Diabetes is a chronic illness caused by the immune system attacking areas of the pancreas where the hormone insulin is produced. Our bodies need insulin to convert blood glucose (the level of sugar in the blood), into energy in the body’s cells. For someone living with diabetes however, a lack of insulin production means glucose cannot be broken down in the same way. It is a serious disease which can have severe consequences over time, increasing the risk of heart disease, nerve damage, kidney failure, eye damage, skin infections and severe complications to foot health.
Two kinds of diabetes can be developed – type 1 and type 2. The former is nonhereditary, and its cause is still unknown, although it is often said to be genetic. According to the American Diabetes Association (ADA), cold weather could be a factor that triggers it, as type 1 has been said to develop more in the winter. Viruses are also thought to influence the development of the disease. Another potential factor could be humans’ early-stage diet. Individuals who have been breastfed in infancy are said to be less likely to develop the disease, and babies who first consume solid foods at an older age seem to be able to avoid it.
Type 2 diabetes on the other hand is a disease that is most often caused by unhealthy lifestyle factors, such as a poor diet and lack of exercise. This branch of the disease can also be genetic, and tends to be more common in white people over the age of 40, and people over 25 from Black African, South Asian or African-Caribbean backgrounds.
Ways of treating diabetes differ for both types, with type 1 requiring regular injections of insulin at mealtimes, while type 2 can usually be treated with a variety of medication.
Whilst both types of diabetes have different causes and forms of treatment, when it comes to what to eat, the list of food for diabetics is not as restricted as some might think. Both types require balanced, nutritious meals to manage blood glucose levels. “There’s no specific diet they need to follow, but the important thing in terms of diet is healthy eating,” says Suyin Chia, a Specialist Diabetes Dietician and Co-Founder of Nutribytes, an educational platform for nutritional education, produced by Registered Dieticians for Dietitians, Nutritionists, and the public alike.
For people with type 2, maintaining a healthy diet alongside keeping active is important to encourage weight loss and ensure the disease doesn’t worsen, says Suyin: “As the disease progresses on you might have to come onto insulin because your pancreas and liver work less effectively. If you don’t lose the weight, eventually you need to rely on insulin injections. So ideally the best thing is for someone with type 2 to switch to a healthy lifestyle as early as possible.”
Type 2, unlike type 1, is reversible through diet and regular exercise. Knowing the best food for type 2 diabetes is therefore key to not only managing the disease, but potentially curing.
What are the worst foods for diabetics?
Bad foods for diabetics often include unhealthy carbohydrates, which are high glycaemic index (GI) foods. These products usually contain high levels of starch, such as processed white bread, white rice, chips, and low grain breakfast cereals.
Many breakfast cereals are not suitable for diabetics as they generally have a high level of added sugar – an ingredient which should be consumed very moderately as it can cause huge spikes in blood sugar levels. Other sweet breakfast items that should be limited or replaced with sugar-free alternatives, include jams and marmalate, chocolate spreads, honey, any tinned fruit conserved in a sweetened syrup, fruit juices with added sugar, and baked goods such as pastries and biscuits.
While items containing high levels of sugar aren’t recommended for people with diabetes, they aren’t strictly banned, says Suyin. Like all other carbohydrates, they can be consumed within moderation, “You need to make sure you have the right amount of insulin to offset any sugar spike. You don’t necessarily need to stay away from sugar, but you do need to be mindful.”
One strategy Suyin recommends is swapping sugar for zero calorie artificial sweeteners, “They tend not to cause a rise in blood sugars,” she says. “They can also be used to help with weight management. However, it is still important to aim for an overall reduction in sweetness in the diet to support healthy eating patterns.”
Salt should also be eaten in moderation according to NHS guidance for newly diagnosed patients. This is because foods which contain a lot of salt often tend to come from pre-packaged ready meals, and unhealthy snacks like crisps, crackers, and popcorn, as opposed to freshly cooked food. These snacks also tend to have a high level of saturated and trans fats which can be bad for the heart.
Products that contain high levels of salt, sugar and carbs tend to be some of the worst food for type 2 diabetes. They make it harder to maintain a healthy weight as well as steady blood glucose levels, which makes it more difficult to manage the disease.
What are the best foods for diabetics?
While some starchy foods need to be avoided, there are low carb foods for diabetics which are more nutritious and have a low glycaemic index (GI). According to Suyin, no matter what type of diabetes you have, “you should switch to high fibre foods. So, if you’re having white bread switch to something with a lower glycaemic index like brown bread, which tends to include more fibre. This fibre prevents the sugar from spiking up too high. You can also switch to brown rice, or wholemeal pasta.” Other low GI foods include oats, rice bran cereals, whole wheat tortillas and barley.
