Eating healthily with diabetes
Enjoy your food and stay well by understanding how your diet affects your diabetes
What’s a healthy diet for someone with diabetes? You might be surprised to know it’s essentially the same as a healthy diet for everyone.1 According to the NHS Eatwell Guide, the building blocks of a healthy diet for adults are2:
- Vegetables and fruit – at least five 80g servings a day, or half your plate at each meal.
- Starchy carbohydrates, choosing wholegrain varieties such as wholewheat pasta, wholemeal bread or brown rice.
- Dairy foods (or alternatives such as soy milk), choosing lower-fat, lower-sugar varieties of products like cheese and yogurt.
- Protein foods, such as beans, pulses (e.g. peas and lentils), eggs, fish or meat
- A small amount of unsaturated fat (rapeseed, vegetable, olive or sunflower oils) rather than saturated fats like butter or lard.
- 30g dietary fibre per day (in foods such as wholegrain cereals, pulses and root vegetables)
- 6-8 glasses per day of water or low-fat, low-sugar drinks
The Eatwell Guide advises that foods high in sugar, fat and salt such as crisps, cakes, chocolate and biscuits aren’t needed in our diet and we should only eat small portions of these occasionally.2
How does The Eatwell Guide work with diabetes?
On average, people in the UK eat too much saturated fat and sugar, and not enough vegetables, fruit and high-fibre foods.3 If this applies to you, being diagnosed with diabetes might mean adjusting your diet to help you stay well and to help manage your glucose levels. But there’s no need to change all your eating habits to fit in with a restrictive ‘diabetic diet’, or to give up your favourite foods.4
How important are carbohydrates for Type 1 diabetes?
Carbohydrates are the food group that has the biggest effect on your glucose.5 There are all kinds of carbohydrate foods, ranging from simple sugars like table sugar and honey to starchy foods like pasta and rice. Foods like fruit and milk contain ‘natural sugars’ and sugar is also added to many processed foods, both savoury and sweet.5
Carbohydrates are the main source of energy in the body. The dietary fibre in plant-based foods is also important for digestive health and can help slow down the rate at which glucose enters your bloodstream.4
If you have Type 1 diabetes and your body’s producing no insulin, it’s important to balance the amount of carbohydrates you eat with your insulin doses, to prevent your glucose going too high or too low.4
Testing your glucose regularly will help you learn about how different types and amounts of carbohydrates affect your glucose. Your diabetes care team can advise on how to count carbohydrates in foods and drinks, and how to plan the content and timing of meals and insulin doses to keep your glucose levels well controlled.4
I have Type 2 diabetes. Are carbohydrates important?
If you have Type 2 diabetes but don’t need insulin injections, following a healthy balanced diet is more important than knowing the carbohydrate content of every food.7 Many people with Type 2 are advised to lose weight to help manage their diabetes, and some find they can put their diabetes into ‘remission’ – with no symptoms at all – by losing weight.8 Choosing bulky carbohydrate foods that fill you up – like porridge or baked potatoes – is a useful way to help control your overall energy (calorie) intake. But watching portion size is also important, and so is eating fewer foods that are high in fat and sugar.
How useful is the Glycaemic Index for diabetes?
The Glycaemic Index (GI) is a system of rating carbohydrate-containing foods according to how quickly they raise glucose levels.9 Foods with a high GI rating raise glucose quickly10:
- White rice
- White bread
Foods with a lower GI rating cause a slow or gradual rise in glucose10:
- Pulses (beans and lentils)
Knowing the GI rating of a carbohydrate-containing food or drink can help you predict its effect on your glucose, but it’s not the whole story. For example, if you have a mixed meal, like pasta with meat sauce, the fat and protein in the sauce will lower the GI of the meal as a whole11.
If you have Type 1 diabetes, the amount of carbohydrate in a food is more important than the GI number when it comes to calculating insulin doses.4 Many low-GI foods are higher in fibre than high-GI foods, so may help you feel fuller. But that’s not to say you can eat as many low-GI foods as you like; portion size is still important, especially if you have Type 2 diabetes and you’re trying to improve your glucose control by losing weight.
