Choosing a Diabetic Diet: Manage Type 2 Diabetes with the Foods You Eat
You’ve probably heard again and again that a diet overhaul through healthy eating, eating right, or cutting back on sugar is one of the major steps to take in preventing or managing diabetes.
These tips sound easy on paper, but it can be an uphill battle in real life because nutrition experts can’t even agree on what “healthy eating” means. And then there’s sugar. A lot of fruits are actually sugar. Should you avoid fruits too?
Asking yourself these questions multiple times a day makes it even more challenging. Every day, you have to decide what to eat. Will you eat at home or cook your own meals? Which snacks are healthy in the vending machine? Should you try making your own snacks?
Whether you’ve been diagnosed with diabetes recently or want to prevent diabetes because it runs in your family, you’ve probably gone through countless websites and online forums on what to eat but still feel lost and overwhelmed.
What foods can you eat if you're a diabetic?
This article is written and designed to make you feel less overwhelmed when making diet and nutrition decisions that are “diabetes-friendly”. Overall, you’ll learn about the right food choices for people with diabetes and eventually stop second-guessing your meal plans.
What Happens to People With Diabetes?
Imagine you’re about to eat a couple of moist and fluffy carrot muffins. The carbohydrates from the muffin is broken down by digestive enzymes into glucose, a simple form of sugar and a source of energy. The breakdown of carbs to glucose increases your blood sugar levels.
The human body is a wonderful machine. Nature designed your body to withstand various forms of stress, make adaptations (like building muscle after lifting weights), and maintain homeostasis (the ideal internal state). When your body is doing its job in sustaining homeostasis, your pancreas produces a hormone called insulin to help manage the sudden spike of blood sugar levels after helping yourself to two (and a half!) carrot muffins.
What does insulin do to your body?
Insulin facilitates the transport and storage of the energy-boosting glucose to cells, tissues, as well as organs. These include your body’s glucose storehouses like your skeletal muscles and liver.
Once your blood sugar returns to baseline levels as glucose is absorbed in the body, the pancreas will start producing glucagon instead of insulin. Glucagon tells your liver to let go of the stored sugar. This typically happens in between meals.
What if you're eating too many muffins (and carbs!) that is way more than your glucose-storing organs can handle?
People with Type 1 diabetes have issues with their pancreas not producing insulin, therefore, these individuals have slightly different concerns. Most of the time, Type 1 diabetics need to control their glucose levels with lifelong insulin therapy.
In Type 2 diabetes, your pancreas will end up producing insulin in frequent outbursts. When this happens more often than normal, your cells eventually become less sensitive to insulin. Consequently, they become “comfortably numb” to your body’s signals that there are excess blood sugar levels in your body. This is what happens in individuals with insulin resistance or Type 2 diabetes. This type of diabetes can be managed or prevented by making changes in your diet.
Why You Need to Focus on Your Diet
Why focus on diet you ask?
While exercise, getting enough sleep, genetics, and other factors can also play a role in the development of diabetes, it all begins with the quality (what you eat) and quantity (how much) of your food.
According to the Centers for Disease Control and Prevention (CDC), one of the most important ways to prevent a diabetic diagnosis is to control your weight. And if weight loss is your ultimate goal, diet is a more effective strategy for promoting fat loss. However, this doesn’t mean that you should jump up and cancel your gym membership. After all, working out has other benefits that go beyond weight loss such as boosting self-confidence.
Now that we’ve settled the matter on why we’re focusing on diet and nutrition in staving off or managing diabetes, let’s take a deeper look at which diets are worth trying out if you are trying to tackle diabetes.
Which Diet Works Best In Managing Diabetes?
If you ask the American Diabetes Association, there’s no such thing as the ultimate diabetes diet. Instead of following a strict diet regimen, the organization encourages everyone to opt for an eating pattern that fits their medical needs, lifestyle, and goals.
An eating pattern describes the foods or groups of foods that a person can choose to eat on a daily basis over time. For a diabetic patient, blood sugar level is a major factor influencing their diet decisions and eating patterns.
Plant-based Eating Pattern
What makes plant-based effective in reducing diabetes risk?
A plant-based eating pattern relies mostly on plant foods, like leafy greens, high-fiber fruits, whole grains, nuts, seeds, and vegetables. Researchers believed that a whole-food, plant-based diet works in reducing the risk of Type 2 diabetes because it also helps improve insulin uptake, or effectiveness, through weight loss, reduction in saturated fat intake, promotion of a healthy gut microbiome, and an increase in fiber consumption.
Can going plant-based all the way help manage your blood glucose levels? Most likely yes.
For 20 years, researchers at The Harvard T.H. Chan School of Public Health used the findings of three prospective cohort studies in the country and collected dietary data.
The researchers found out the following:
- People who consumed predominantly plant-based foods and minimal animal products, lowered their risk for developing type 2 diabetes by 20 percent.
- Consumption of a plant-based diet that emphasized healthy plant foods (nuts, vegetables, fruits) was associated with larger risk reductions (around 35 percent) in diabetes, while consumption of a plant-based diet high in less healthy plant foods was associated with a 16 percent increased diabetes risk.
