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Healthy eating with type 2 diabetes

https://kingstonhospital.nhs.uk/information/healthy-eating-with-type-2-diabetes

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What is type 2 diabetes?

Diabetes is a condition in which your blood glucose (sugar) level becomes too high. 

Blood glucose levels are controlled by the hormone insulin.

Insulin moves glucose out of your blood, into your muscles, where it can be used for energy.

Type 2 diabetes occurs because your insulin is not working properly or you do not produce enough insulin. 

To find out more, ask your GP to refer you to a type 2 diabetes education programme (for example DESMOND). 

What happens if my glucose level is high?

A high glucose level can cause you to feel thirsty, tired or pass urine frequently (especially at night). It can also cause recurrent infections.

If your glucose level is high over a long period of time, it increases the risk of developing diabetes complications. These complications can include heart disease and stroke.

How can I control my glucose level?

Taking care of your diet and keeping active is key to controlling your glucose level. It reduces the risk of diabetes related health problems in the future.

You may also need tablets or insulin injections to manage blood glucose levels. But being careful with what you eat and drink will always be important.

Take care of your diet

Being overweight is often the reason your insulin does not work well.  Losing weight will help your insulin work better. Losing just 5% of your weight can make a big difference.

If you are overweight, losing a significant amount of weight, especially soon after diagnosis of diabetes, can put diabetes into remission. This does not mean you will be ‘cured’, but you may avoid or delay any medication being required for your diabetes.

Ask your dietitian or GP for further advice on weight loss diet plans and recipes.

Try to keep active

You can improve your blood glucose level by being active and by avoiding long periods of sitting still.. 

Increasing your muscle strength will help your insulin to work more effectively at all times.

How much activity do I need?

Try to get slightly out of breath by being active for 150 minutes (2.5 hours) each week.  You can spread this across 5 or more days each week.

Try to do something every day, for example walking, cycling, swimming, dancing, gardening or housework.

Icon of moving feet
Remember: any form of movement helps!

What is a healthy diet for diabetes?

You can help control your glucose level if you choose the right food and drink, in the right amounts.

Your diet should be well balanced and provide all the nutrients your body requires for health.

A well balanced diet includes carbohydrates, protein, vegetables and salad.

Try to plate your meals as follows.

Non weight loss plate graphic
weight loss plate graphic

Carbohydrates

When you eat or drink, your carbohydrates digest into glucose, which your body uses for energy.  If you consume too much carbohydrate, it will be stored as fat.

  • Make sure you choose the right type of carbohydrate.
  • Make sure you choose the right amount of carbohydrate.
  • Try to space your carbohydrate intake evenly across the day.  

Talk to your healthcare professional if you take medication for your diabetes. They may need to change your dosage before you reduce the amount of carbohydrate in your diet.

Do not follow an ultra low carbohydrate diet if you take Dapagliflozin, Empagliflozin or Canagliflozin tablets for your diabetes.

Which foods contain carbohydrate?

Starchy food
  • Starchy food will give you energy and many important nutrients for health.   Wherever possible, try to choose the wholegrain version of starchy food. 
  • Your best choice is starchy foods that are digested most slowly (also known as ‘low glyncaemic index’). These foods are shown in bold on the list below.

Starchy foodsStarchy foods that digest slowly
Breakfast cereals, for example Weetabix, Shredded Wheat, bran flakes. (Avoid sugar and honey coated cereals)Porridge oats, no added sugar muesli, Special K, Fruit & Fibre, All Bran 
Bread (all types)Rye bread, wholegrain seeded bread, pitta
Crispbreads, crackersRyvita, oatcakes
Chapattis, naanBulgur wheat, quinoa
Grains: couscous, polenta
Pasta, noodlesEgg noodles
RiceWholegrain basmati rice
PotatoesSweet potato, new (salad) potatoes
Plantain, green bananaYam, cassava

