Best foods to control diabetes By Franziska Spritzler, RD, CDEFranziska Spritzler, RD, CDE, medical review by Dr. Bret Scher, MDDr. Bret Scher, MD – Updated June 17, 2021 Evidence based

Best foods to control diabetes By Franziska Spritzler, RD, CDEFranziska Spritzler, RD, CDE, medical review by Dr. Bret Scher, MDDr. Bret Scher, MD – Updated June 17, 2021 Evidence based Diabetes diet Foods and blood sugar How many carbs? Diabetes friendly meals Summary What should you eat if you have diabetes? If you’re confused because you’ve heard a lot of conflicting information, you’re not alone. Fortunately, the answer can be simple: Eat foods that don’t raise blood sugar very much, such as low-carbohydrate foods. 1 Although low-carb diets were routinely prescribed for people with diabetes more than 100 years ago — often with excellent results — recommendations to eat more carbs became the standard once insulin and diabetes medications were available. 2 Although diabetes medications can temporarily slow the blood sugar rise, they cannot reverse the underlying problem. Going back to the time-honored approach of eating low-carb foods can help control blood sugar in type 1 diabetes and potentially reverse type 2 diabetes, while reducing the need for medications. 3 In this comprehensive guide, you’ll learn what are the best foods to eat if you have diabetes. Disclaimer: Medication reduction may be necessary, and you may initially need to check your blood glucose more frequently when eating to control diabetes. In particular, insulin doses may need to be lowered to avoid low blood sugar, and SGLT2 inhibitors may need to be deprescribed. Learn more Please follow up with your healthcare provider for medical guidance before changing your diet to treat diabetes. If you are looking for a healthcare provider knowledgable with low-carb nutrition, see our find a doctor map. If you experience severe nausea, dizziness, weakness or fatigue, please take it seriously as these can be symptoms of dangerously low blood sugar. Options include checking your blood sugar, eating carbs or sugar for a short term fix, and contacting your healthcare provider for further guidance. Full disclaimer 1. The diabetes diet: what to eat and what to avoid There are many delicious foods that you can and should enjoy on a low-carb diabetes diet. Here’s a list of the best foods to eat — and the ones to stay away from. Foods to eat Protein Meat of all types: ground beef, steak, roast beef, pork chops, ribs, sausage, bacon, chicken, turkey 4 Seafood of all types: fish, shrimp, scallops, oysters, clams, mussels, crab, lobster Canned fish of all varieties: tuna, salmon, sardines, anchovies Luncheon meat: ham, roast beef, pastrami, salami, pepperoni, turkey, chicken 5 Eggs 6 Tofu, edamame, tempeh 7 Full-fat dairy products 8 Cheese: all varieties 9 Greek yogurt, ricotta cheese, or cottage cheese (limit to one-half cup) 10 Butter, cream, whipping cream, ghee 11 Sour cream and cream cheese Natural fats 12 Natural oils (olive oil, coconut oil, avocado oil, nut oils of all types) Lard Tallow Chicken fat (schmaltz) Duck fat Coconut milk Coconut cream (unsweetened) Vegetables All non-starchy vegetables, including: Artichoke Arugula Asparagus Avocados Bok Choy Broccoli Broccolini Brussels sprouts Cabbage Cauliflower Celery Celery root Chives Cucumbers, pickles Eggplant Endive Fennel Garlic Green Beans Greens, all types Green onions Heart of Palm Jicama Kale Kohlrabi Leeks Lettuce Mushrooms Okra Olives Onions (small amounts) Parsley Peppers Pumpkin (unsweetened) Radishes Rhubarb Scallions Shallots Snow peas Spring onions Sugar snap peas Sprouts Spinach Squashes (summer) Tomatoes Zucchini Berries (limit to one-half cup per day) 13 Blackberries Raspberries Strawberries Nuts (limit for weight loss) 14 Almonds Brazil nuts Hazelnuts Macadamia nuts Pecans Peanuts Walnuts Coconut (unsweetened) Seeds Chia seeds Flaxseed Hemp seeds Sunflower seeds Pumpkin seeds Sesame seeds Condiments Herbs and spices (no added sugar) Hot sauce Mustard (plain) Tomato salsa (limit to 2 tablespoons) Soy sauce or tamari Beverages Water (still or sparkling) Coffee Tea Broth Dry wine (limit to 1 glass per day, consumed with a meal) 15 Top 5 Alcoholic Drinks Keto alcohol – the best and the worst drinks GUIDEWhat are the best and the worst