So does that mean that vegetarians are less likely to develop diabetes? Not necessarily.
The researchers emphasized that the study is not focused on vegetarian or vegan diets (which can include less healthy plant products, such as sweetened foods and beverages), but rather plant-based foods. However, you could follow a plant-based diet all your life and still develop diabetes.
While it’s difficult for many individuals to completely give up some or all animal-based foods and become vegetarian, it is important to understand how gradually increasing plant foods in your diet and decreasing intake of animal foods can significantly reduce diabetes risk.
Going Plant-Based via the Mediterranean Diet
If there’s one specific diet that highlights plant-based food minus the sugar-laden vegan or vegetarian meat substitutes, the Mediterranean diet is the way to go. In this type of diet, the emphasis is placed on whole grains, fruits, vegetables, legumes, nuts, herbs, spices, and healthy fats.
A 2015 systematic review of studies on the efficacy of a Mediterranean diet on the management of type 2 diabetes and prediabetic states concluded that the diet was associated with better blood glucose management than other commonly used diets (including a low-fat diet), suggesting that it is suitable for the overall management of type 2 diabetes.
The diet ranked #1 (tied with the DASH diet) was noted as the best diet last year by U.S. News. The rankings were made after a panel of nationally recognized experts in nutrition, food psychology, heart disease, and diabetes reviewed almost every diet profile out there.
While ranking diets from best to worst is not really the most accurate way to gauge which diet will work best for diabetic patients (and for everyone), you can use the rankings as your starting point in experimenting with your own eating patterns.
Increasing Insulin Sensitivity with Intermittent Fasting
One of the initial steps in preventing diabetes is to understand the concept of insulin resistance and insulin sensitivity. A major concern regarding poor dietary habits is that it can lower your body’s ability to manage the glucose being ingested from your food. This means that more insulin will be required to lower blood glucose, creating a state of insulin resistance.
The good news is 20-hour fasting periods (also known as Intermittent Fasting or IF) has been shown to increase insulin sensitivity.
As IF increases your insulin sensitivity, your body becomes more efficient and requires less insulin to lower blood glucose. In those trending towards developing diabetes,each 10 percent increase in skeletal muscle index (ratio of skeletal muscle to body weight), there was an associated 11 percent increase in glucose sensitivity. Because excess glucose may be stored as fat mass, improvements in insulin sensitivity can lead to better weight management. This is good news if you’re currently working to lose fat mass (and gain lean body mass later on) as part of your plans to change your body composition. It’s also worth noting that improving your body composition can help you stave off diabetes!
For more info on IF, we’ve written a comprehensive guide to intermittent fasting here. If you are prediabetic or diabetic, please consult your doctor before considering a fasted diet regimen.
How About Going Low-Carb to Manage Diabetes?
Going on a low-carb diet to potentially manage diabetes doesn’t necessarily mean ditching carbs altogether and eating mainly from fat or protein. In a nutshell, it means limiting or avoiding food that is primarily made of highly-refined carbs and grains.
According to the American Diabetes Association, there is no standard at this time for the grams of carbohydrate in a low-carb eating pattern for diabetic patients.
A 2015 review of related research on the subject revealed that although low carbohydrate diets lead to significantly greater short-term weight loss and improvements in glucose control (HbA1c) and triglycerides, it doesn’t have long-term benefits. As a whole, low-carb diets failed to show long-term improvements over higher carbohydrate intakes on weight loss or promoting healthy levels of glucose.
The bottom line is if you have Type 2 diabetes and are wondering if cutting back on your sugar intake can help manage the symptoms, the straight answer is: yes!
But there’s a caveat: sugar is not synonymous with carbs.
In their nutrition recommendations for Type 2 diabetes patients, the American Diabetes Association doesn’t endorse cutting down on carbs but limiting added sugars or sweeteners from your diet. They further declared that there’s no reason to recommend that people with diabetes should avoid naturally occurring fructose in fruits, vegetables, and other whole foods. According to the ADA, the sugars from these sources usually accounts for only 3–4 percent of your daily energy intake.
Your Major Takeaways
In the end, it’s not about avoiding a specific macronutrient like carbs if you want to make your own version of a diabetic diet. Nor you should stick to what’s considered the “best diet” for the year.
Like there’s no one-size-fits-all healthy diet, there’s no such thing as the ultimate diabetes diet. A plant-based diet that's hard to stick to for one diabetic patient might be easy for someone else. Plus, you also have to consider culture, body types, and the presence or absence of other disease states. As always, talk to your doctor first before embarking on a quest to find your own “best diabetic diet”.
Finally, if you’re looking to offset the negative effects of diabetes (or prediabetes), taking your body composition into account is also a priority. Work with a knowledgeable and experienced professional who can help determine your body composition and help you set goals to improve your body composition through diet and physical activity.
Kyjean Tomboc is a nurse turned freelance healthcare copywriter and UX researcher. After experimenting with going paleo and vegetarian, she realized that it all boils down to eating real food.