Sugars

  • The diet for diabetes does not need to be completely free of sugar.  It needs to be low in added sugar and sugary foods.
  • If you want an occasional sweet treat, it is best to include this as part of a meal.  To compensate for the sweet treat, you can reduce the amount of starchy food that you eat in the meal.  This will reduce the impact that the sweet treat has on your blood glucose level.
  • Many savoury foods contain small amounts of sugar, but can be included in your diet.  These include baked beans and ketchup.  Often there are reduced sugar versions that you can buy (always read the labelling carefully).
  • Many sweets and drinks which are labelled as ‘sugar free’ contain artificial sweeteners.  You can eat these because they do not raise blood glucose levels. 
  • Be careful if the sweetener is xylitol, mannitol, sorbitol. These types of sugar alcohol are often found in ‘sugar free’ sweets and can have a laxative effect if you eat a large amount.

The following table gives more information about sugary foods and offers some alternative suggestions.

 
Avoid these

Choose these
Sugar, glucose, fructose, honey, syrups, jaggury, gurArtificial sweeteners such as Truvia, Canderel, Hermesetas, Sweetex, Splenda
Energy drinks eg Lucozade, Red Bull, Monster
Ordinary fizzy drinks eg cola, lemonade, tonic water
Ordinary fruit squash, Ribena
Water: still or sparkling
‘No sugar’ drinks labelled as ‘diet’, ‘no added sugar’ or ‘slimline’
Some ‘lite’ or ‘light’ drinks (always check the label)
Hot chocolate, Ovaltine, HorlicksHighlights, Options, cocoa
Fruit tinned in syrupFruit tinned in juice (drained)

.


Cut down on these

Possible alternatives
Jam, marmaladeReduced sugar varieties, or use just a scrape
Sweet pickles and chutneysVinegar pickles, or use sparingly
Sweets, chocolates, desserts and puddings, Indian sweetmeats, baklavaSugar free jelly, reduced sugar milk pudding or custard, occasional small portion of plain ice cream
Sweet yoghurts and fromage frais‘Diet’ or ‘No added sugar’ fruit yohurt (less than 100kcals per pot). Low fat plain or Greek yogurt
Biscuits and cakesSee under ‘Snacks’ below

Fruit

  • Fruit contains many nutrients which help maintain health. It is a good idea to include some in your diet. 
  • All fruit and products made from fruit (eg fruit juice) contain sugars. Eating too much at once will raise your blood glucose level. 
  • Avoid pure unsweetened fruit juices or fruit smoothies.  These contain ‘free sugars’ which have a much greater effect on blood glucose levels. 
  • Dried fruit is also rich in sugar so avoid it or only eat a small amount.
  • Limit fruit to approximately a ‘handful sized’ portion at a time.
  • Only eat 2 to 3 portions, spaced over the day.   
What is a portion?
Each of the following = 1 portion
1 bowl (150g) berries (raspberries, blueberries, strawberries etc)
1 medium fruit (apple, pear, orange etc)
1 small banana or 1 grapefruit
2 small fruits (plums, kiwi, clementines etc)
Small handful grapes (10 large or 15 small)
Small slice of melon, watermelon or mango, or 2 rings pineapple

Protein

What foods contain protein?

  • Protein is found in large amounts in meat, fish, cheese, eggs, beans, pulses, tofu, soya, Quorn, milk and nuts.
  • Try to include a variety of protein foods regularly in your diet.  This is essential for health and protein. It also helps to fill you up and stop you feeling hungry. 
  • If you eat meat, choose lean cuts and limit the amount of red and processed meat products you choose.
  • Where possible include 2 portions of oily fish each week.  Oily fish includes mackerel, salmon and sardines.  These contain omega 3 fats and can help protect the heart.
  • Try to use some vegetarian ‘protein’ sources in place of meat regularly in your diet.  Vegetarian protein includes beans, lentils, soya and Quorn.
Dairy milk and yogurt
  • Dairy milk and yogurt provide carbohydrate as well as valuable protein and important nutrients for bone health. 
  • Include some in your diet but choose reduced fat versions and plain or ‘no added sugar’ fruit yogurts.   
  • Do not drink more than one cup ( 250ml) at any one time as it may raise your glucose level.
Beans, lentils, pulses
  • These foods contain some carbohydrate but they are slowly digested and have a limited effect on blood glucose level. 
  • They contain soluble fibre which can help to improve your blood cholesterol level. They are also a healthy source of protein.