alcoholic drinks on a keto diet? Keto foods Ketogenic diet foods – what to eat GUIDE Are you not sure what to eat on a keto diet? Here you’ll find a quick food list and visual guide, showing you what to eat and avoid on keto. Foods to avoid Avoiding any foods that aren’t on the list above can help prevent blood sugar elevations. This includes many foods that most people agree are not good for your health, like: Sugar in any form: white sugar, brown sugar, coconut sugar, honey, maple syrup, agave Cakes, pies, cookies, ice cream, candy, and other sweets Pizza, hamburgers and hot dogs, burritos, and similar foods White bread, white rice, pasta, and potatoes Soda, punch, sweetened tea and coffee, sweet alcoholic beverages Beer However, there are also some foods on the “avoid” list that may surprise you, such as: Whole grains (cereal, pasta, bread, tortillas, rice) Sweet potatoes Corn Beans and lentils All fruit juice and most fruit (other than berries) If you have diabetes, why should you avoid eating these foods — even those that are typically considered healthy? Because they can all raise blood sugar quite a lot, once they’ve been digested and absorbed by your body. 16 Learn more about how different foods affect blood sugar Diabetes breakfast tips A good diabetes breakfast needn’t be elaborate or time-consuming. In fact, it can even be skipped altogether if you’re not hungry. 17 There’s also no rule that your first meal must contain traditional breakfast fare, like eggs. Although eggs are always an excellent choice, last night’s leftovers are great too — and a huge time saver on busy mornings. Here are a few quick and easy breakfasts to get your day off to a good start: Popular breakfasts Keto frittata with fresh spinach Keto frittata with fresh spinach 5g Simple low-carb breakfast with fried eggs and veggies Simple low-carb breakfast with fried eggs and veggies 6g Keto avocado eggs with bacon sails Keto avocado eggs with bacon sails 2g Pickle sandwich with deli turkey and mustard mayo Pickle sandwich with deli turkey and mustard mayo 6g Keto baked eggs Keto baked eggs 2g Keto cauliflower hash with eggs and Poblano peppers Keto cauliflower hash with eggs and Poblano peppers 9g Classic bacon and eggs Classic bacon and eggs 2g Jill's cheese-crusted keto omelet Jill's cheese-crusted keto omelet 5g Quick and easy capicola egg cups Quick and easy capicola egg cups 2g Simple keto breakfast with fried eggs Simple keto breakfast with fried eggs 1g Keto breakfast with fried eggs, tomato and cheese Keto breakfast with fried eggs, tomato and cheese 4g Scrambled eggs with basil and butter Scrambled eggs with basil and butter 3g Scrambled eggs with spinach and smoked salmon Scrambled eggs with spinach and smoked salmon 2g Keto Caprese omelet Keto Caprese omelet 4g Spinach and feta breakfast scramble Spinach and feta breakfast scramble 4g Keto cheese omelet Keto cheese omelet 4g Keto Italian breakfast casserole Keto Italian breakfast casserole 7g Keto salmon-filled avocados Keto salmon-filled avocados 6g Keto bacon and mushroom breakfast casserole Keto bacon and mushroom breakfast casserole 6g Scrambled eggs Scrambled eggs 1g Low-carb strawberry smoothie Low-carb strawberry smoothie 10g Low-carb coconut cream with berries Low-carb coconut cream with berries 9g Vegetarian keto breakfast casserole Vegetarian keto breakfast casserole 6g Keto taco omelet Keto taco omelet 8g Keto egg muffins Keto egg muffins 2g Lox omelet Lox omelet 2g Keto BLT with cloud bread Keto BLT with cloud bread 7g Low-carb blueberry smoothie Low-carb blueberry smoothie 9g Keto dosa Keto dosa 4g Keto chaffles Keto chaffles 2g Diabetes meal tips What can you eat for lunch when sandwiches are off the table? How do you plan a balanced dinner without potatoes, pasta, or rice? No need to worry — the options are unlimited! Little changes can make a big difference: Use lettuce in place of bread for sandwiches and burgers Shred cauliflower and pan-fry in oil to make cauliflower “rice” for a low-carb burrito bowl, or as a side dish for meat or fish Cut zucchini into spirals to make noodles, aka “zoodles”; saute in butter and garlic, then top with chicken or protein of choice Boil cauliflower until tender, then blend together with butter, cream, and salt to make mashed “faux-tatoes” as a side dish for turkey