Type 2 diabetes occurs when your body's cells are insulin-resistant, making your pancreas work harder to keep your blood sugar (glucose) levels within a healthy range. Type 2 diabetes develops over time.
Risk factors for type 2 diabetes include:
The disease is manageable — and sometimes reversed — through medication, an active lifestyle, and healthy eating.
Building a type 2 diabetes meal plan involves getting the right balance of calories and carbohydrates from different foods at regular times each day to keep your glucose levels steady.
Glucose comes from the carbohydrates in the foods we eat, fueling our bodies with energy in much the way we fuel our cars.
We make it easy for you to participate in a clinical trial for Type 2 diabetes, and get access to the latest treatments not yet widely available - and be a part of finding a cure.
Many people with type 2 diabetes suffer from comorbidities (two or more diseases in the same person) such as heart and kidney diseases, obesity, and NAFLD. This can make meal planning confusing, as there are dietary guidelines for each condition.
Following one over the other can leave a gap in your nutritional approach. It's best to work with a dietician to ensure that you incorporate healthy choices from each set of guidelines.
The Dietary Approaches to Stop Hypertension (DASH) diet is a low-sodium plan that promotes healthy eating to reduce high blood pressure. The DASH diet contains foods high in potassium, magnesium, and calcium. Saturated fat, sodium, and sugars are limited as they can raise blood sugar, blood pressure, and LDL cholesterol, which are the main risks for heart disease and stroke. DASH limits sodium to 2,300mg daily.
That's about the amount of sodium in one can of condensed chicken noodle soup or one teaspoon of table salt.
There is a DASH diet with an even more restrictive sodium recommendation (1,500 mg per day) for those who need to lower their sodium intake even further.
The Mediterranean diet has become popular in the US. It is a nutritional approach that promotes foods traditionally consumed in Mediterranean countries like France, Greece, Spain, and Italy.
High in healthy fats like extra virgin olive oil, this diet includes fruit and vegetables, whole grains, nuts, seeds, and oily fish like salmon. Eggs and cheese are eaten in moderation. Red meat, processed foods, and refined oils and grains are rarely eaten.
Studies¹ have shown that people with diabetes who eat the Mediterranean diet have lower insulin resistance and lower A1C (test that measures blood sugar over the past three months) levels. What's more, according to another study,² the Mediterranean diet may protect your brain's cognitive function. This could mean:
Increased processing speed
Lower risk of neurological diseases such as Alzheimer's and dementia
This approach reminds us that the best 'diet' for managing diabetes is not just a diet but a lifestyle change.
Consistency is important in diabetes management. Meal planning helps you to be consistent in your eating habits while balancing your daily intake of carbohydrates. This is especially important if your treatment plan includes insulin injections, as insulin doses may need to change depending on your food intake.
Meal planning also provides a visual representation of how many calories and carbohydrates each food choice contains, whether you manually write a list or chart your consumption in an app.
By mapping out what foods you are eating at each meal, along with portion sizes, calories, and carbohydrates, you can see at a glance what foods work together for breakfast, lunch, dinner, and a snack.
Some doctors may recommend eating up to six smaller meals a day, depending on other conditions that you may have. If you need to lose weight, your meal plan may provide between 1,200 and 1,600 calories per day.
Benefits of sticking to your type 2 diabetes meal plan include:
Lower need for diabetic medication
Reduced risk of heart conditions like high blood pressure
Reduced risk of high cholesterol
You can include in your diet any food under 20 calories a serving and less than 5g carbs per serving ('free' foods). Pay attention to what constitutes a serving size for any free food.
Portion control and carb counting are imperative no matter what foods you choose. If you are not familiar with portion sizes, portion control can seem subjective. You may find sizing up your portions confusing or tricky.
You can use your hand to illustrate portion sizes. Let's take a look at some examples of foods for each size:
A fingertip portion is about one teaspoon. Think mayonnaise, oils, butter, and margarine.
