Type 2 diabetes accounts for 95% of all diagnosed cases and more than 34 million Americans have it. All types of diabetes occur as a result of a body that doesn’t produce or respond to insulin, or both. Insulin is a natural pancreatic hormone that regulates how glucose (blood sugar) is used and stored. For people with type 2 diabetes, without properly functioning insulin, the body is often in a state of hyperglycemia (or high blood sugar). Hyperglycemia can develop gradually, and a persistent state of hyperglycemia can lead to many serious complications, even premature death.
Type 2 diabetes doesn’t affect people of just one body type, gender, age or race. In fact, anyone can get type 2 diabetes over time, but the most indicative risk factors are:
- having a family history of diabetes
- being obese, particularly around the abdominal area
- not getting regular physical activity
- being of a certain race or ethnicity, particularly Native American, African American and Hispanic American
- being older than age 45
Type 2 diabetes is usually diagnosed with a blood test called the A1C. (This reflects your average blood glucose over the last two to three months.) An A1C reading of 5.8% to 6.4% indicates prediabetes, and an A1C of 6.5% or higher indicates diabetes. The goal for most adults with type 2 diabetes is to keep A1C below 7%. What you consume is one of the most influential factors in both preventing type 2 diabetes, and controlling A1C over time.
While low-carb diets are often associated with diabetes, there is no specific diet for everyone to follow. However, there are overall eating guidelines that can be beneficial to balance blood sugars.
Foods high in fiber
Fiber is a type of carbohydrate that isn’t digested. It doesn’t increase blood sugar, and can help reduce blood sugar by slowing the absorption of sugars and starches in other foods. Additionally, some research shows that improved gut microbiome health – as a result of eating prebiotic fiber foods – can improve insulin resistance. These are especially good fibrous food choices:
Beans: black beans, black-eye peas, edamame (soybeans), chickpeas, kidney beans, lentils, lima beans, pinto beans
Non-starchy vegetables: artichoke, asparagus, bean sprouts, Brussels sprouts, broccoli, cabbage, cauliflower, celery, cucumber, eggplant, jicama, lettuce greens, peppers, radishes, snow peas, squash and zucchini, tomatoes, turnips
Whole grains: air-popped popcorn, bran, brown rice, buckwheat, quinoa, oats, whole-grain bread and pasta, wild rice
Whole fruits: ½ cup serving of avocado, berries, banana, citrus, fresh mango, grapes, peaches, pears, skin-on apples
Nuts and seeds: chia seeds, pistachios, skin-on almonds, sunflower kernels
Elevated blood sugar can cause dehydration, so it’s important for people with diabetes to drink fluids. But, as a category, beverages are the single highest source of added sugars in the standard American diet. Selecting no-added-sugar drinks can have a great impact on lowering blood sugars.
Water: Make regular H2O your main fluid since it doesn’t raise blood sugar and can help flush blood sugar out of the body through urination
Something sweet: If you want sweetened flavor, select 0-calorie drinks sweetened with natural sugar alternatives, such as stevia or monk fruit sweetener
Carbonation: If it’s carbonation you love, try sparkling water with a squeeze of citrus, berries or fresh herbs
Studies have shown that replacing sources of unhealthy fat and carbohydrate in the diet with mono- and polyunsaturated fats provides a dual benefit. It lowers blood glucose (by improving insulin resistance and secretion) and also improves heart health.
Better-Fat Snacks: Select nuts (almonds, walnuts, pistachios, cashews, peanuts) instead of palm-oil based packaged snacks like microwave popcorn and cookies; mashed avocado or hummus with veggies instead of cheese and crackers; Greek yogurt instead of ice cream or processed frozen yogurt products. (Brands with under 12 g carb/serving, no added sugars or sweeteners, and no palm/coconut oil)
Avocado: Top foods with chopped or mashed avocado
Fatty fish: Enjoy monounsaturated-rich salmon, tuna, anchovies, mackerel and herring
Foods to reduce when you have type 2 diabetes
Simple sugars: Foods that contain added sugars, as well as foods that are highly processed and high in carbohydrate have been shown to significantly increase blood sugar levels. These foods are often low in fiber and other beneficial nutrients.
