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Diabetes Diet: Foods to Eat and Avoid, According to an RD
A registered dietitian explains how to build a diabetes eating plan around your diabetes type, medications, and favorite foods. It covers the plate method, carb counting, and when to get one-on-one support.
Key Takeaways
- There’s no single diabetes diet. The American Diabetes Association focuses on overall eating patterns built around non-starchy vegetables, fiber-rich carbohydrates, lean proteins, and healthy fats.
- Carbohydrates affect blood sugar most, but portion size, carb type, and pairing carbs with protein, fat, and fiber all shape the response.
- The plate method and carb counting are two CDC-recommended meal planning tools, and carb counting matters most if you take mealtime insulin.
- Insulin, sulfonylureas, and GLP-1 medications can change how and when you eat, so talk with your care team before major diet changes.
- A registered dietitian can personalize your plan — check if your insurance covers a dietitian to get started.
If you’ve recently been diagnosed with diabetes, you might feel like every meal suddenly comes down to numbers. How many carbs are in that sandwich? Is fruit okay? Do you need to eat at the same time every day?
But here’s something I want you to know as a registered dietitian (RD): Eating with diabetes doesn’t have to revolve around a calculator and crunching numbers!
A diabetes diet is a balanced eating plan built around high-quality whole foods and regular meals to help manage blood sugar and lower the risk of heart disease. There’s no one-size-fits-all approach, though. Your diabetes type, medications, food preferences, and cultural traditions all matter — and you don’t have to figure it out alone!
While your prescriber, such as a primary care clinician or endocrinologist, manages your diagnosis and medications, a diabetes dietitian can help you navigate carb portions, balance your favorite meals, and make eating with diabetes less stressful. And I can help you get a head start by walking you through the basics right here!
What Is a Diabetes Diet?
There’s no single “diabetes diet,” and the general recommendations aren’t much different from those for healthy eating overall.
According to the American Diabetes Association, it’s about your overall eating habits rather than any one food or meal. That includes plenty of non-starchy vegetables, quality carbohydrates, lean meats or plant-based proteins, and heart-healthy fats, while making room for your favorite foods and cultural traditions.
And yes, you read that right: carbohydrates are included! One of the biggest misconceptions I hear is that people with diabetes need to avoid carbs altogether. But that’s simply not true.
Carbs have the most direct effect on blood sugar because your body breaks many of them down into glucose. However, a bowl of white rice may affect your blood sugar differently than a smaller portion of brown rice with chicken and broccoli. The amount and type of carbs, along with what else you eat, all matter.
Protein generally has less of an effect on blood sugar, while fat can slow digestion. Pairing carbs with protein, healthy fats, and fiber — like Greek yogurt topped with berries and pecans — can help moderate blood sugar spikes.
Many of these same principles also apply to a prediabetes diet, which aims to prevent or delay type 2 diabetes.
How Your Diabetes Diet Changes by Type
While the basics of healthy eating are similar across diabetes types, your nutrition priorities may vary based on the type you’re managing.
Type 2 Diabetes
With type 2 diabetes, nutrition focuses on managing blood sugar and improving insulin sensitivity. Choosing fiber-rich carbohydrates, paying attention to portions, and, when appropriate, losing excess weight can help improve blood sugar control.
Type 1 Diabetes
With type 1 diabetes, the main priority is matching carbohydrate intake with insulin. Learning to count carbs can give you more flexibility with food while helping you manage blood sugar and reduce the risk of highs and lows.
Gestational Diabetes
Gestational diabetes requires managing blood sugar while getting enough nutrients to support a healthy pregnancy. Spreading carbohydrates across meals and snacks can help prevent large blood sugar spikes without cutting out an important energy source for you and the baby. Learn more about a gestational diabetes diet.
Diabetes-Friendly Foods to Eat and Limit
Diabetes-friendly foods include non-starchy vegetables, fiber-rich carbohydrates like beans and oats, lean proteins, and unsaturated fats like olive oil. Some foods are especially helpful for managing blood sugar, while others are worth eating more sparingly.
Eating Patterns That Work for Diabetes
Several eating patterns can help manage blood sugar, so you can choose an approach that supports your health goals and includes foods you enjoy.
Mediterranean Eating
Research shows that the Mediterranean diet can help improve blood sugar management in people with type 2 diabetes. It emphasizes vegetables, fruits, whole grains, beans, nuts, fish, and olive oil, while limiting red meat and highly processed foods.
To get started, cook with olive oil instead of butter, add chickpeas to your salad, or choose salmon instead of steak for dinner.
Lower-Carb Eating
Eating fewer carbs can help manage blood sugar, especially with type 2 diabetes. You can still make room for bread and pasta, too! Try a smaller portion of either at dinner, alongside chicken and non-starchy veggies like roasted asparagus.
