Diabetes: An Overview
To fully recognise the big picture connecting diabetes and diet, we must first have a basic understanding of diabetes and the effect it has on our bodies.
The Main Problem with Diabetes
A person with diabetes has one distinct problem: high blood sugar.
The normal values depend on several considerations, such as the type of test (Fasting Blood Sugar, Oral Glucose Tolerance Test, A1C, etc.) and the device used. Still, in general, an FBS reading of 126 mg/dl or higher on two different occasions indicates diabetes.
But, why does diabetes happen?
The Role of Insulin
To explain why diabetes takes place, we must understand the role of insulin, a hormone produced by our pancreas.
After our body breaks down the carbohydrates in the food, the sugars or glucose from it do not directly enter our cells where we can use them for energy. What happens is that they just float in the blood until insulin enables them to enter our cells, where we can then turn this glucose into energy or store them. Essentially, our cells are locked, and insulin acts as the key to open them up for glucose.
Insulin Issues that Lead to Diabetes
Diabetes occurs when we have insulin issues. This usually happens in two ways:
- The pancreas is not producing enough insulin, or not producing insulin at all, or
- Our body no longer recognises insulin
Lack of insulin usually happens in people with type 1 diabetes, while insulin resistance develops later in life and is classified as type 2 diabetes.
Regardless of the type of diabetes, the result of insulin issues is the same: the glucose or sugar cannot enter our cells, and so, they stay afloat in the blood, causing high blood glucose or hyperglycemia.
Diabetes and Diet: What’s the Connection?
Now that we have a clearer picture of diabetes, it is easier to see the connection between diabetes and diet and nutrition.
When someone has diabetes, it naturally makes sense for them to reduce their intake of high-sugar foods. After all, the less sugar they eat, the less likely they will experience hyperglycemia.
But sugar restriction is not the goal of a diabetic diet. There is more to choosing the best foods for people with diabetes than just making sure that blood sugar level stays normal.
According to experts, the goals of medical nutrition therapy are to:
- Attain and maintain optimal metabolic outcomes. This means that beyond trying to get the blood sugar to the normal ranges (or as close to normal as possible), patients also need to consider other things like cholesterol levels and foods that affect their blood pressure.
- Prevent and treat complications. The dietitian or nutritionist will also consider the possibility or presence of complications such as nephropathy (deterioration of kidney function) when planning your diet.
- Improve health. Of course, the right diabetic food choices also help patients improve their overall health. With a balanced diet, they will be able to get the nutrients they need to function well, boost their immunity, and protect themselves from illnesses.
- Address individual needs. And finally, the diabetic diet also aims to address the unique needs of patients. In their meal plans, the healthcare team needs to consider food allergies, requirements, and preferences.
The bottom line is: the diabetes diet does not simply revolve around sugar restriction.
Recommended Diabetic Diet Food List
People with diabetes often think that their shopping list ought to be limited; however, that’s not the case. The truth is, many food items are good for diabetics.
Here’s the expert-recommended diabetic diet food list:
Vegetables are always on the list when we talk about a healthy, balanced diet for people with diabetes. This is because vegetables contain many nutrients such as vitamins, minerals, and antioxidants that boost our immune system and prevent micronutrient deficiencies.
However, the diet for diabetics focuses more on non-starchy vegetables because they have fewer calories and starch, a kind of complex carbohydrates.
However, if you find it hard to distinguish between starchy and non-starchy vegetables, do not fret because both starchy and non-starchy veggies are rich in nutrients and fibre. Just make sure to have a wide variety of colourful vegetables for a balanced diet.
- Green beans
- Green beans
- Sweet potato
Some people may not know about it, but fruits are also great additions to our diabetes food list. The doubt stems from the fact that fruits are sweet, so some people believe they may add unnecessary sugar to our body.
But, like veggies, fruits are also packed with vitamins, minerals, fibre, and antioxidants that make them integral to the diabetic diet. Here are some fruits that are great for people with diabetes:
As much as possible, choose fresh fruits. If you are having canned fruits, make sure to drain the syrup first and rinse the fruit to eliminate the extra sugars.
The diet for diabetics also includes grains. However, it’s important to choose whole grains over refined grains wherever possible.