or other protein Check out these delicious diabetes-friendly recipes: Popular keto meals right now Tap into the wisdom of millions of readers. What keto meals are viewed, over and over? Whether you need a great recipe for keto pizza or want to mix-up your weekly routine with other people’s favorites, check out some of our most popular keto meals for inspiration: Keto oven-baked chicken in garlic butter Keto oven-baked chicken in garlic butter 1g Prosciutto-wrapped salmon skewers Prosciutto-wrapped salmon skewers 1g Salmon with olive-pistachio tapenade and tomatoes Salmon with olive-pistachio tapenade and tomatoes 5g Keto pulled pork Afelia Keto pulled pork Afelia 7g Orange-braised pork Orange-braised pork 5g Bacon-wrapped keto meatloaf Bacon-wrapped keto meatloaf 7g Low-carb garlic chicken Low-carb garlic chicken 3g Caramelized onion and bacon pork chops Caramelized onion and bacon pork chops 5g Keto coconut curry chicken Keto coconut curry chicken 8g Lemon baked chicken thighs with cauliflower mash Lemon baked chicken thighs with cauliflower mash 7g Ginger lime chicken Ginger lime chicken 2g Sweet and sticky keto chicken wings Sweet and sticky keto chicken wings 4g Barbecue ribs Barbecue ribs 6g Keto baked salmon with pesto and broccoli Keto baked salmon with pesto and broccoli 7g Indian keto chicken korma Indian keto chicken korma 3g Keto baked salmon with lemon and butter Keto baked salmon with lemon and butter 1g Crispy Cuban roast pork (Lechon asado) Crispy Cuban roast pork (Lechon asado) 6g Keto zucchini pizza boats with goat cheese Keto zucchini pizza boats with goat cheese 5g Shrimp salad with hot bacon fat dressing Shrimp salad with hot bacon fat dressing 3g Pork tenderloin with olive tapenade Pork tenderloin with olive tapenade 2g Buttery harissa shrimp skewers Buttery harissa shrimp skewers 2g Diabetes dessert tips Although we don’t recommend it on a regular basis, occasionally enjoying a sugar-free dessert is entirely compatible with low-carb diabetes eating. Unlike people who eat low-carb for weight loss alone, those with diabetes are at higher risk for blood sugar swings from conventional sweets — both from the sugar itself and the potential need to “manage” it with medications. 18 Here are several delicious options for diabetes-friendly treats to enjoy every now and then: Ketolicious desserts Ready for a treat? Below you will find our most popular keto dessert recipes. If you’re OK with a dessert that’s slightly higher in carbs every once in a while, check out our low-carb dessert page with ALL of our goodies. Coffee with whipped cream Coffee with whipped cream 2g Keto baked goat cheese with blackberries and roasted pistachios Keto baked goat cheese with blackberries and roasted pistachios 4g Keto vanilla panna cotta Keto vanilla panna cotta 5g Gingerbread crème brûlée Gingerbread crème brûlée 3g Keto buttercream Keto buttercream 1g Keto gingerbread spice Dutch baby Keto gingerbread spice Dutch baby 2g Keto brownies Keto brownies 1g Keto mug cake with chocolate Keto mug cake with chocolate 2g Keto no-bake chocolate cake Keto no-bake chocolate cake 4g Keto tres leches cake Keto tres leches cake 2g Keto chocolate macadamia nut fat bombs Keto chocolate macadamia nut fat bombs 2g Keto hot chocolate Keto hot chocolate 1g Crunchy keto berry mousse Crunchy keto berry mousse 3g Keto Argentine cookie and caramel sandwiches (Alfajores) Keto Argentine cookie and caramel sandwiches (Alfajores) 1g Keto Instant Pot spice cake Keto Instant Pot spice cake 2g Keto lemon layer cake with lemon curd and mascarpone frosting Keto lemon layer cake with lemon curd and mascarpone frosting 3g Keto chocolate cake with peanut buttercream Keto chocolate cake with peanut buttercream 7g Keto vanilla ice cream Keto vanilla ice cream 6g Mini keto coconut cupcakes with lime-curd topping Mini keto coconut cupcakes with lime-curd topping 1g Keto pancakes with berries and whipped cream Keto pancakes with berries and whipped cream 4g Keto French pancakes Keto French pancakes 4g Keto and dairy-free vanilla custard Keto and dairy-free vanilla custard 1g Keto oven-baked Brie cheese Keto oven-baked Brie cheese 1g Keto butter pecan cheesecake Keto butter pecan cheesecake 6g Keto waffles with blueberry butter Keto waffles with blueberry butter 3g Keto cinnamon coffee Keto