If you take insulin or medications that can cause low blood sugar, check with your care team before significantly reducing carbs. Your medication doses may need adjusting.
Plant-Forward and DASH-Style Eating
Plant-forward eating focuses on getting more vegetables, fruits, beans, whole grains, nuts, and seeds into your meals without cutting out meat or dairy. One easy way to start? Swap half the ground beef in your favorite chili recipe for lentils.
The DASH (Dietary Approaches to Stop Hypertension) diet includes many of these same foods, plus low-fat dairy, while encouraging less sodium and saturated fat. Simple changes include choosing unsalted nuts, buying lower-sodium canned foods, and choosing low-fat milk or yogurt.
Both approaches can support blood sugar management while helping improve blood pressure and cholesterol levels.
Meal Planning Methods for Diabetes
Wondering how to put together a diabetes-friendly meal? The Centers for Disease Control and Prevention (CDC) recommends two approaches: the plate method and carb counting. The glycemic index can also help you compare carbohydrate-containing foods.
The Plate Method
If you’re a visual person, picture a dinner plate that’s about 9 inches across, divided into three sections:
- Fill half your plate with non-starchy vegetables, like broccoli or peppers.
- Fill one-quarter with lean protein, like chicken or tofu.
- Fill the remaining quarter with carbohydrate foods, preferably fiber-rich options like brown rice or beans.
For example, dinner could be grilled chicken, roasted broccoli, and a serving of brown rice. The plate method helps you balance your portions without weighing food or counting every gram of carbs.
Carb Counting
Carb counting means adding up the grams of carbohydrates in your meals and snacks. One carb serving equals about 15 grams of carbohydrates, but that’s not necessarily the same as the serving size listed on a food package.
For example, if one slice of bread contains 20 grams of carbs, a sandwich made with two slices has 40 grams from the bread alone. Check the Total Carbohydrate line on the Nutrition Facts label, multiply by the number of servings you’re eating, and include carbs from other ingredients in your meal.
Carb counting is especially useful if you take mealtime insulin, since your dose may depend on how many carbs you eat. If you take fixed mealtime insulin doses, eating similar amounts of carbs at each meal from day to day can help reduce unexpected blood sugar changes.
Glycemic Index and Pairing Carbs
The glycemic index (GI) ranks carbohydrate-containing foods based on how much they raise blood sugar. Lower-GI foods, like lentils and oats, generally produce a smaller rise than higher-GI foods, like white bread.
But you don’t need to memorize GI scores — I don’t even know them all by heart as a dietitian! Besides, how much you eat and what you pair your carbs with can also affect your blood sugar.
For example, you could pair an apple with peanut butter or add eggs to your whole-grain toast. The protein, fat, and fiber in these combinations can slow digestion and help moderate the rise in blood sugar after eating.
Eating Around Diabetes Medications
Some diabetes medications affect your appetite or increase your risk of low blood sugar (hypoglycemia). Alcohol and illness can also affect your blood sugar, so it’s important to know what precautions to take.
Insulin and Low Blood Sugar
Delaying or skipping meals after taking mealtime insulin can cause low blood sugar. Sulfonylureas, like glipizide (Glucotrol), can also cause lows. Watch for shakiness, sweating, dizziness, or sudden hunger.
If your blood sugar drops below 70 mg/dL and you can swallow safely, follow the 15-15 rule:
- Consume 15 grams of fast-acting carbs, like ½ cup of juice or glucose tablets, then wait 15 minutes.
- Check your blood sugar again. Still below 70 mg/dL? Repeat until your blood sugar is back in your target range.
- Once your blood sugar has recovered, eat a balanced snack or meal with protein and carbs.
Follow your care team’s instructions, especially if you use an automated insulin delivery system. Severe lows may require glucagon and emergency medical help. Never give food or drinks to someone who is unconscious or unable to swallow safely.
GLP-1 Medications
Glucagon-like peptide-1 (GLP-1) medications, like Ozempic (semaglutide), slow stomach emptying, which can make you feel full sooner or cause nausea.
If you’re struggling to finish meals, try eating smaller portions more often and include protein-rich foods like eggs, Greek yogurt, or tofu to help preserve muscle. If you’re nauseated, try toast or crackers, avoid greasy foods, and take small sips of water throughout the day.
Contact your prescriber if you keep vomiting or can’t keep food or fluids down. You can also get additional guidance through GLP-1 nutrition support.
Alcohol and Sick Days
Alcohol can cause low blood sugar, especially if you take insulin or sulfonylureas. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) recommends eating when you drink and checking your blood sugar afterward.
Being sick can also raise your blood sugar, even if you’re eating less than usual. Ask your care team for a sick-day plan, which may explain how often to check your blood sugar, how much fluid to drink, whether to adjust medications, and when to seek medical care.