A thumb portion is around one tablespoon. Nut butter, cheese sticks, sour cream, and salad dressings are examples of thumb portions.
One handful is approximately one to two ounces. Nuts, pretzels, and snack crackers fit into the average size palm (2.91 to 3.30 inches depending on gender) without filling it.
A palm portion is three to four ounces, which fits completely in your palm up to your fingers and thumb. Serving sizes of fish, meat, poultry, pasta, cooked vegetables, and potatoes fit the average palm portion. To get an idea of the rough size, imagine holding a deck of cards in your palm.
A fistful is about one cup or eight ounces. This could be one cup of soup, raw vegetables, salad, or cereal.
US portion sizes are larger than European ones. Our plate sizes have grown over 36% during the last 50 years. We've gone from nine-inch to 1ft diameter plates, especially in restaurants where portion sizes are often two to three times the average serving size.
Now that you have a better understanding of portion and plate sizes let's look at what types of food you should eat.
Every food that contains carbohydrates can potentially increase your glucose levels. The glycemic index was developed to categorize foods as low, medium, or high, based on how fast they raise your blood sugar, using a scale from 1 to 100.
Low levels indicate less potential to raise your glucose level quickly.
Foods can be classified as:
Low glycemic: GI of 50 or less
Medium glycemic: GI of 50–70
High glycemic: GI of 70 or above
Foods like prepackaged and flavored oatmeal tend to have a GI of around 80. On the other hand, steel-cut rolled oats lower the GI to 55, making it a better choice for your meal plan.
Look for whole grains, non-white bread, and whole-grain or vegetable pasta that contain complex carbohydrates over simple ones.
Complex carbohydrates take longer to break down than simple carbs that quickly turn to sugar. Whole grains are also high in fiber and help you feel full faster, but watch portion sizes since they may also be higher in calories.
Nuts are high in protein and can be high in calories. Legumes, represented especially by beans, are a great source of protein but tend to be relatively lower in calories.
Keep in mind that peanuts, and therefore peanut butter, are legumes.
Starch is the type of carbohydrate that is stored by vegetables. The following starchy vegetables should be consumed in moderation, or they will raise your blood glucose levels:
When it comes to starchy vegetables, make good choices and practice portion control. Instead of a white baked potato, choose a sweet potato or a yam. Instead of french fries, choose sweet potato fries or baked radish slices.
There is no need to avoid all 'white' foods. You need a diversity of foods in your meal plan.
Vegetables low in starch tend to be dark, leafy, and green, although they can also be light in color, like cauliflower and bamboo shoots.
Cruciferous vegetables, like broccoli and cabbage, contain a lot of water, fiber, and glucosinolates. Glucosinolates are known to inhibit cancer cell growth and act against inflammatory disease. They include:
Dark-green, leafy vegetables
For the most variety in your meal plan, choose both starchy and non-starchy vegetables daily.
Stick to low-fat dairy products over full-fat offerings. Foods in this category include:
Watch out for hidden sugars in flavored dairy products. A single serving of flavored yogurt may contain 40g of sugar. After you factor out the natural sugar, lactose, you are left with five to seven teaspoons of hidden sugar.
Fruit naturally contains fructose, which causes a low rise in blood sugar levels compared to glucose. However, you need to include fruit in your meal plan since it contains fiber and phytochemicals.³
Fiber slows the digestive process and helps alleviate blood sugar spikes. Phytochemicals stimulate the immune system and slow cancer cell growth.
Fruits you can eat include:
A good snack will satisfy food cravings while keeping carbs at a minimum level. It's important to add snacks into your meal planning each day to maintain a variety of your favorite foods.
Some ideas for snacks are:
Crackers (whole-grain, baked)
French fries (baked)
Popcorn (air-popped or microwave, no butter)
Potato chips (whole-grain, baked)
Snacking should have the purpose of keeping your glucose normalized and your energy levels up.
Foods without condiments can be very plain, making it difficult to stick to a healthy diet. Sauces and condiments should be a fingertip or thumb portion in your diabetic meal plan.