Vegetables and salad

  • These are an essential part of a healthy diet. They are rich in vitamins and minerals. They are also rich in soluble fibre which can help to control your blood glucose. 
  • They also help to fill you up and stop you feeling hungry. 
  • Eating a good amount of vegetables and salads can help to control your blood pressure and cholesterol levels.
  • Include vegetables and salad foods whenever possible. Try to use them to make up a large part of your lunch and evening meals.

Snacks

  • Try to avoid snacking between meals, especially on foods rich in carbohydrate which will raise your glucose level. 
Try these lower carbohydrate snack ideas if you feel the need to eat between meals
Vegetable sticks (carrot or cucumber or celery).  Eat these with or without tomato salsa or cottage cheese or reduced fat hummus.  You can also eat them with a slight smear of peanut butter
3 to 4 tablespoons of low fat Greek yogurt with berries or seeds
2 rye crispbreads or 2 oatcakes with some low fat hummus or low fat cream cheese or tomato salsa
A small handful of fruit
A few olives or cherry tomatoes
A small eggcup full of unsalted nuts (6 to 8 unsalted almonds or walnuts)
A small pot of ‘no added sugar’ fruit yogurt
A hardboiled egg

Cholesterol and blood pressure

There are other reasons to eat healthily if you have type 2 diabetes.                

  • If you have diabetes, we will need to monitor your cholesterol levels and blood pressure regularly.
  • Healthy eating helps maintain good cholesterol levels and blood pressure levels.

Cholesterol

  • If your diet contains a lot of saturated fat, this can raise your cholesterol levels. This is a risk for heart disease.  
  • You can help control your cholesterol by reducing your saturated fat intake and replacing it with unsaturated fats. 
  • You can also reduce cholesterol levels by eating a good amount of vegetables, beans, lentils and some fruit.
  • Fats and oils are highly fattening.  If you are trying to lose weight, try to limit your intake of all types of fats and oils.

This table gives guidance on sources of saturated and unsaturated fats.

Try to avoid these sources of saturated fats Try to choose these sources of unsaturated fats
Butter
Ghee
Coconut oil
Lard
Palm oil
Pastry and pies
Fatty meats and meat products (eg sausages)
Chocolate
Cheese
Full fat milk or yogurt
Cream  
Olive oil or spread
Rapeseed oil
Vegetable oil
Avocado
Seeds and nuts
Sunflower oil or spread
Soya oil or spread
Corn oil
Oily fish eg salmon, sardine, mackerel etc
Seeds and nuts  

Cooking methods

Here are some useful tips on healthy ways to cook food.

  • When cooking, limit the amount of food you fry.
  • If you do fry food, use a maximum of 1 teaspoon of oil per person in any dish.
  • It is healthier to air fry, grill, boil, poach, dry roast or microwave your food.
  • Choose vegetable oil (rapeseed) or sunflower oil for frying rather than olive oil.

This table offers guidance on high fat foods to avoid, and alternatives you can choose.

   red cross
Limit your consumption
   green tick
These are a better choice
Pies, pork pies, salami, pate, sausages, scotch egg, burgers, fish in batterGrilled or roast meat with fat removed
Chicken and turkey without skin
Fish, baked or grilled
Use beans or lentils regularly in place of meat
Whole milk
Full fat or Greek yogurt
Skimmed or semi-skimmed milk
Low fat yoghurt (less than 100kcals per pot)
Most cheese (limit to 100g per week) PaneerCottage cheese, Quark, ricotta, reduced fat hard cheese
Mayonnaise, salad cream, salad dressing
Full fat dressing coleslaw
Low fat vinaigrette, lemon juice, balsamic vinegar
Coleslaw with lower fat ‘yogurt’ dressing
Fried chips
Crisps (including low fat versions)
Small portion of thick cut oven chips, boiled potatoes
Plain popcorn
High fat prepackaged sandwichesReduced fat sandwiches (less than 350kcals per pack)
Cream or cheese based sauces, for example carbonara, cauliflower cheeseTomato based sauces
Indian snack foods such as pakora, bhajia,puri, paratha, chevda, sevSamosa and pakoras that are sprayed lightly with oil and oven baked.  Chapattis made without ghee or oil
Many fast foods and takeawaysChoose carefully from the menu or only have them occasionally

Blood pressure

High blood pressure and diabetes can contribute to the risk of damage to your eyes, kidneys and heart.