Using Blood Sugar Readings to Guide Your Diet
Checking your blood sugar lets you see how different foods and meals affect your levels. A glucose meter gives you a reading at a specific moment, while a continuous glucose monitor (CGM) tracks glucose throughout the day and night.
Depending on your diabetes type and treatment plan, your care team may recommend checking before meals and one to two hours after starting a meal to see how much your blood sugar rises.
For example, if your blood sugar is consistently above your target after breakfast, try reducing your usual cereal portion and adding Greek yogurt and nuts. Check your blood sugar at the same times after similar breakfasts over several days to see whether your readings improve.
Keep in mind that food isn’t the only factor. Poor sleep, stress, physical activity, and medications can also affect blood sugar. That’s why one high reading doesn’t necessarily mean you need to change what you’re eating.
Your care team can recommend when to check your blood sugar and what targets to aim for. An RD can review your readings with you and suggest meal adjustments if your blood sugar is consistently above target.
Protecting Your Heart and Kidneys
Diabetes increases your risk of heart and kidney disease, so your food choices matter beyond blood sugar control.
To protect your heart, focus on reducing sodium and saturated fat. Choose lower-sodium canned soups and vegetables, rinse canned beans, and season foods with garlic, lemon, or herbs instead of salt. Cook with olive oil instead of butter more often.
If you have chronic kidney disease (CKD), you may need to limit sodium to help control blood pressure, adjust protein intake based on your kidney function, or limit high-potassium foods if your blood potassium is elevated.
Not everyone with CKD needs to restrict protein or potassium. A renal dietitian can review your lab results and help you decide what, if anything, needs to change in your diet.
How a Dietitian Can Help You Manage Diabetes
Knowing what to eat for diabetes is one thing. Figuring out how to make it work with your medications, grocery budget, family meals, and busy schedule? That’s where a dietitian comes in!
An RD can help you figure out how many carbs to eat, adjust family recipes, plan affordable meals you enjoy, and troubleshoot any challenges. If you take mealtime insulin, they can also teach you how to count carbs.
Your needs may change over time, too. A dietitian can help you adjust your eating habits when your medications, activity levels, or blood sugar patterns change. Some are also Certified Diabetes Care and Education Specialists (CDCES), with additional expertise in diabetes management.
Insurance may also help cover the cost of seeing a dietitian. Medicare Part B covers medical nutrition therapy (MNT) for eligible people with diabetes who have a doctor’s referral. Many private plans also cover RD visits. Top Nutrition Coaching is in-network with Aetna, Anthem, BCBS, Cigna, Curative, and UnitedHealthcare, though coverage varies by plan.
Ready for one-on-one support? Check if your insurance covers a dietitian, and you’ll be matched with an available RD who can help support your goals, with between-session messaging when questions come up.
FAQs
What is the best diet for diabetes?
There’s no single best diet for diabetes, but eating patterns like the Mediterranean, lower-carb, DASH, and plant-forward diets can help manage blood sugar. These diets emphasize fiber-rich carbohydrates, lean proteins, and healthy fats.
How many carbs should I eat a day with diabetes?
There’s no set daily carb target for everyone with diabetes. Your needs depend on your medications, activity level, and blood sugar goals. A registered dietitian can help you set a daily carb target and decide how to spread carbs throughout the day.
What foods should people with diabetes avoid?
People with diabetes don’t need to avoid specific foods, but it’s best to limit sugary drinks, sweets, and refined carbohydrates, which can raise blood sugar quickly. Also, pay attention to portions of carbohydrate-rich foods.
Can people with diabetes eat fruit?
Yes, people with diabetes can eat fruit. Choose whole fruits like berries and apples over juice for more fiber and nutrients. Pay attention to portions, and try pairing fruit with protein or healthy fats, like apple slices with peanut butter, to help manage blood sugar.
Is a low-carb or keto diet safe for diabetes?
Low-carb diets can be safe and help manage blood sugar, especially with type 2 diabetes. However, significantly cutting carbs can increase the risk of low blood sugar if you take insulin or certain medications. Keto also raises concerns about diabetic ketoacidosis, particularly with type 1 diabetes or sodium-glucose cotransporter-2 (SGLT2) inhibitors like Jardiance (empagliflozin). Talk to your care team before making major changes.
Does insurance cover a dietitian for diabetes?
Many insurance plans cover diabetes nutrition counseling. Medicare Part B, for example, covers medical nutrition therapy (MNT) for eligible people with diabetes, while Medicaid and private insurance benefits vary. Top Nutrition Coaching is in-network with Aetna, Anthem, BCBS, Cigna, and UnitedHealthcare; coverage varies by plan.
