Living with type 2 diabetes doesn’t mean you have to give up all the things you love: Although you’ll want to strike certain types of food from your diet, or at least limit them, you can enjoy a wide range of foods and still manage the condition. In short, an eating plan for type 2 diabetes should include a variety of healthy carbohydrates, fats, and proteins, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
Ultimately, Mayo Clinic says the trick is to choose foods that are naturally rich in nutrients to help keep your blood sugar levels within a healthy-for-you range and prevent wide swings that can cause a range of symptoms: frequent urination and thirst caused by hyperglycemia (high levels of sugar in the blood), fatigue, dizziness, headaches, and mood changes caused by low blood sugar (hypoglycemia), according to the American Diabetes Association (ADA).
To follow a healthy diet for diabetes, you must first understand how different foods affect your blood sugar. Carbohydrates — most abundant in grains, bread, pasta, milk, sweets, fruit, and starchy vegetables — are broken down into glucose in the blood, which raises blood sugar, potentially leading to hyperglycemia, according to Mayo Clinic.
This means you’ll want to keep your carb intake within a healthy target range for yourself, which will be based on factors such as your age, weight, and activity level, according to the Centers for Disease Control and Prevention (CDC). A certified diabetes care and education specialist or registered dietitian can help determine your personal daily carb goal.
To hit that goal, you can eat many foods, but you’ll need to limit portions of foods high in carbs, because they “have the most impact on blood sugar level,” says Alison Massey, RD, a certified diabetes care and education specialist in Chesapeake Beach, Maryland.
To help choose the right foods in the right proportions for managing type 2 diabetes, follow these helpful guidelines from the NIDDK.
Fill half of a 9-inch plate with nonstarchy vegetables, a quarter with lean protein (animal or plant based), and a quarter with a grain or starchy vegetable. You may be able to include a piece of fruit and a small glass of milk, if that’s allowed in your eating plan.
Because processed and sugary foods are unhealthy carbs, limit them in your diet, says Massey. That includes soda, candy, and packaged or processed snacks, such as corn chips and potato chips. Note that although artificial sweeteners (such as those in diet soda) won’t necessarily spike your blood sugar like white sugar does, they can still affect your blood sugar — and even alter your body’s insulin response.
A study published in July 2023 in Diabetes Care found that people who consumed high amounts of artificial sweeteners, such as aspartame and sucralose, had an increased risk of developing type 2 diabetes. Another study, published in September 2022 in the journal Cell, found that artificial sweeteners may alter the gut microbiome, which may lead to elevated blood sugar levels. More research is needed to determine how artificial sweeteners affect people with diabetes.
For people with diabetes, the ADA recommends proteins that are low in saturated fat. If you’re following a vegan or vegetarian diet, you can rely on beans (dried or canned beans and bean products, such as hummus and falafel), tempeh, and tofu, notes Cleveland Clinic.
Nuts and nut butters/spreads are good protein sources for people with diabetes, too, but are high in fat and calories, so it’s crucial to keep serving sizes in check. For example, the ideal portion of whole nuts, according to the American Heart Association (AHA), is 1.5 ounces — a small handful. If you eat that amount of unsalted almonds, for example, you’ll down approximately 255 calories and over 22 g of fat, according to the U.S. Department of Agriculture (USDA).
The ADA’s list of the best proteins for a diabetes-friendly diet includes:
- Fish high in omega-3 fatty acids, such as salmon, sardines, albacore tuna, mackerel, and rainbow trout
- Shellfish, including clams, crab, imitation shellfish, lobster, oysters, scallops, and shrimp
- Skinless chicken
- Skinless turkey
- Beans and legumes
- Cottage cheese
- Nuts and nut spreads, such as almond butter (in moderation)
- Whole eggs
- Deli meats (with the exception of turkey), including bologna, ham, roast beef, and salami
- Meat-based jerky
- Processed meats, such as hot dogs, pepperoni, and sausage
- Sweetened or flavored nuts, such as honey roasted or spicy
- Sweetened protein shakes or smoothies
Not all carbs are off limits when managing diabetes. In fact, the ADA recommends vitamin-rich whole grains in a healthy diabetes diet. These foods contain fiber, which is beneficial for digestive health. Fiber can also fill you up and keep hunger pangs — and the urge to reach for unhealthy snacks — at bay. It also helps slow the rise of blood sugar, research shows. How? Dietary fiber slows the breakdown of starches (a type of carb) into glucose (sugar), which helps keep blood sugar levels steady, according to the Harvard T.H. Chan School of Public Health. Plus, whole grains contain vitamins, minerals, and antioxidants that are healthy for anyone, regardless of diabetes status.
On the other hand, grains in the form of popular foods such as white bread, as well as processed or packaged grains (like cereal), should be avoided or limited to help prevent unwanted blood sugar spikes. Refined white flour may be enriched with B vitamins and iron, which are removed during milling, but does not contain fiber, according to the USDA.
Just keep in mind that it’s still important to keep tabs on your overall carb count and practice portion control to keep your blood sugar levels steady, according to the NIDDK.
The best options (in moderation), per the ADA and NIDDK, include:
- Brown or wild rice
- Whole-grain breads, such as 100 percent whole-wheat bread (but check that each slice contains at least 3 grams of fiber)
- Whole-grain cereal, such as steel-cut oats
- Whole-wheat pasta
The worst options, per Mayo Clinic and the ADA, include:
- Sugary breakfast cereals
- White bread
- White rice
- White pasta
When chosen well and eaten in moderation, dairy can be a great choice for people with diabetes. A review published in March 2023 says that dairy products such as milk and yogurt offer protective benefits against type 2 diabetes. Whenever possible, opt for low-fat or fat-free dairy options to keep calories down and unhealthy saturated fats at bay. Also, try to avoid flavored dairy, such as chocolate milk or yogurt with added sugar.