Some examples include:
'Low sugar' does not mean 'no calories'. Read your labels and choose your extras with care. Smothering whole-grain waffles with syrup won't keep blood sugar at healthy levels. Try fruit jam for a sweet change-up or salsa for a savory treat.
People with diabetes should avoid processed foods like prepackaged deli meat, cheese, chips, and convenience meals. Other foods to avoid include:
High-fat meat, especially beef, duck, skin-on poultry, dark meat
Full-fat dairy like whole milk, sour cream, butter
Non-diet sodas and sugar-sweetened fruit juices
Sugars, especially table sugar, honey, molasses, and brown sugar
Foods high in trans fat like shortening, dairy-free creamers, and anything containing partially hydrogenated oils
Fried foods, unless you fry them in olive oil or use an air fryer
If you just can't do without some of these foods, eat them sparingly and together with healthier foods.
When choosing foods for your type 2 diabetes meal plan, it's important to learn how to read food labels. This is especially important if you have food allergies to consider.
When choosing which foods to include in your meal plan, read the labels for their ingredients, carbs, fiber, and fat content.
Ingredients are listed in descending order, with the most-used ingredient to the least.
Look at the total grams of carbohydrates on the label. This is divided into added sugars, complex carbohydrates, and fiber. Check if the carbohydrates are natural sugars or processed. Natural sugars like those in milk and fruit are better choices than the sugars in cereals. If your label says 'sugar-free,' it isn't necessarily carb-free. Sugar-free labels mean that there is less than 0.5g of sugar in one serving.
Fat-free foods may still have carbohydrates. Fat has more than twice the calories of either carbs or sugars. Trans fats and saturated fats can raise cholesterol. Choose mono- or polyunsaturated fats as they are heart-friendly.
It can seem overwhelming to create suitable meals from scratch, especially if you are newly diagnosed and are just learning about diabetes. However, general rules of thumb can make meal planning easier.
45–60g of carbs per meal
15–25g of carbs per snack
Whole foods over processed ones
A variety of food choices
Inclusion of healthy foods you love
More protein, more fiber, and fewer sweet foods
Note that the level of carbohydrates in a type 2 diabetes diet can vary depending on factors such as weight, age, and physical activity level. The best starting point is to consult a dietician experienced in diabetes diet planning.
If you have comorbidities to consider, it is also helpful to have an experienced dietician's input.
2 scrambled eggs
1/2 medium banana (14g)
2 slices of whole-wheat bread (30g)
2 tablespoons walnuts (2g)
Total carbs: 46g
1 slice of whole-wheat bread (15g)
1 tablespoon almond butter (3g)
4oz low-fat yogurt (9g)
1/2 cup raw carrots (9g)
2 tablespoons low-fat ranch dressing (6g)
Total carbs: 42g
3oz roast chicken without skin
1/2 large baked potato (32g)
1 cup fresh cherries (12)
Total carbs: 44g
1/2 cup strawberries (11g)
2 pieces of dark chocolate (10g)
Total carbs: 21g
The key to designing your unique type 2 diabetes meal plan is to educate yourself about your diabetes and other conditions you may have (comorbidities), know which foods to eat and which to avoid, and carefully read food labels.
Creating your unique type 2 diabetes meal plan doesn't have to be cumbersome or overwhelming. Educate yourself, make good food choices based upon your dietician's recommendations for your diabetes and other medical conditions, practice portion control, and count carbohydrates and calories.
Diet planning is a therapeutic tool that will help you maintain stable glucose levels but can become a lifestyle that will affect your health for the rest of your life. It can help you to manage your diabetes rather than it managing you.
Carbohydrate food list | Michigan Medicine
Diabetes 101 | University of Michigan Health
5 hidden sources of sugar | Eating Made Easy
Digestive system processes | Lumen
Cruciferous vegetables | Oregon State Univerity
The heartache of cardiovascular comorbidities | Georgetown University
Diabetes - A major risk factor for kidney disease | National Kidney Foundation