Added-sugar foods: Added sugar shows up in obvious places (cereal and granola, baked goods and desserts, candy, packaged snacks and bars, jelly and honey) and less obvious places (condiments, flavored yogurts, some pasta sauces and soups, low-fat products, frozen entrees)
Processed grains: white bread, white pasta, white rice and rice-based gluten-free products raise blood sugar the highest and the fastest
Certain beverages: Beverages can be a double whammy for people with diabetes, providing things that can make diabetes management harder while also not providing much (if any) nutrition or feeling of fullness.
Sugar- or artificially sweetened beverages: Avoid soda, energy drinks, juice, smoothies, flavored and sweetened dairy and non-dairy milks, and lemonade or tea sweetened with sugar, syrups or artificial sweeteners
Caffeine: Growing research shows that people with type 2 diabetes react to caffeine differently than people without diabetes. Caffeine can lower insulin sensitivity, so limit coffee and caffeinated tea to less than 16 ounces (2 cups) per day. Also avoid sweetened caffeinated beverages
Alcohol: For people with diabetes, alcohol can be detrimental in several ways. Alcohol can temporarily increase blood sugar and also cause dangerous drops in blood sugar. It can also cause weight gain, impair your liver from processing blood sugar and interfere with diabetes medications. Men diagnosed with diabetes should limit alcohol to two drinks or less per day. Women with diabetes should limit to one drink or less per day. (This is equivalent to 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof spirits)
Supplements that can help with type 2 diabetes
There are several supplements that could help lower blood sugar. And while supplements will likely never replace a prescribed medication, they have been connected with lowered dosages over time. Always consult your doctor before starting a new supplement.
Vitamin D: Deficiency in vitamin D has been connected to type 2 diabetes, and in one study three out of four people with type 2 diabetes were shown to be deficient in vitamin D. Vitamin D may improve the function of pancreatic cells to increase your body’s ability to make and react to insulin
Magnesium: Low blood levels of magnesium have been observed in up to 1 in 3 adults with type 2 diabetes, and studies show that supplemental magnesium taken for up to six months could reduce blood sugar. The recommended dose for people with diabetes is 250 to 350 milligrams taken daily with a meal
Prebiotics, probiotics and synbiotics: Damage to the gut and poor microbiome health has been connected to many conditions, including diabetes. Improved microbiome health has been linked to improved insulin resistance
Cinnamon: There is promising research connecting lowered blood sugar with high doses of cinnamon taken before meals. The recommended dose is 250 milligrams of cinnamon extract or 500 milligrams of non-extract cinnamon taken twice a day before meals
Have type 2 diabetes? Do this first.
If you are overweight, losing 5 to 10 percent of your body weight can have a significant impact on lowering blood sugar. It can also help avoid or slow the progression of complications that come with type 2 diabetes. If you are in a normal weight range, the most impactful thing you can do is consume fewer added sugars while eating more foods high in fiber.
What else to know about type 2 diabetes
There are many things that you can do to control diabetes beyond what’s on your plate. Combine the above recommended changes to your diet with the following in mind:
Medication: Depending on your A1C, motivation to make lifestyle changes, family history and other factors, your doctor may or may not prescribe one or more medications after a diagnosis of diabetes. Diabetes medications can be helpful in your quest to control your blood sugar. But medications can also come with side effects, such as weight gain, nausea, or too-low blood sugars. Work with your doctor if you would like to make lifestyle modifications before going on medication or in conjunction with lower-dose medications. But never stop taking a prescribed medication without consulting your doctor first. Common type 2 diabetes medications include those that improve insulin sensitivity (like metformin and thiazolidinediones), those that help your body make more insulin (sulfonylureas and glinides), as well as taking insulin itself.
Consistency and monitoring: Creating a pattern of consistent meal times, consistent food and beverage amounts, consistent movement, consistent mood and consistent bedtimes is extremely beneficial at regulating blood sugar. Consistent monitoring of your blood sugar can also help you understand helpful and harmful patterns in your life.
Reign in portions: Many people find that they can eat all of their favorite foods despite a diagnosis of type 2 diabetes just by modifying portions and eating smaller meals and snacks.
Get moving: Find an activity – any activity – that you enjoy (biking, table tennis, gardening, hiking) and get moving. Consistent daily activity is one of the best natural ways to improve your body’s ability to react to insulin.
Decrease stress: Stress can increase blood sugar immediately and make you less sensitive to insulin over time. By actively working to remove, limit, or manage sources of stress in your life you can reduce your blood sugar in both the short and long term.