What is the Best Diet for Type 2 Diabetes?

One of the most common questions people have after a diagnosis of type 2 diabetes is, “what can I eat?”. 

There seems to be a lot of information out there, most of it conflicting, and it leaves people feeling lost, confused, and frustrated. 

Those feelings, amidst a new and oftentimes tricky medical diagnosis, are not easy to deal with when trying to navigate to a new lifestyle and way of being.

In this article, I will outline some of the more popular diets people with type 2 diabetes follow, the pros and cons of each one, and how to tailor an eating plan that will work for you. 

Why do people with diabetes have to eat differently? 

First, it’s important to acknowledge that everyone’s journey to a type 2 diagnosis is different; some people had gestational diabetes that then turned into type 2, some people developed type 2 after many years, and some people are more genetically susceptible to type 2, with the diagnosis coming out of nowhere, even while they maintain a low BMI and live an active life. 

But having type 2 diabetes means that the body is not utilizing the insulin it produces properly, or even that the body isn’t producing enough insulin. Type 2 diabetes management differs, but almost always requires exercise (sometimes to lose weight, sometimes to just maintain it) and dietary changes, sometimes along with oral or injected medications. 

Without proper treatment, including adjustments to diet, someone with type 2 diabetes may suffer from poor blood sugar control, struggle with higher hba1c levels, and ultimately face diabetes complications later on in life. 

Although you can include most foods into a healthy eating plan for type 2 diabetes, you do need to pay most attention to the types of carbohydrates you choose in order to prevent blood sugar spikes. 

Why must people with diabetes pay attention to carbohydrates? 

Carbohydrates, one of the three necessary macronutrients for living, primarily come from the sugars and starches found in fruits, grains, vegetables, and dairy products. 

For people living with diabetes who cannot metabolize glucose (a form of sugar) on their own, they must carefully count carbohydrates and calibrate exogenous insulin or other medications and exercise accordingly, to avoid high blood sugars and negative health complications. 

“Carbohydrates are macronutrients, meaning they are one of the three main ways the body obtains energy, or calories,” said Paige Smathers, a Utah-based registered dietitian. Carbohydrates, although often criticized in diet culture today, are the body’s main source of energy. 

Foods high in simple carbohydrates, mostly from added sugars like cane sugar, brown sugar, maple syrup, and honey, and refined grains, especially white flour and white rice will cause your blood sugar levels to spike quickly. 

When eating carbohydrates, people with type 2 diabetes should opt for foods that contain fiber, such as 100% whole-grain bread and oats. It’s important to count the number of carbohydrates you eat as a person living with diabetes, and make sure you’re incorporating them into an overall healthy diet. 

What are the most popular diets for someone with type 2 diabetes?

There are countless diets on the planet, but the following are the three most popular for people who live with type 2 diabetes.

“The more weight you lose, the more you’ll improve your blood sugar levels. But how you do it is largely up to you,” says Michael Dansinger, MD, director of the Diabetes Reversal Program at Tufts Medical Center.

Some diets are healthier and safer than others, so make sure to talk with your doctor before you change your eating patterns. Always weigh the pros and cons of any diet before making a lifestyle change. 

The Mediterranean diet

The Mediterranean diet is an extremely popular diet that includes plenty of fresh, seasonal produce, extra virgin olive oil, whole grains, and emphasizes vegetables and healthy fats instead of processed foods. 

This way of eating is excellent for blood sugar control and weight loss, but since many of the foods included are not processed, it can become harder to count carbohydrates, which is a cornerstone of diabetes management. 

Also, this way of eating can quickly become expensive, and if you live in a colder climate, you may struggle to find fresh produce year-round, making sticking to the diet difficult for some people. 

The Mediterranean diet can become pretty high in carbohydrates, so make sure you’re counting carbohydrates and weighing your foods to make sure you aren’t overeating while following this plan.

The DASH diet 

“DASH” is an acronym for Dietary Approaches to Stop Hypertension and is recommended primarily for people who have high blood pressure, although this diet is also a fantastic option for people with type 2 diabetes.

It’s a plant-forward diet that focuses on fruit, vegetables, nuts, and legumes, as well as low-fat dairy, meats, fish, whole grains, and heart-healthy fats. The diet is low in sodium and fat and can help those who follow it to lose weight, lower blood pressure, and better manage their blood sugars.

Nearly two-thirds of people with diabetes have hypertension, so following a diet that addresses both conditions is super beneficial. 

However, following the diet strictly can become very expensive, as fresh produce is more costly than packaged foods, and preparing meals from scratch can take a lot of time and energy in the kitchen. 

Ketogenic diet 

The ketogenic diet is a very low-carbohydrate, high-fat diet that was originally prescribed for children suffering from epilepsy. It involves drastically reducing carbohydrates in the diet and replacing it with fat, putting the body into a state of ketosis. 

Common side effects include constipation, low-grade acidosis, and hypoglycemia, leading to lethargy have been reported. People have experienced kidney stones while following the ketogenic diet. People strictly following this diet will require supplements to counter the dietary deficiency of many micronutrients not found in the diet itself. 

This is an excellent diet for weight loss and blood sugar management but lacks many vital nutrients needed to thrive and is hard to follow long-term. 

How do I know which diet is right for me? 

Simply said, there is no one perfect diet for everyone with type 2 diabetes. Always work with your doctor and diabetes care team to make sure you are choosing a diet and eating plan that works for your activity level, personal goals, palate, and budget, and make sure it is something that you can stick with long-term. 

Some questions to ask yourself before choosing a specific eating plan:

• Am I looking to lose weight?
• Am I looking for a super low-carbohydrate eating plan?
• Do I need a meal plan to fuel my workouts better?
• How much money do I have to dedicate to buying specific foods?
• Is the rest of my family willing to support my new eating plan? 
• Will the rest of my family be joining me on this new eating plan? 
• What types of foods do I gravitate to? What types of foods do I not enjoy eating? 

Making healthier eating a long-term commitment 

Whatever diet you choose, know that managing type 2 diabetes is a long-term commitment, and so should your commitment to a healthy eating plan be. 

Focus on what types of foods make you feel good, help maintain your blood sugars and blood pressure, manage your weight, and give you energy. Focusing on how your eating plan will help you feel better will make your eating plan easier to stick to. 

Also, seeking advice from a registered dietitian or certified diabetes educator can help you come up with an individualized meal plan that will help you meet your goals while still enjoying foods that you love. 

Enlisting support from family and friends can help cement your commitment; if you do not have support at home, finding a type 2 diabetes support group online or in-person will help you find like-minded people who are also trying to live healthier lives that can support you on your journey. 

There are also virtual coaching programs that can be very effective. These virtual programs can give you individualized dietary guidance from the comfort of your own home.

“While the idea of changing your diet can be confusing and overwhelming at first, research shows that making healthy lifestyle choices can help you manage your blood sugar levels in the short term and may even prevent many of the long-term health complications associated with diabetes,” says Lori Zanini, RD, CDE, and author of The Diabetes Cookbook and Meal Plan for the Newly Diagnosed.

Ultimately, everyone is different and you know best how your body responds to different types of foods. You may make different choices when you’re eating out at a restaurant, or cooking at home, or traveling, or exercising a lot, or even celebrating special occasions, and that’s okay. 

There is no “best diet” that everybody should follow. It’s important to do what works for you, both physically and mentally.