cinnamon coffee 1g Keto rhubarb tart Keto rhubarb tart 3g Keto Chai latte Keto Chai latte 1g Old-fashioned keto cake donuts Old-fashioned keto cake donuts 1g Kristie’s keto carrot cake cheesecake Kristie’s keto carrot cake cheesecake 4g Spanish low-carb almond cake (Tarta de Santiago) Spanish low-carb almond cake (Tarta de Santiago) 2g Dairy-free keto egg custard tarts Dairy-free keto egg custard tarts 4g Keto no-bake gingerbread bites Keto no-bake gingerbread bites 1g Keto saffron pannacotta Keto saffron pannacotta 2g Creamy dairy-free keto vanilla ice cream Creamy dairy-free keto vanilla ice cream 2g Keto gingerbread Bundt cake Keto gingerbread Bundt cake 2g Keto mason jar ice cream Keto mason jar ice cream 4g Quick Swedish keto hazelnut cookies Quick Swedish keto hazelnut cookies 1g Keto lemon ice cream Keto lemon ice cream 3g Low-carb cookie dough ice cream Low-carb cookie dough ice cream 5g Keto Tiramisu Keto Tiramisu 6g Keto lemon bars with shortbread crust Keto lemon bars with shortbread crust 2g No-bake keto cheesecake No-bake keto cheesecake 4g Keto cinnamon rolls Keto cinnamon rolls 1g Cinnamon and cardamom fat bombs Cinnamon and cardamom fat bombs 0.5g Low-carb coconut pancakes Low-carb coconut pancakes 3g Keto lemon cheesecake cookies Keto lemon cheesecake cookies 1g Keto chocolate chip cookies Keto chocolate chip cookies 1g Keto buñuelos Keto buñuelos 5g Keto Christmas cupcakes with orange frosting Keto Christmas cupcakes with orange frosting 4g Diabetes snack tips Like desserts, snacks don’t necessarily need to be part of your daily diet. However, if you do get hungry in between meals and feel you need to eat, choose cheese, olives, eggs, or other foods on this list of healthy keto snacks. 2. How do different foods affect blood sugar? The diabetes foods list above contains sources of three broad categories called macronutrients (major nutrients): carbohydrates (carbs), protein, and fat. Instead of being 100% protein, fat or carbs, many foods are actually a combination of two or all three — like nuts, seeds and yogurt. But how does each macronutrient affect your blood sugar? Carbohydrates Of the three macronutrients, carbs raise blood sugar the most — especially in people who have diabetes. 19 This is why the American Diabetes Association recently announced that regardless of the type of diet you follow, reducing carbohydrate intake improves blood sugar control. 20 The two types of carbs that raise blood sugar are starches and sugars: Starches: long chains of sugar units that are linked together Examples: grains, rice, pasta, potatoes, peas, corn Sugars: two sugar units that are linked together Examples: fruit, milk, table sugar, honey After carbs are consumed, they’re broken down into single sugar units in your digestive tract and absorbed into your bloodstream. This causes your blood sugar to rise immediately. As a result, starchy foods like rice and bread can raise blood sugar as much as sweet foods. 21 Importantly, one portion of the carbs in whole plant foods isn’t digested and absorbed into the bloodstream: fiber. 22 For this reason, fiber that occurs naturally in foods generally doesn’t raise blood sugar in most people. 23 The digestible, non-fiber portion of carbs is often referred to as “net carbs,” which are calculated by subtracting fiber from the total carbs a food contains. For example, if you eat one-third of a cup of white rice, which has about 15 grams of carbs and no fiber, your body absorbs all of the carbs, leading to a rise in blood sugar. By contrast, 3 cups of chopped cauliflower also has about 15 grams of carbs, including 7 grams of fiber. If you eat the cauliflower, you’ll only get 8 grams of net carbs, and your blood sugar will increase much less and more gradually due to the lower net carbs and a slowing effect from the fiber. Furthermore, 3 cups of chopped cauliflower is perhaps more than you’d even want to consume at one sitting, and eating a smaller portion would further reduce your net carb intake. Protein Just as carbohydrates are made up of chains of sugar (glucose) molecules, the protein you eat is made up of chains of individual units called amino acids. During digestion, these chains are broken down into those amino acids, which are absorbed into your bloodstream. Although responses among different people vary slightly, consuming a moderate amount of protein at one time generally has little effect on blood sugar in people with type 2 diabetes who produce insulin. 