So the Glycaemic Index is just one tool to help you become more aware of the carbohydrates you eat, which can be useful when you’re learning how to eat healthily and manage your diabetes well.
Can I drink alcohol with diabetes?
If you enjoy a drink, having diabetes needn’t mean going teetotal. The same official health advice applies to everyone who drinks alcohol: to have no more than 14 units a week, spread over three or more days of the week, and not to drink every day.12
It’s important to be aware though that alcohol can cause your glucose levels to rise initially, then fall sharply. If you manage your diabetes with glucose-lowering treatments like insulin or sulphonylureas, this can result in a low glucose (hypo) that can happen up to 24 hours after you’ve had a drink.13 This is because when your liver’s processing alcohol it produces less glucose.13 Drinking on an empty stomach, or doing lots of exercise (such as dancing) can lower your glucose even further, making a hypo more likely. Tips to stay safe include:
- Stick to recommended drinking limits14
- Avoid binge-drinking14
- Eat something when you’re drinking15
- Test your glucose after you’ve been drinking, especially before bed and first thing in the morning.15
1. Cleveland Clinic 2013, Nutrition basics for people with diabetes, accessed 21 March 2019, <https://my.clevelandclinic.org/health/articles/11650-nutrition-basics-for-people-with-diabetes>.
2. NHS 2019, The Eatwell Guide, accessed 21 March 2019, <https://www.nhs.uk/live-well/eat-well/the-eatwell-guide/>.
3. Public Health England 2018, National Diet and Nutrition Survey (NDNS) 2014-2016, accessed 21 March 2019, <https://www.gov.uk/government/statistics/ndns-results-from-years-7-and-8-combined>.
4. Diabetes UK 2019, I have Type 1 diabetes; what can I eat?, accessed 21 March 2019, <https://www.diabetes.org.uk/diabetes-the-basics/food-and-diabetes/i-have-type-1-diabetes>.
5. NHS 2018, The truth about carbs, accessed 21 March 2019, <https://www.nhs.uk/live-well/healthy-weight/why-we-need-to-eat-carbs/>.
6. Joslin Diabetes Center 2019, How does fiber affect blood glucose levels, accessed 21 March 2019, <https://www.joslin.org/info/how_does_fiber_affect_blood_glucose_levels.html>.
7. Diabetes UK 2019, I have Type 2 diabetes; what can I eat?, accessed 21 March 2019, <https://www.diabetes.org.uk/diabetes-the-basics/food-and-diabetes/i-have-type-2-diabetes>.
8. Diabetes UK 2019, Diabetes remission, accessed 21 March 2019, <https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/treating-your-diabetes/type2-diabetes-remission>
9. The Glycaemic Index Foundation 2017, What is GI?, accessed 21 March 2019, <https://www.gisymbol.com/about-glycemic-index/>.
10. Harvard Health Publishing 2018, Glycaemic Index for 60+ Foods, accessed 16 April 2019, <https://www.health.harvard.edu/diseases-and-conditions/glycemic-index-and-glycemic-load-for-100-foods>.
11. NHS 2018, What is the Glycaemic Index (GI)?, accessed 21 March 2019, <https://www.nhs.uk/common-health-questions/food-and-diet/what-is-the-glycaemic-index-gi/>.
12. UK Chief Medical Officers 2016, Low Risk Drinking Guidelines, accessed 21 March 2019, <https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/545937/UK_CMOs__report.pdf>.
13. Drinkaware 2016, Alcohol and diabetes, accessed 21 March 2019, <https://www.drinkaware.co.uk/alcohol-facts/health-effects-of-alcohol/diseases/alcohol-and-diabetes/>.
14.Diabetes UK 2019, Alcohol and diabetes, accessed 21 March 2019, <https://www.diabetes.org.uk/guide-to-diabetes/enjoy-food/what-to-drink-with-diabetes/alcohol-and-diabetes/>.
15. Diabetes UK 2019, Type 1 diabetes and drinking, accessed 16 April 2019, <https://www.diabetes.org.uk/guide-to-diabetes/young-adults/type-1-drinking/>