To help to control blood pressure you can do the following:

no saltReduce your salt intake.
Use less salt in cooking.  Avoid adding salt at the table. Use pepper, herbs, spices instead to flavour food
Choose lower salt options by checking food labels
Do not use salt substitutes like ‘Losalt’
fruit and vegEat a good amount of vegetables, salads and some fruit
no alcoholLimit your alcohol consumption
Icon of moving feetKeep as active as you can

Alcohol

It is important to be aware of your alcohol intake if you have type 2 diabetes.

  • A safe level of intake is no more than 14 units* per week for both men and women.
  • Space out your intake over at least 3 days of the week.
  • Alcohol is high in calories.  Reduce your alcohol if you are trying to lose weight.
  • Cocktails often contain a large amount of sugar.  Avoid them or only have them as an occasional treat.
  • If you drink spirits, use a ‘diet’ or ‘slimline’ mixer.
1 unit of alcohol =Half a pint  average strength beer
or
Half a medium glass of average strength wine
or
1 single measure of spirits (25 mls)

Alcohol and hypos (hypos = low blood glucose)

If you take insulin or certain diabetes tablets (eg gliclazide) alcohol can make a ‘hypo’ more likely. The hypo may be more serious and difficult to treat because alcohol will stop your liver releasing glucose.

Important information graphic
  • Never drink on an empty stomach.
  • If you are drinking over a long period, make sure you eat something which contains carbohydrate.
  • Always have a starchy snack before bed (eg a small bowl of cereal or slice of toast).
  • At all times, carry identification with you that says you have diabetes.
  • Make sure your friends and family know what to do if you experience a hypo.

More information

diabetes uk logo
Information from Diabetes UK on all aspects of type 2 diabetes, including nutritional advice and recipes
https://www.diabetes.org.uk/diabetes-the-basics/types-of-diabetes/type-2
diabetes uk logo
Sign up to the Diabetes UK Learning Zone to learn how to manage all aspects of your diabetes.
https://learningzone.diabetes.org.uk/
diabetes uk logo
The Carbs and Cals book offers guidance on the carbohydrate and calorie content of food and drink
https://shop.diabetes.org.uk/products/carbs-cals
BHF logo
Information on heart health from the British Heart Foundation
https://www.bhf.org.uk/
heart uk logo
Information on lowering your cholesterol from Heart UK
https://www.heartuk.org.uk/
drink aware logo
Information on cutting alcohol intake from Drink Aware
https://www.drinkaware.co.uk/

My fitness pal phone app to monitor food and drink intake (also available for Apple)
https://www.myfitnesspal.com/
carbs and cals logo
Carbs and cals phone app to monitor food and drink intake (also available for Android)
https://apps.apple.com/gb/app/carbs-cals-diet-diabetes/id388459613
diabetes uk logo
Guidance on diabetes and exercise
https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/exercise
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Information from MyNutriWeb on a healthy South Asian diet
https://mynutriweb.com/the-south-asian-eatwell-guide/
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Information from MyNutriWeb on a healthy African and Caribbean diet
The African and Caribbean Eatwell Guide • MyNutriWeb
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NHS information on understanding food labels
https://www.nhs.uk/live-well/eat-well/food-guidelines-and-food-labels/how-to-read-food-labels/
diabetes uk logo
Diabetes UK information on understanding food labels
https://www.diabetes.org.uk/guide-to-diabetes/enjoy-food/food-shopping-for-diabetes/understanding-food-labels



Contacts

Kingston Hospital Dietetic Department, Monday to Friday 9am to 5pm 020 8973 5277
khft.dietetics@nhs.net

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