24 Many studies demonstrate that people following higher protein diets improve their blood sugar more than people following lower protein diets. 25 However, in people with type 1 diabetes or those with type 2 who are no longer producing insulin, even moderate amounts of protein may raise blood sugar — although more gradually and to a lesser extent than carbs do — unless a small amount of insulin is injected. 26 Fat Dietary fat has very little effect on blood sugar. In fact, consuming pure fat all by itself is unlikely to increase your blood sugar at all. Including fat at a meal delays the rate at which carb-containing foods are broken down and absorbed. This can help prevent blood sugar increases if carbs are kept low. However, studies conducted on people with type 1 diabetes have shown that consuming a high-fat, high-carb meal can prolong the time that blood sugar remains elevated after eating. 27 This is one reason why it’s important to avoid eating meals that are high in both fat and carbs. 3. How many carbs can I eat if I have diabetes? What should your daily carb intake be? Although lower is generally better, exactly how many carbs you can tolerate is somewhat individual. 28 You and your friend may both have diabetes. Yet after eating an identical meal, your own blood sugar may be higher or lower than your friend’s an hour or two later. More importantly, one of you may now have a blood sugar level above the normal range. Monitoring blood sugar response If you keep net carbs very low (under 10 grams per meal), your blood sugar is likely to remain well controlled at all times. 29 If you want to experiment with eating slightly more carbs, make sure to test your blood sugar to determine your personal carb tolerance. Try to measure your blood glucose before eating and then at 1 and 2 hours after eating. Keep a log of your blood sugar readings along with what you ate, and adjust your carb intake as needed based on your results. Blood cells and glucose in the vein Understanding HbA1c — the long-term blood sugar GUIDEThis guide will help you interpret your HbA1c results, and explain why HbA1c is an important way to measure metabolic health. We’ll also explain reasons for occasional unexpected variations in HbA1c results and the strengths and weaknesses of the test. Woman with diabetes checking her blood glucose using her glucose meter What you need to know about blood sugar GUIDE Testing your blood sugar can help you better identify what dietary patterns lower your blood sugar over time. For more information about what a normal blood sugar is and how to monitor your blood sugar response to meals, check out this guide. 4. Diabetes meal planning: keep it simple There are just three steps to planning a meal to keep blood sugars low. Start with adequate protein, include minimally processed fats, and keep your carbs low and consistent across meals. Start with adequate protein Protein is important for maintaining muscle, preventing bone loss, and helping to control appetite, among its many other functions. 30 Make sure to include a good protein source at each meal. Aim for about 4-7 ounces (110-200 grams) of meat, poultry, fish, or tofu; or 4-6 eggs. Learn more — including how to calculate your personal protein needs — in our complete protein guide. Include minimally processed fat Fat is the macronutrient that has the least effect on blood sugar, adds richness and flavor to meals, and provides the majority of your energy needs on a low-carb diabetes diet. Remember to focus mostly on minimally processed fat sources as often as possible. Check out our guide to healthy fats on a low-carb or keto diet Keep carbs low and consistent across meals With diabetes, it’s not just how many carbs you consume per day that matters; your carb intake at each meal is important because it can affect your blood sugar for several hours. It may be best to aim for roughly the same amount of net carbs (10 grams or less) at each meal instead of eating most of your carbs at one sitting. 31 Remember that testing your blood sugar will confirm whether your blood sugar remains within the normal, healthy range. DD+ MEMBERSHIP