The best options, per the ADA and Mayo Clinic, include:
- Nonfat, low-sodium cottage cheese
- Nonfat plain Greek yogurt
- Nonfat, unsweetened kefir
- Reduced-fat cheese (in moderation)
- Skim milk
The ADA and Mayo Clinic list these among the worst dairy options:
- Full-fat or 2 percent milk, especially chocolate or other flavored milks
- Full-fat cheese, including cottage cheese
- Full-fat or sweetened yogurt
- Full-fat, sweetened kefir
Vegetables are an important food group to include in any healthy diet, and a diabetes diet is no exception. Veggies are full of fiber and nutrients, and nonstarchy varieties are low in carbohydrates — a win for people with diabetes who want to gain control over their blood sugar levels, Massey says.
As for packaging, frozen veggies without sauce are just as nutritious as fresh, and even low-sodium canned veggies can be a good choice if you’re in a pinch. Watch your sodium intake to avoid high blood pressure, and consider draining and rinsing salted canned veggies before eating them, says the ADA. If you go that route, opt for low-sodium or sodium-free canned veggies whenever possible.
The best veggie options, according to the ADA, include:
- Artichoke hearts
- Brussels sprouts
- Cruciferous veggies, including broccoli and cauliflower
- Dark, leafy greens, such as spinach, kale, and Swiss chard
Veggies to enjoy in moderation, the ADA notes, include:
- Sweet potatoes
- White potatoes
- Winter squash, such as pumpkin, acorn squash, and spaghetti squash
Fruit often gets a bad rap due to its carb content, but this food group can actually be great in a diabetes diet when chosen wisely and eaten in moderation. In particular, fruit can be a great replacement for unhealthy processed sweets, such as cakes, cookies, and pastries, while providing disease-fighting antioxidants, vitamins, minerals, and satiating fiber to boot.
But, as with grains, it’s important to roll out your carb-counting skills when noshing on nature’s candy. The ADA notes that a small piece of whole fruit or 1/2 cup of canned or frozen fruit typically contains 15 g of carbs, while fruit juice — a less ideal source of fruit — can have that much in 1/3 to 1/2 cup.
Also, dried fruit may not be the best way to get your fix. Because so much water is removed, a serving is much smaller and usually less filling than whole fruit: The ADA points out that just 2 tablespoons of raisins contains the same 15 grams of carbs found in a small piece of whole fruit!
Same goes for canned fruit, which often contains sugary syrup in a high concentration, which should be avoided at all costs. Instead, look for terms such as “packed in its own juices,” “unsweetened,” or “no added sugar,” the ADA says. Trendy juices are similarly less than ideal, as they’re stripped of the beneficial fiber that you’d find in whole fruit with the skin on.
But, some pleasant news: When consumed in moderation and made with whole ingredients and no added sugar, fruit smoothies can be a good food for diabetes. Consider stocking your fridge with unsweetened frozen fruit, so you can whip one up in a hurry for breakfast. Use no more than 1 cup of fruit (to keep carbs under control) and add ingredients with protein, such as yogurt or a small amount of nut butter, which will help your body break down the carbohydrates more slowly, leading to less of a spike in blood sugar.
When in doubt, consider the fruit’s glycemic load — a measure of how much a certain food is likely to spike your blood sugar— to pick one that’s diabetes friendly. Your healthcare team can also help you safely incorporate fruit into your diabetes diet.
You have many fruit choices at your disposal, according to the ADA. The best options include:
- Apples with the skin on
- Apricots with the skin on
- Berries, such as blueberries, strawberries, and raspberries
- Peaches with the skin on
- Pears with the skin on
- Tart cherries
The worst options, according to the NIDDK and ADA, include:
- Canned fruit in syrup
- Dried fruit
- Packaged juices
Despite what you may have thought, fat isn’t always your enemy when it comes to healthy eating for diabetes. One meta-analysis noted that getting enough of the right kinds of fat can ultimately help you lower insulin resistance and attain better control over your blood sugar. The key is knowing how to tell a good fat from a bad fat.
The monounsaturated fats found in almonds, avocados, and pecans and the polyunsaturated fats found in walnuts and sunflower oil, which can also help lower LDL (“bad”) cholesterol, are great picks when eating for type 2 diabetes, according to the ADA.
Meanwhile, saturated fats and trans fats can harm your heart and overall health, according to the AHA. To spot trans fats, look for the terms “hydrogenated” or “partially hydrogenated” oils on labels for processed foods, such as packaged snacks, baked goods, and crackers. “I always tell my clients to double-check the ingredient list to make sure they don’t see any partially hydrogenated oil in their food products,” Massey says.
The best fat sources, per the ADA, include:
- Fish, including salmon and tuna
- Nut butters
- Nuts, such as almonds, cashews, peanuts (technically a legume), pecans, and walnuts
- Plant-based oils, such as corn, olive, soybean, or sunflower
- Seeds, such as chia seeds and flaxseed
The worst options, per the ADA, include:
- Bacon, beef, hot dogs, salt pork, sausage, and spareribs
- Coconut and palm oils
- Fast food
- Full-fat dairy products
- Margarine and butter in sticks
- Packaged snacks, such as corn chips, crackers, and potato chips
- Processed sweets, including cakes, cookies, doughnuts, and muffins
Additional reporting by Lauren Bedosky.