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Patient Information Healthy Eating with Diabetes

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What is Diabetes?
Diabetes is a condition in which the body is unable to control the amount of glucose (sugar) in the blood. This happens because your body is not producing enough insulin or your body is not using the available insulin effectively. Insulin is needed to take glucose from the blood to other body tissues where it is used as energy. Any glucose not used for energy is stored as fat.

Why is diet important?
It is important to follow a healthy diet, whether your diabetes is controlled by diet only, tablets or insulin. A healthy diet will help control your blood glucose levels and your weight, and will help protect you against developing long-term complications. A diabetic diet is not a special diet; it is a healthy way of eating which is suitable for everybody. You don’t need special ‘diabetic’ foods.

Which foods increase blood sugar levels?
 Sugary foods (e.g. sugar, sweets, fizzy drinks)
 Starchy carbohydrates (e.g. bread, potatoes, rice, pasta)
 Food containing natural sugars (e.g. fruit, fruit juice, milk, yoghurt)

Sugary foods will make your blood sugar levels rise quickly and should therefore be avoided. Starchy carbohydrates are broken down more slowly, causing a slower rise in blood glucose levels, making it easier to control your diabetes.

Foods containing sugar
It is important to cut down on these foods as much as possible:
 Sugar, glucose, honey, jam, marmalade, sweets, chocolate, mints
 Fizzy drinks, cordials, ordinary squash, glucose drinks e.g. Lucozade
 Foods with a lot of added sugar e.g. sugary breakfast cereals, fruit tinned in syrup, cakes, biscuits, ice cream and puddings.

Other names for sugar
When you read labels watch out for words like ‘sucrose’, ‘glucose’, ‘dextrose’, ‘fructose’ and ‘molasses’. These are all different types of sugar. Honey and syrup are also forms of sugar and should be avoided. Sweeteners e.g. Splenda, Candarel, Sweetex, Hermasetas, Stevia can be used instead of sugar, in small quantities.

Starchy carbohydrate foods
It is usually important to include something from this list of foods at each meal. The portion should be no larger than your own fist. Higher fibre foods are preferable but will still increase blood glucose.
 Potatoes – preferably boiled, new potatoes or sweet potato rather than chipped, mashed or in jackets.
 Breads – try to choose multigrain, seeded or granary bread. One large wrap or chapatti is equal to 2 slices of bread.
 Cereals – have high fibre cereals e.g. Porridge, Shredded Wheat, muesli Branflakes, Weetabix etc
 Pasta, rice & other grains – preferably choose whole wheat varieties of spaghetti, macaroni, brown rice, couscous, maize and bulgur wheat.
 Biscuits & crackers – choose plain types e.g. Digestives, Ryvitas, Rich Tea, fig rolls. Keep to small quantities.
 Cassava, yam, plantain, maize, millet, sorghum are all starchy and can increase blood glucose.

Milk and dairy foods
 These foods contain a natural sugar called lactose. It is best to keep the amount of milk you use to ½ -1 pint a day.
 Choose a reduced sugar or ‘diet’ yoghurts like Shape or Muller light
 Cheese will not put up your blood sugar but it can be high in fat. Have small amounts, or choose low fat cheeses such as Edam, Brie, cottage cheese, reduced fat cheese.

Remember that these foods are good sources of protein and calcium. Don’t cut them out altogether.

Fruit
Fruit can affect your blood sugar, so don’t eat too much fruit all at once. It is better to have it as a dessert after your meal. Include the skins of the fruit where appropriate, as it is high in fibre.
Fruit juice, even if labelled ‘unsweetened’, contains the natural sugar of the fruit in a concentrated form. So it is best to limit it to a small glass a day, at meal times.

Which foods do not increase blood sugar levels?
Meat, fish and alternatives and most vegetables. These foods provide protein, vitamins and minerals. It is best to include protein and vegetables at each meal, to help regulate blood glucose levels and avoid hunger.

Meat
 Choose leaner meat, if possible, and trim off visible fat.
 Grill or bake, rather than fry, and skim any excess fat from casseroles, stews or mince.
 Try substituting some meat in a casserole with lentils or vegetables.
 Avoid eating too much processed meat such as sausages, corned beef, pies, pasties and bacon.

Fish
 Oily fish, such as herring, mackerel, sardines, pilchards and salmon, contain omega 3 which may help to protect us from heart disease.
 White fish – try to grill, poach, bake or steam rather than frying.

