If you have developed Type 2 Diabetes you have probably been informed by your doctor of the need to improve your diet and ideally start to take regular exercise to help manage your condition.
Type 2 Diabetes is degenerative, which means over time the pancreas will produce less insulin and the condition will become harder to manage. However, regardless of how far the condition has progressed, a healthy and balanced diet is vital to help control your blood sugar (glucose) levels.
What Is Type 2 Diabetes?
Type 2 Diabetes (T2 Diabetes) is caused when the body becomes resistant to insulin and / or the pancreas (actually a part of the pancreas called the islets of Langerhans) start to produce an inadequate amount of the hormone insulin.
Insulin is needed when we digest food to remove glucose from the blood and transport it into the tissues of the body, such as muscle and fat storage. If insulin is in short supply glucose levels in the blood rises, and this causes long-term damage to the vascular system (cardiovascular, as well as the blood vessels which supply oxygen to the extremities, the eyes and the reproductive organs).
This is why sufferers of T2 diabetes can eventually suffer from eye problems (diabetic retinopathy), heart disease and heart attacks, strokes, kidney damage, nerve damage (which also causes impotence and loss of feeling in the feet).
Diagnosis and Treatment
To reduce glucose levels more insulin is needed. This is generally supplied with oral medication, or in extreme cases (and in Type 1 diabetes) by injection.
There are many drugs that treat diabetes in different ways; your doctor may prescribe Sulfonylureas, Biguanides, Meglitinides, Thiazolidinediones, DPP-4 inhibitors, SGLT2 Inhibitors, Alpha-glucosidase inhibitors, or Bile Acid Sequestrants. Sometimes a combination of drugs may be given.
When you are first diagnosed with diabetes your doctor may provide you something like the Dexcom blood glucose meter, which will constantly monitor blood sugar levels to allow a personalized insulin prescription. Insulin levels fluctuate throughout the day and each person will require a different dosage at different times.
In addition to managing glucose levels you also need to manage cholesterol and blood pressure – two common conditions that affect people with T2 diabetes. Another important goal is to reduce your weight. Fortunately a healthier diet can help to reduce and / or manage weight more easily.
However, many people are able to manage T2 diabetes and their glucose levels by following a healthy and balanced diet, at least during the early stages of the disease.
Low Glycemic Foods and Blood Glucose
All carbohydrates are broken down into sugars when digested, however, the amount of sugar produced and the rate at which blood glucose levels rises depends on the amount of carbohydrate that is eaten, and the source of that carbohydrate. Also, the cooking method makes a difference too – the more you cook food such as pasta, potato and carrots, the easier it is for the body to digest the food, and the faster blood sugar levels rise.
So, the first step in eating a healthy diet is to ensure that you limit all high-GI foods and strive to eat mostly low GI and some medium GI foods. Fortunately this is not too hard to do for 2 reasons:
- Low GI foods are all “natural” foods – such as fruits, vegetables, pulses, nuts and seeds. Any processed foods, most breads (especially white bread), white rice, pasta, anything made from wheat flour really – are high GI.
- You can easily find lists of low GI foods to eat – e.g. inside our own Low GI Diet ebook.
Good carbohydrates choices include most fresh fruits, vegetables, pulses, nuts and seeds. Freshly prepared salads, steamed vegetables and stewed pulses (e.g. in chilli-con-carne) are all good. Sweet potatoes, yam and new potatoes are better choices than fries, mashed potatoes and baked potato.
Starchy carbs are still allowed, but stick to pasta (cooking al dente is best), basmati or brown rice, Grainy breads such as granary, pumpernickel and rye can be eaten. Porridge oats, all bran and branflakes are good breakfast options.
Not Just About Carbs
A healthy diet does not just involve eating the right carbohydrates though. The other macronutrients, protein and fats, must also be eaten to have a balanced diet, but only the healthy versions. All protein is healthy, so that is not a problem as such. However, the sources of protein contain a wide variety of types of fat.