There is a wide range of fruits and vegetables that also make healthy foods for diabetics. Nearly all vegetables are safe to consume, such as leafy greens, green peas, tomatoes, bok choy, artichokes, aubergine, mushrooms, cauliflower, and Brussels sprouts. Apples, dried apricots, unripe bananas, peaches, strawberries, oranges, cherries, avocados, grapefruit, cranberries, and blueberries are also fine to consume. Many fruits contain natural sugars however, so it’s important to adjust your insulin level accordingly and try to stick to fruit in the above list.
It is also important to monitor the amounts of carbohydrates in the diet and maintain an overall balanced carb intake. “Make sure you don’t just have carbs in your diet,” says Suyin, “so if you’re having some rice and potatoes, make sure that you have a bit of protein as well to make sure that you’ve got a healthy mixture of protein, fats and veg. A well-balanced diet prevents the sugar from spiking up too high.”
When it comes to proteins, staying away from red meat is also recommended. “We tend to advise people to go for more lean proteins, but also to go for a more sustainable option and to avoid red meat as much as they can. Things like beans, fish, eggs, chicken and plant-based proteins are all great alternatives.”
Some meat- and plant-based proteins which are better for type 1 and 2 diabetes are the breast meat of poultry, seafood and tofu. Meat fried in fat such as pork, should be avoided.
Numerous studies have found a healthy plant-based diet can be associated with a lower risk of developing type 2 diabetes and is good for overall management of the disease. The diet is known for having a lower GI as it tends to consist of more fibrous foods. Suyin says: “If you’re trying to follow a more flexitarian diet or even a vegan lifestyle, you just need to make sure you keep enough whole foods in your diet.” Plant-based products suitable for diabetics includes fibrous low-carb and high-protein foods like lentils, pulses, whole grains, and seeds. If following an exclusively plant-based diet, it’s important to take B12 and iron supplements.
Good foods for diabetics also include dairy items such as milk, yoghurt, and cheese, which all have a high calcium content. It is important however to opt for low-fat, unsweetened alternatives which have fewer saturated fats wherever possible. Dairy-free products such as oat, nut and soya milks are also recommended, but they should be calcium-fortified and sugar-free.
Many kitchen and cupboard staples are some of the best foods to eat for diabetes and make brilliant snacks too. They often include unsalted nuts and seeds, carrot, cucumber, and celery sticks dipped in low-fat hummus, raisins, frozen unsweetened yoghurt, cottage cheese and sugar-free jelly.
And when it comes to drinks?
As with food, it is important to not consume too many beverages with added sugar, such as soft drinks, cordials, and juices. Natural fruit juices also still contain a high amount of sugar, so it’s still recommended to opt for low or no sugar varieties. Some great sugar-free drink options include herbal teas, coffee with or without milk, still or sparkling water with fresh lime or lemon slices, and kombucha.
When it comes to alcohol, having diabetes does not mean you have to steer clear from it altogether, but you do need to be wary of the amount you consume. Alcoholic drinks can have a negative impact on the liver, the organ which helps manage blood sugars, so it’s important to stick to healthy drinking patterns. It’s also important to be careful and test your blood sugar before and after drinking alcohol, as it has the potential to cause a drop in glucose levels, which could lead to an experience of hypoglycaemia, which needs immediate treatment.
The important thing is to drink in moderation, and not too quickly. “You don’t need to stop drinking completely, but just follow the recommended guidelines, which is 14 units in a week,” says Suyin. “You need to make sure that it’s not a binge. Break it up into once every two or three days and break up the units throughout the week if possible.”
Many alcoholic drinks on the market can also have a high sugar load, especially sweet cocktails and liquors. The best types of alcoholic drinks for people with diabetes are those low in sugar and carbohydrates, like red and white wines, light beers and distilled spirits.
Low and no alcohol drinks are also suitable options, if they are low carb and low sugar. As demand has grown over the past few years and consumers develop more concern for their health, innovation in the sector has boomed, meaning the selection and quality of low and no alcohol available is better than it ever was before.
Following a diabetes diet doesn’t mean an end to eating tasty food. In fact, good foods for type 2 diabetes, as well as type 1, can be just as delicious as they are healthy. “There isn’t a best type of diet to consume for either condition,” says Suyin. “A diet works around our lifestyle and preferences, and it is hard to give a one-size-fits-all solution. The best diet is the one that works for that individual.”
The most important thing is to eat foods that are good for you, and prioritise the best food for diabetes control, which is ideally food that is least likely to cause GI spikes, and in the case of type 2 diabetes, most likely to help you reach remission.