes recommends eating 6-7 small meals a day (including lunch). This regimen aims to adjust nutrition to the action of long-acting insulin. This is necessary because if a person skips a meal, hypoglycemia is possible, and if a person consumes a large amount of carbohydrates, a peak increase in blood sugar, which cannot be covered by the action of prolonged insulin. Medicine recommends adapting insulin therapy to your diet, and not vice versa.

Basic nutritional guidelines for type 2 diabetes

Clinical recommendations of the Russian Federation, approved in 2022, suggest that dietary restrictions, including for weight loss, should be used with caution. Their use is justified if they lead to a marked improvement in carbohydrate or lipid metabolism, blood pressure levels, or other important indicators of health. It should be noted that hypocaloric nutrition can adversely affect bone tissue, the intake of vitamins, and the development of sarcopenia.

Older people with type 2 diabetes who are not overweight and not on insulin should not be given a fixed amount of carbohydrates. If the patient is taking short-acting (ultra-short-acting) insulin, a practice-oriented assessment of the amount of carbohydrates in a meal is allowed.

What can I eat if I have type 2 diabetes?

What is recommended to limit, if possible completely eliminate?

More precise recommendations about which foods for type 2 diabetes are suitable for you and which are not, always give a doctor. As a rule, this is preceded by a series of laboratory tests.

Healthy foods for diabetes

Prohibited foods for diabetes

Avoid or limit as much as possible:

It is recommended not to cook food that involves frying. Use utensils that allow you to cook food without adding fat. Vegetable oil is an important component of the daily diet, and it should be consumed in very small quantities.

Fatty fish are a key source of Omega-3 and many other substances that are extremely beneficial for the human body. Because of this, this product is not as strictly limited as fatty meat.

Other dietary strategies in diabetes mellitus

As already noted, any dietary restriction must be individualized. Today, there are several options for dietary strategies for diabetes in overweight patients. Good results can be obtained by the Mediterranean diet, which also involves daily physical activity.

Its key principles:

• you need to eat fractionally 5 times a day – 3 main meals and 2 snacks;

• breakfast should be predominantly low glycemic complex carbohydrates;

• light dinner including lean protein and vegetables;

• it is recommended to eat more than 400 g of various vegetables and herbs per day;

• observe the drinking regime – at least 7-8 glasses of water per day.

Another dietary strategy for diabetes is LCHF. To understand its principle, it is enough to simply decipher the abbreviation Low Carb High Fat (“low carbs, high fat”). This power system was developed in 2000. She suggests composing your diet in such a way that it contains a minimum of sugar and starch. Whole foods rich in fat, protein and fiber should be preferred. Carbohydrates on LCHF are limited to 50 grams per day.

Author

Yulia Konstantinovna Nuzhnova

endocrinologist

Doctor of the first category

Experience 22 years

+7 (495) 032-15-21

Nutrition for diabetes

• Home
• Blog
• Nutrition for diabetes

Content:

• Why nutrition is important in diabetes

• Relationship between glucose and food

• Diet and nutrition in diabetes

• Type 2 diabetes nutrition

Proper nutrition is an essential element of diabetes therapy. Thanks to drug treatment, physical activity, diet, you can control your condition and prevent serious complications. That is why it is important for every member of the family of a diabetic to understand the basic principles of nutrition in diabetes and to help the patient follow the doctor’s recommendations.

Why nutrition is important in diabetes

Diabetes is a chronic disease that can be of two types:

• type 1. It develops with insufficient production of its own insulin. First of all, the introduction of doses of the drug is required.
• 2 typ. The hormone is produced, but the body cannot use insulin efficiently. Diet and medical support is needed.

Diabetes is a nutritional non-communicable disease, that is, it is caused by insufficient or excessive intake of substances from food. Many organs and systems suffer from malnutrition: stomach, liver, intestines, pancreas, skeleton, heart, bile ducts. Therefore, it is extremely rare that a patient has no other diseases besides diabetes. With a high calorie daily menu and little physical activity, weight gain occurs, which is a risk factor for developing type 2 diabetes.

A well-chosen diet has a beneficial effect on the whole body, allows you to lose weight and feel better, and not just control blood sugar levels. At the same time, it is necessary to take into account the calorie content of the diet and observe the balance of BJU, because a lack of nutrients is harmful to the body, as well as an excess of calories.