If you have T2 diabetes then you are already at greater risk of developing heart disease and clogged up arteries (atheroma – actually a furring and hardening of the arteries) so need to reduce the amount of saturated fat that you consume. Now, this is still a controversial subject. If you ask just about any doctor or diabetic nurse, they will tell you to cut back on saturated fat. If you speak to fanatical Primal dieters, even those with T2 diabetes, they will tell you that there is nothing wrong with saturated fat, because sugar is the problem. Well, the problem is both sugar and saturated fat! You can read more about diet and your heart here.
To avoid saturated fats you need to cut back on red meats, cheese and butter. Good sources of protein are most fish, seafood, poultry, game meats (they are much leaner), and eggs.
Yes, eggs! Eggs have a bad reputation for being high in cholesterol, but we now know that the body does not actually convert dietary cholesterol into blood cholesterol – it converts saturated fat into blood cholesterol. Eggs do contain some saturated fats, but they also contain healthy fats, protein and vitamins, which makes them a healthy choice.
It is always best to boil or poach eggs though, rather than fry. If you do fry an egg, use sunflower oil, or any other oil that is low in saturated fat. However, as with all things, moderation is key. Research has found that “high levels of egg consumption (daily) are associated with an increased risk of type 2 diabetes in men and women” Djousse (2009). However, overall dieticians believe that eggs are an important food source in a diabetic meal plan.
As a guideline, 2 eggs have less saturated fat than a small hamburger and The American Diabetic Association still suggests that you eat no more than 3 eggs a week, however, this is a guideline which errs heavily on the side of caution – other groups say that you can eat as many eggs as you like so long as they are part of a balanced diet. If you are worried about the fat content of eggs, do what bodybuilders do and remove the yolk, that way you get the healthy protein of the egg white without the excess fat (energy) of the yolk.
Healthy Eating Guidelines
In all honesty these guidelines do not differ much from that of Our Essential Guide To Healthy Eating.
- Learn to cook! By learning to cook you can take full control of everything you eat. You also save a lot of money.
- Eat 3 meals a day – breakfast, lunch and dinner. Avoid snacking on junk food and avoid skipping meals.
- Balance each meal, being careful to include low GI carbohydrates.
- Reduce the amount of fat you eat. Eat less chips, red meats, butter, cheese. If you have this type of food, have a very small portion. Remember moderation. Drink lower fat milk, grill or steam fish and meats, avoid creamy sauces and avoid fatty stews.
- Eat more fruits and vegetables. These carb sources are not only lower GI but packed with nutrients that boost health and make your body work better. Although fruits and vegetables contain sugar, they are all healthy and you should not cut back on any. The 5-a-day target should be considered a minimum – aim to eat 8-10 portions a day for optimum health.
- Learn to love lentils and beans – they are not just for hippies! Lentil curries, mixed bean salads, bean stews, and of course lean beef chilli-con-carne with plenty of kidney beans and chickpeas makes a great meal.
- Eat oily fish, such as sardines, mackerel and salmon. 2-3 portions a week is enough. The omega 3 helps to prevent heart disease and they provide a lean source of protein.
- Cut back on all sugary foods – all candy, sodas, processed meals with added fructose and corn syrup. Sugar is health – in moderation.
- Reduce salt intake. Aim for no more than 6g a day, ideally less. Salt raises blood pressure, which in turn damages the cardiovascular system. If you prepare all your own meals with fresh ingredients you can control your salt levels.
- Limit alcohol. Alcohol contains calories, but also causes people to snack on junk food – it is harder to control yourself when you have been drinking.
- Diabetic Foods are not needed. Do not buy diabetic foods, they really are not needed. It is better to learn to cook.
If you have T2 diabetes regular exercise is also very important. Exercise helps to remove sugar from the blood and increasing muscle mass (muscle consumes a lot of sugar in the form of glycogen) helping you to manage diabetes better. Studies have found that weight-bearing exercise, such as weight lifting and resistance training helps to control diabetes too.
References and Further Reading
Egg Consumption and Risk of Type 2 Diabetes in Men and Women by Luc Djoussé et al. Diabetes Care. 2009 February; 32(2): 295–300.
Sherri Shepherd’s Plan D Diet for Diabetes – MotleyHealth
General cooking tips – Diabetes UK.
Fruits – American Diebetes Association
Living with type 2 diabetes – NHS Choices