Anna Rhoads Tyner, MS, RD, LD, CDCES

Diabetes is a health epidemic in the United States. In 2021, over 10% (or 38 million people) had some form of diabetes, and over 97 million had prediabetes. The rate of diabetes continues to rise, and research indicates that the number of people with Type 2 diabetes, the most common form, will double by the year 2050.

Nutrition and healthy lifestyle choices play a key role in prevention and treatment for people with diabetes and prediabetes. A popular myth for people with diabetes is that they have to eat particular foods to treat their condition. While there are different treatment plans depending on whether a person has Type 1, Type 2, or prediabetes, the truth is, no “special foods” are needed, and following a healthy eating plan is a mainstay of treatment.

Diabetes is a chronic medical condition affecting how the body uses glucose, or blood sugar, for energy. When food is consumed, carbohydrates such as starches, fruit, sugar, and many processed foods are broken down into glucose and absorbed into the bloodstream. To move glucose from the bloodstream into the cells for energy, a hormone produced in the pancreas, called insulin, is needed to “unlock” the cells and let glucose molecules in.

Type 1 diabetes is an autoimmune disease that occurs when the immune system destroys the insulin-producing cells in the pancreas. Due to this, the pancreas produces little or no insulin and must be supported by injections or an insulin pump. For those diagnosed with Type 2 diabetes, the body may not make enough insulin or may be unable to use insulin properly. Prediabetes occurs when blood sugar is high, but not high enough to be diagnosed with diabetes.

A balanced meal plan of carbohydrates from whole, high-fiber foods, lean proteins, and healthy fats is recommended for Type 1 and Type 2 diabetes, as well as prediabetes. Good nutrition and a healthy lifestyle can actually help reverse prediabetes and Type 2 diabetes in some instances.

Carbohydrates and Diabetes

The type and amount of carbohydrates are important for blood sugar control in people with diabetes and prediabetes. While carbohydrates often get a bad rap, they are the preferred source of energy for the body and the brain and can be classified as simple or complex.

Complex carbohydrates are found mainly in plants, including fruits, vegetables, whole grains such as oats, quinoa, brown rice, and whole wheat breads, beans, peas, and potatoes. These foods are packed with fiber, vitamins, and minerals, and raise blood sugar more slowly since they take longer to digest. Milk products also contain carbohydrates.

Simple carbohydrates include sugars, sweet drinks, refined grains including products made from white flour, white rice, and many processed snack foods. These foods are often low in fiber and nutrients and raise blood sugar quickly. They also contain other additives and preservatives linked with obesity, diabetes, cardiovascular disease, and certain types of cancers.

Eating more complex carbohydrates and limiting simple carbohydrates is recommended for overall health and better blood sugar control. People with Type 1 and Type 2 diabetes need to understand how different carbohydrates affect blood sugar levels and can greatly benefit from learning about carbohydrate counting.

Work with your health care provider to discuss healthy lifestyle changes, including diet, exercise, and medications based on your individual needs. Ask for a referral to a Registered Dietitian Nutritionist or a Certified Diabetes Care and Education Specialist for more individualized diabetes education. These specialized medical professionals are an excellent resource for help in meal planning, carb counting, monitoring blood sugars, and other aspects of managing diabetes. As part of The Diabetes Institute, HopeHealth offers the National Diabetes Prevention Program, which is facilitated by specialists and is free for those with prediabetes.

Other useful tips and hacks:

Use the plate method for portion control. The plate method for meals is a simple way to keep portions in line. On a dinner plate, add protein to one quarter of your plate, whole grain starches to the other quarter, and vegetables to half.

Aim for high-fiber carbohydrates. High-fiber foods mean slower carbohydrate absorption, which helps improve blood sugar control. Aim for 25-35 grams of fiber a day. Choose fruits and vegetables with edible skins and seeds, beans, peas, nuts, seeds, whole grains like oats, whole wheat products including bread, crackers, and pasta, brown rice, and popcorn. A cupped hand is generally one to two servings of a carbohydrate.

Pile on the vegetables. Non-starchy vegetables are high in fiber, low in carbohydrates, and can be eaten in larger quantities, including leafy greens, onions, peppers, tomatoes, cucumbers, celery, carrots, mushrooms, green beans, broccoli, cauliflower, cabbage, zucchini, squash, and asparagus.

Limit highly processed foods and added sugar. Read the nutrition facts panel on packaged foods and limit added sugar to 25 grams or less from juice, sweet drinks, candy, baked sweets, and other processed foods like chips, white flour crackers, and sugary breakfast cereals.

Focus on lean proteins. Choose lean cuts of beef and pork (sirloin, tenderloin, round), poultry without skin, seafood, eggs, nut butter, low-fat cheese, tofu, beans, and peas. Your palm size is a reasonable serving size of meat for lunch and dinner.

Choose healthy fats. Watch out for too much animal fat and fried foods. Instead, bake, broil, stew, grill, or air fry foods and use olive oil for cooking. Look for grass-fed butter, olive oil mayonnaise, vinaigrette, or oil-based dressings, and keep portions reasonable. Your thumb size is equivalent to 1 serving.

Keep your body hydrated. Adequate fluids can help regulate blood sugar, improve insulin function, and protect the kidneys. Aim for 9-11 glasses of water daily (72-88 ounces) and more if physically active. Carry a water bottle with you and check your urine for a pale-yellow color as a sign of good hydration.

Read nutrition labels. Review the ingredient list and look for a short list of ingredients you recognize. Use the nutrition facts panel to analyze the carbohydrate, fiber, and sugar content.

Plan meals and snacks. Take time to develop healthy options for breakfast, lunch, dinner, and snacks. These could include eggs, fruit, and whole wheat toast for breakfast, a turkey sandwich and salad for lunch, and air-fried chicken, brown rice, and oven-roasted broccoli for dinner. Easy snack ideas include an apple with peanut butter or popcorn with a handful of nuts.

Physical activity, adequate sleep, and managing stress are also important for managing diabetes and prediabetes. Having regular visits and a good relationship with your health care provider can make a huge difference in detecting and improving diabetes and prediabetes over time.