The Glucose-Food Relationship

The body needs all nutrients to function properly, although they have different effects on insulin levels:

• Carbohydrates. Contribute to an increase in sugar levels, the rate of transformation of carbohydrates into glucose is indicated by the concept of “glycemic index”. They can be quickly absorbed, causing a sharp jump in insulin: these are sweet foods like honey, confectionery, carbonated drinks, sugar, potatoes, rice. Difficult-to-digest carbohydrates saturate for a long time without causing a strong increase in sugar: legumes, vegetables, cereals. Patients with diabetes should drastically limit their intake of foods with a high glycemic index – fast carbohydrates. At the same time, a complete rejection of carbohydrate foods is also unacceptable, because this is the main source of energy.
• Proteins. Another source of energy, but without a pronounced sugar-boosting effect. Must be present in the diet for normal growth, tissue repair, hormone formation. However, their unlimited consumption leads to an excess of urea, which leads to rheumatic diseases.
• Fats. Should be a third of the calories. It is necessary to distinguish between harmful fats that cause the accumulation of cholesterol (fast food, red fatty meat, coconut and palm oils), and healthy ones (found in vegetable oils, especially olive, avocado). Direct fatty food is not contraindicated in diabetes, but it provokes atherosclerosis, which worsens the prognosis in case of diabetic foot syndrome.

When compiling a diet menu for diabetics, it is necessary to take into account that all types of food should be present in the diet, but in a rational amount. It makes no sense to give up grains, greens, fruits, lean meats, vegetables, low-fat dairy products if you only have diabetes. Any product is banned if a concomitant disease is detected during the diagnosis.

Diabetes diet and nutrition

Diabetic food can be not only healthy, but also delicious. There are many adapted recipes, so steamed, baked, boiled dishes can be just as delicious as smoked or fried.

Tips for organizing a healthy diet:

• The whole family should support the pursuit of a healthy lifestyle.
• Do not allow long breaks between meals for more than 5-6 hours.
• Eat small meals. When a feeling of fullness appears, you should not forcefully eat up everything that is left on the plate. Eat 5 times a day.
• Choose unrefined foods: virgin oil, brown rice, whole grain bread and pasta, wholemeal pastries.
• Include more fiber in your diet. This allows you to slow down the absorption of carbohydrates during digestion, as well as remove excess cholesterol.
• Drink plenty of clean water to thin your blood.
• Do not add salt to dishes, avoid foods with hidden salt.

Not only the content of the dish matters, but also the portion size. When switching to a healthy diet, you will need time to decide on the amount of food you eat. It is important that food does not provoke high sugar levels. Take measurements just before a snack and a couple of hours later.

Type 2 diabetes nutrition

Type 2 diabetes usually does not require insulin therapy. Insulin therapy at first requires no more than 5-10% of patients. However, regardless of medication, diet plays a huge role for a diabetic. Treating diabetes with nutrition helps control the glycemic index.

The most common problem among patients with type 2 diabetes is being overweight. It is he who prevents the body from efficiently distributing its own insulin. With even a 5% weight loss, carbohydrate metabolism improves, and in the early stages of the disease, it is possible to achieve target glucose levels without additional funds. Such information motivates patients to reduce weight, but it must be understood that weight loss must be safe:

• It is necessary to discard all illusions about pills and folk recipes for weight loss. By themselves, herbs and drugs have no effect if you continue to eat everything in a row and spend little energy.
• To lose weight, you will have to change your eating habits and give up high-calorie foods. Unhealthy foods with cholesterol are completely replaceable by vegetable fibers: they are healthy and saturate effectively, so you do not have to reduce the amount of serving.

Diabetes Nutrition Principles:

• Avoid alcohol. Ethanol damages blood vessels, impairs metabolism, which is extremely dangerous in diabetes. Don’t drink malt beer – it’s high in carbs.
• Limit your intake of fatty meats, nuts, cream, peas, corn, beans by 75%.
• Reduce by 50% consumption of starch, eggs, pasta made from white flour.
• Eat more mushrooms, green beans, cabbage, zucchini. Fresh berries and fruits are rich in fiber, but do not forget about their high calorie content and fructose content.
• Track your daily calorie intake based on body weight, height and activity. Plan your meals on the basis that the menu for the day should be 50% carbohydrates, up to 30% fats, and the rest proteins. Calorie analyzers, available today in the form of applications or services on websites, will help you accurately calculate the daily calorie requirement in each case.
• When compiling the menu, control the glycemic index of the foods consumed – avoid foods with a high GI.

It is important to choose the right nutrition for diabetic women, since they are the ones who are primarily prone to weight gain with age.

Menu examples taken from the Internet are recommendations. Each diet needs to be adapted to suit other diseases, such as gastritis or hypertension.

Remember that diabetes has a devastating effect on the cardiovascular system, often causing the development of diabetic foot syndrome and subsequent disability.