From the Guidelines
People with type 2 diabetes should focus on a balanced diet, limiting foods high in simple carbohydrates and sugars, and emphasizing vegetables, whole grains, lean proteins, healthy fats, and high-fiber foods to maintain stable blood glucose levels. The most recent and highest quality study, 1, recommends an individualized medical nutrition therapy program, provided by a registered dietitian nutritionist, to achieve treatment goals. This study suggests that there is no single ideal dietary distribution of calories among carbohydrates, fats, and proteins for people with diabetes, and meal plans should be individualized while keeping total calorie and metabolic goals in mind.
Some key recommendations for people with type 2 diabetes include:
- Restricting sugary beverages, processed sweets, white bread, white rice, and other refined carbohydrates that can cause rapid blood sugar spikes
- Emphasizing nonstarchy vegetables, minimal added sugars, fruits, whole grains, and dairy products
- Reducing overall carbohydrate intake to improve glycemia
- Using carbohydrate counting and considering fat and protein content to determine mealtime insulin dosing for those with flexible insulin therapy programs
- Maintaining a consistent pattern of carbohydrate intake with respect to time and amount for those using fixed insulin doses
- Limiting sodium consumption to <2,300 mg/day
- Avoiding sugar-sweetened beverages and minimizing consumption of foods with added sugar
It's also important to note that moderate alcohol consumption is acceptable for most people with diabetes, but should be limited to 1-2 drinks per day and consumed with food, as recommended by 1. Additionally, people with diabetes should be educated about the signs, symptoms, and self-management of delayed hypoglycemia after drinking alcohol, especially when using insulin or insulin secretagogues. Overall, a balanced and individualized diet, combined with regular physical activity and medication adherence, can help people with type 2 diabetes manage their condition and improve their overall health outcomes.
From the Research
Food Restrictions with Type 2 Diabetes
There are several dietary patterns that can help manage type 2 diabetes, including:
- Low carbohydrate diets
- Macrobiotic diets
- Vegan diets
- Vegetarian diets
- Mediterranean diets
- Intermittent fasting diets
Effectiveness of Different Diets
Studies have shown that:
- Vegan, vegetarian, and Mediterranean dietary patterns can improve glycemic control and reduce body weight 2
- Low carbohydrate diets may have some benefits, but the evidence is mixed 2
- Pioglitazone, a medication used to treat type 2 diabetes, can improve glycemic control and reduce insulin resistance when added to sulfonylurea or metformin therapy 3, 4, 5, 6
Key Findings
- A systematic review of randomized clinical trials found that Mediterranean, vegan, and vegetarian diets can improve glycemic control and reduce body weight in patients with type 2 diabetes 2
- A study comparing pioglitazone and insulin glargine as add-on therapy to sulfonylurea or metformin found that insulin glargine resulted in greater improvements in glycemic control, but also increased the risk of hypoglycemia 6
- Another study found that pioglitazone improved post-load glucose excursions without affecting insulin secretion when added to metformin or sulfonylurea therapy 5