Published by PMR of NY & CT
Hearing that you have type 2 diabetes can bring a flood of questions, and "What can I eat now?" is usually near the top. The reassuring answer is that a type 2 diabetes diet isn't a strict list of forbidden foods. It's a flexible way of eating that helps keep your blood sugar in your target range and protects your heart.
There's no single type 2 diabetes diet that's right for everyone. Mediterranean-style, DASH, vegetarian and lower-carbohydrate patterns can all work. The best one fits your tastes, culture, schedule and medicines, and it's one you can keep up. Your diabetes care team, including a registered dietitian or diabetes educator, can help you shape it.
How food affects type 2 diabetes
In type 2 diabetes, your body doesn't respond to insulin as well as it should, and over time it may not make enough. Insulin is the hormone that moves glucose out of your blood and into your cells, so when it falls short, glucose builds up.
Type 2 diabetes develops from a mix of factors, including family history, age, weight and activity level. It isn't caused by any single food. Carbohydrates have the biggest direct effect on blood sugar, while protein and fat have less. Because diabetes also raises the risk of heart disease, a diabetic diet limits saturated fat and sodium too.
Plan your type 2 diabetes diet with the plate method
The diabetes plate method, from the American Diabetes Association, is a simple way to plan meals without weighing or counting everything. Using a 9-inch plate:
- Fill half with non-starchy vegetables, such as salad greens, tomatoes, mushrooms, zucchini, carrots or asparagus.
- Fill a quarter with lean protein, such as chicken or turkey, salmon or shrimp, lean beef or pork, tempeh or cottage cheese.
- Fill a quarter with carbohydrate foods, such as brown rice, whole-wheat pasta, potatoes, corn, beans or fruit.
- Drink water or another zero-calorie drink.
It works for most meals, including takeout.
Carbs: choose them, count them and spread them out
Carbohydrates aren't off limits, but the type and amount matter:
- Choose high-fiber carbohydrates. Beans, lentils, whole fruit and less-processed grains such as bulgur, quinoa and barley raise blood sugar more gently than white bread, sweets and sugary drinks.
- Learn what a serving looks like. In carb counting, 15 grams of carbohydrate is one “carb choice.” That’s about one slice of bread, one small piece of fruit or a third of a cup of cooked rice or pasta.
- Keep amounts fairly steady. Eating similar amounts at meals from day to day makes blood sugar more predictable.
- Don’t skip meals if you take insulin or a medicine that can cause low blood sugar.
Your dietitian can suggest a carbohydrate target for each meal based on your medicines, activity and goals.
Make physical activity part of the plan
Activity works hand in hand with a type 2 diabetes diet. It helps your muscles use glucose and makes your body more sensitive to insulin. The American Diabetes Association recommends that most adults with diabetes:
- Get at least 150 minutes of moderate activity, such as brisk walking, each week, spread over at least three days
- Do strength training two to three times a week, on days that aren't back to back
- Break up long stretches of sitting with a few minutes of movement
For people with overweight, even modest weight loss can improve blood sugar. If joint pain, an old injury or balance problems make exercise hard, a physical therapy program can be built around what your body can do today.
When to call your care team or 911
Call 911 for:
- Chest pain or pressure, shortness of breath, or pain spreading to your arm, jaw or back
- Signs of stroke, such as a drooping face, arm weakness or trouble speaking
- Severe low blood sugar, such as passing out or being too confused to eat or drink safely
- Very high blood sugar with vomiting, labored breathing or confusion
Call your diabetes care team soon if your readings are often above your target, you have frequent lows, you're sick and can't keep food down, or you notice a foot sore that isn't healing or new numbness, tingling or burning in your feet. When nerve symptoms need a closer look, tests such as electromyography (EMG) and nerve conduction studies can help find the cause.
Frequently asked questions
Can type 2 diabetes be reversed with diet?
Some people, especially soon after diagnosis, can bring their blood sugar back below the diabetes range without medicine through weight loss and lasting changes to diet and activity. Doctors call this remission rather than a permanent fix, because blood sugar can rise again and still needs regular checks. Never stop or change a diabetes medicine on your own; work with your care team.
Is intermittent fasting safe if you have type 2 diabetes?
It can be risky without medical guidance. Long gaps between meals can cause low blood sugar if you take insulin or certain diabetes pills, so your doses may need to change. Research suggests time-restricted eating can help some people lose weight and improve blood sugar, with results similar to other ways of cutting calories. Talk with your care team before you try it.
Can you drink alcohol if you have type 2 diabetes?
Some people with diabetes can drink in moderation, but alcohol has risks, and there's no health reason to start. It can cause low blood sugar, sometimes hours later, especially if you take insulin or sulfonylureas, and many drinks add sugar and calories. If you drink, have it with food, check your blood sugar and ask your care team whether it's safe with your medicines.
Get help staying active with diabetes
If pain, an injury or balance problems keep you from staying active, Physical Medicine & Rehabilitation of NY & CT (PMR) can help with the movement side of managing type 2 diabetes, while your diabetes care team manages your medicines and blood sugar plan. Request an appointment and our team will contact you.
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