Whole grains refer to products that retain the entire kernel, while refined grains have been processed to achieve finer texture and longer shelf-life. Experts report that whole grains are better for people with diabetes since they contain more fibre, retain most of the original nutrients, and have less impact on blood sugar.
In grocery stores, it is easy to spot whole grain products. Examples include:
- Whole oatmeal
- Brown or wild rice
- Whole Grain cornmeal
It will also be beneficial if you can choose “brown” or “whole” instead of “white” food products. This applies to flour, pasta, and bread.
The diet for diabetes also pays close attention to foods high in protein since they are crucial for internal functions like the production of hormones and enzymes, tissue repair, and cell generation.
The best protein choices for the diabetic diet plan are as follows:
- Nuts and seeds
- Beans and lentils
- Poultry like chicken, turkey, and duck without skin
- Lean cuts (cuts with fewer fats) of lamb, pork, and beef
- Meat substitutes such as tofu
Diabetics also need healthy fats in their system; however, it is not advisable to eat “fatty” foods, so the best way to go about it is to incorporate healthy fats together with other foods.
Case in point, nuts and seeds, such as almonds, hazelnut, cashew, and peanuts, contain healthy fats. Other good sources are:
- The cooking oils used in meal preparation. Best choices are canola, olive, and corn oil.
- Avocado and olives
- Salad dressings
And finally, a diabetic diet is not complete without dairy products for calcium. The recommended dairy products typically have “low-fat” or “fat-free” on their labels. Choose from:
A Note on the Recommended Food Items for Diabetics
Please keep in mind that the above-mentioned foods are merely recommendations. The foods which your dietitian or nutritionist chooses may vary, depending on your needs and preferences.
To put things into perspective, people who practice veganism are not amenable to consuming animal food products. Likewise, people with lactose intolerance may need lactose-free milk for their calcium source.
Diabetes Food Items to Avoid
Here’s a little clarification: there is no one food that diabetics cannot eat at all. But there are foods that people with diabetes can live without and others they can eat, but only in limited amounts.
Generally, a diabetic diet plan limits the consumption of the following foods:
Foods High in Sugar
Foods like candies, pastries, ice cream, and milk chocolate can quickly cause blood sugar spikes. Additionally, diabetics need to be careful about “drinking their calories.” Many drinks, such as fruit juices, sodas, and sports drinks, have high amounts of sugars.
Foods High in Saturated and Trans Fats
People with diabetes are already at an increased risk of cardiovascular diseases, such as heart attack and stroke, so doctors emphasise limiting the consumption of “bad fats”. Foods that contain high amounts of saturated and trans fats include processed snacks and meats (bacon, hotdogs, sausages, etc.), animal protein such as butter, and coconut oil.
Foods High in Sodium
Sodium or salt retains excess water in the body, adding burden to the heart and increasing the risk of high blood pressure. The usual goal is 2,300 mg of salt for the whole day.
Many foods naturally contain salts. Instead of adding salt to foods, consider using herbs, spices, and other salt-free seasonings.
What About Alcohol?
Essentially, people with diabetes do not need to cut back from drinking alcohol if they are already drinking moderately. “Moderately” generally means 1 drink a day for women and 2 drinks for men. But, what’s the measurement for 1 drink?
Well, experts say it depends on the drink itself.
For beer, 1 drink is equal to 12 ounces or about 354 ml. If it’s wine, then a drink only accounts for 148 ml. For hard liquor such as gin and whiskey, 1 drink is only about 44 ml.
Moreover, please remember that alcohol can cause your blood sugar levels to fall rapidly, so if you are drinking, do have some food at the same time.
A Note on Food to Avoid for Diabetes
Please remember that depending on the patient’s overall health status, the list above may not be exhaustive. Furthermore, the recommendations may change depending on the presence of other health conditions.
For instance, diabetic patients who also have hypertension may need stricter restrictions on sodium consumption. Those with kidney conditions may be advised to monitor their fluid intake as well.
Create Your Diabetic Food Plan
Preparing a diabetes diet plan means people need to ask three things:
- What to eat?
- When to eat?
- How much to eat?
And since we have answered the first question previously, let’s focus on when to eat and how much to eat.
When to Eat: Why Meal Schedules Matter
People without diabetes usually have 3 main meals and a few snacks throughout the day. If they have something important to work on, they may skip a meal or two and still be okay after.