Eggs
 Poach, scramble or boil instead of frying. People used to limit the number of eggs eaten but they are a good source of protein and do not need to be avoided, even if you are worried about your cholesterol.

Nuts, beans & lentils
 These are good alternatives for vegetarians but can be enjoyed by anyone. Nuts contain ‘good’ fat so are suitable for snacks or nibbles, in small quantities.

Cheese
 This is also a good source of protein and could be used as an alternative to the above. Choose low fat options where possible.

Vegetables
 Vegetables and salad at a meal should cover at least a third to half of your plate. Green vegetables and salads can be eaten freely. They are a good source of fibre, vitamins and minerals. To retain the most nutrients, cook vegetables as quickly as possible and only use a small amount of water. Frozen vegetables can be just as nutritious as fresh.

Diabetic foods
 Diabetic biscuits, cakes, sweets and ice cream are available but they tend to be high in fat, calories and salt and can also be expensive. It is better to have just a small amount of the ordinary product.
 Some of them also contain sweeteners like Sorbitol, Maltitol or Xylitol, which can act as a laxative – they are, therefore, not recommended.
 Diabetic jam and marmalade may be made using fructose, (fruit sugar). This is suitable for people with Diabetes but will not help you lose weight so be careful how much you have.

Watch your weight
If you are overweight, losing weight will help to control your diabetes. You should aim to lose ½ -1 kg (1-2 lb) per week. But don’t get discouraged if it is less than that. If you only lose 1lb a month, it will be nearly a stone in a year.

Tips for losing weight
 Eat regular meals. If you eat big portions, reduce your portion sizes. Try eating from a smaller plate. Eat more slowly and chew well. Try to include some protein at each meal – it will help you feel less hungry. Be careful with the size of meat and cheese portions, especially if they are high in fat.
 Regular exercise will help you lose weight. Aim for at least 30 minutes a day. If you take insulin, you may need to reduce your insulin dose when you change your diet or if you take more exercise. (Consult your doctor or diabetic nurse about this).

Alcohol
Alcohol is high in calories so avoid it or cut down if you are overweight. Diabetes UK recommends the following guidelines for sensible intakes:-
Men & Women – 2 units/day

1 unit of alcohol =:

  • ½ pint ordinary beer, lager or cider or
  • 1 pub measure of spirits (25ml) or
  • 1 small glass of wine (125ml) or
  • 1 pub measure of sherry, aperitif or liqueur (50ml)

Everyone should have at least 2-3 alcohol free days a week.

Alcohol and low blood sugar
People on insulin or tablets for diabetes may need to take an extra starchy carbohydrate snack if they drink alcohol, because alcohol lowers blood sugar and can cause a ‘hypo’. It is important that alcohol is taken with or after a meal.

Suggested meal plan

Breakfast
High fibre breakfast cereal and milk
Wholemeal bread, a little margarine, butter or low fat spread with
boiled or poached egg.
Mid-morning
Tea or coffee
Fruit or plain biscuit if necessary
Main meal
Lean meat or fish or egg or beans or cheese
Plenty of vegetables or salad
New potatoes or brown rice or pasta
Low sugar yoghurt or fresh fruit or low sugar milk pudding
Mid-afternoon
Tea or coffee
Fruit or plain biscuit if necessary
Light meal
Cheese or egg or beans or fish or meat
Wholemeal toast or bread or potato or rice
Salad or vegetables if liked
Low sugar yoghurt or fresh fruit or low sugar milk pudding
Evening snack
Slice of wholemeal toast or fruit or plain biscuit or a milky drink
Remember it is important to drink enough fluid, especially water.

Snacks
 Most people with Diabetes do not need to have snacks.
 If you are requiring a snack to prevent your blood glucose from dropping, you need to contact your diabetes nurse or GP to adjust your insulin.
 If you need a snack because you are hungry or use a lot of energy, try to keep to high fibre foods and, if possible, include some protein.
 If you do need a snack try to ensure it contains no more than 10g carbohydrate

Further information
In the UK, there is a charitable association known as Diabetes UK. Their aim is to improve the lives of people with diabetes providing support, up-to-date information on a range of issues, including recipe books and useful dietary information.

Contact Address:
Diabetes UK
Macleod House
10 Parkway
London NW1 7AA
Telephone: 020 7424 1000
Website www.diabetes.org.uk