This is because, typically, our pancreas produces insulin in response to blood sugar levels. But, that is not the case for people with diabetes. Their insulin problems make their body unable to adjust insulin levels according to their blood glucose levels. This is why many individuals need to take medications or receive insulin injections.
In case a person with diabetes takes medicines or receives insulin shots and then skips a meal, there may not be enough glucose in the blood, resulting in low blood sugar (hypoglycemia).
When you need to eat depends on the type of medicines that you take, but in general, most diabetics eat the same amount of carbohydrates at the same time each day. Others find that eating small meals instead of 2 to 3 huge meals helps because:
- It gives them a constant source of energy
- They are less likely to feel hungry and overeat in the next meal
- It helps to bring blood sugar levels to a normal range
Please be advised that since mealtimes are highly connected with your medicines and insulin shots, you will need to consult your doctor before deciding to change your meal schedule.
How Much To Eat: Food Portion Control
Once again, how much to eat depends on the individual’s needs. Case in point, people with diabetes who also have excessive weight need to work on achieving a healthy Body Mass Index (BMI) to reduce the risk of certain conditions like cardiovascular diseases.
Doctors often suggest three kinds of meal planning to patients: The Plate Method, Carbohydrate Counting, and Portion Sizes.
The Plate Method
For many people with type 2 diabetes, this diet meal planning strategy is the easiest because there is no need to count the carbohydrate and calorie intake.
Think of this strategy as a diabetes diet food chart, but contained in a plate. Follow the instructions below.
- For main meals, usually, lunch and dinner, prepare a 9-inch plate.
- Fill ½ of the plate with non-starchy veggies.
- Fill ¼ of the plate with protein foods.
- And finally, fill the other ¼ of the plate with starchy vegetables or grains.
- You can have a piece of fruit or a bowl of fruits on the side.
- For drinks, you can have a glass of milk along with water.
And that’s it! However, please keep in mind that you also need little snacks to go along with your main meals.
Using Portion Sizes
In creating the diabetic diet meal plans, portion sizes will also come in handy. Individuals with diabetes can use it when preparing both the main meals and the snacks so they will not eat too much or too little of certain foods.
To put things into perspective, consider rice.
Many people have a cup of rice per meal. However, 1 serving of cooked rice for individuals with diabetes is only about 1/3 cup. A person with diabetes who ate a full cup of cooked rice already had about 3 servings of it in one go.
Below are the recommended portion sizes (1 serving):
- ½ cup of cooked cereal or pasta
- 1 slice of bread
- 1 small potato; ½ if it’s large
- 1 cup of raw veggies
- ½ cup of cooked vegetables
- 1 small fruit
- Meat or poultry about the size of the palm or deck of cards
Carbohydrate or calorie counting specifies that individuals with diabetes need to count how many calories and carbs they are taking in.
This can be quite tiring and off-putting for many people, especially those who have a busy schedule. The best course of action is to consult your doctor, dietitian, or nutritionist. As experts, they will teach you how to properly read food labels and count calories in foods with no nutritional facts.
Furthermore, they can also help prepare the meal plans for you in a way where you will be getting the calories that your body needs.
Busting Diabetes Myths
Before finally ending our discussion about diabetic diets, let’s bust some common misconceptions that people have about diabetes:
Myth 1: People with diabetes cannot eat sweets
We already know that this is not true. Individuals with diabetes can have sugar, but they need stricter rules on what kind, how much, and when to eat it.
Myth 2: The diet for diabetes has many rules
Based on our discussion, we know that the rules are pretty much minimal.
Diabetics also need variety in their diet. They need fruits and vegetables, grains, protein foods, dairy, and healthy fats. The only added rules are:
- They need to be more mindful of what, when, and how much to eat.
- They need to consider their medicines and insulin shots.
Other “rules” like choosing whole grains over refined grains and limiting fats, salt, and alcohol, are actually beneficial for our general wellbeing and apply to everyone.
Myth #3: It’s okay to eat freely as long as people with diabetes take their medication and insulin
We now know that medicines and insulin do not “cover” what you eat. Just because individuals with diabetes take insulin does not mean they can eat all sorts of foods. In fact, people with diabetes need to be more careful of their diet because of the medications and insulin. The general rule is to eat everything in moderation.
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