General People with
diabetes can eat any food that they want, preferably a
healthy diet with some
carbohydrates, but they need to be more cognizant of the carbohydrate content of foods and avoid simple sugars like juices and
sugar-sweetened beverages. For people dependent on insulin injections (both
type 1 and some
type 2 diabetics), it is helpful to eat a consistent amount of carbohydrate to make blood sugar management easier.
Macronutrients As of 2019 there was no consensus that eating a diet consisting of any particular
macronutrient composition (
i.e.: the ratio of fat, protein, and carbohydrate in the diet) is more beneficial for diabetics. However, research on diabetic diets is limited due to the difficulty of nutritional research. These studies tend to be
observational as opposed to
experimental, relatively short in duration, and have relatively poor compliance due to the difficulty of controlling the diets of study participants at all hours of the day for extended periods of time. There is no minimum required amount of daily dietary carbohydrates as the body can make glucose through various metabolic processes including
gluconeogenesis and
glycogenolysis.
Fiber Benefits may be obtained by consumption of dietary fiber. There is some evidence that consuming dietary fiber may help control blood sugar levels; however, the ADA does not recommend any different fiber intake for diabetics than for non-diabetics. A
meta-analysis published in 2018 found only nine papers that had adequately studied the implementation of low carbohydrate diets in type 1 diabetics as of March 2017. In a 2019 consensus report on nutrition therapy for adults with diabetes and prediabetes the
American Diabetes Association (ADA) states "
Reducing overall carbohydrate intake for individuals with diabetes has demonstrated the most evidence for improving glycemia (blood sugar) and may be applied in a variety of eating patterns that meet individual needs and preferences.", it also states that reducing overall carbohydrate intake with low- or very low- carbohydrate eating plans is a viable approach. In fact, some investigations say that patients adhering to an low carbohydrate diet may experience remission of diabetes type 2 without adverse consequences The ADA say low-carbohydrate diets can be useful to help people with type 2 diabetes lose weight, but that these diets were poorly defined, difficult to sustain, unsuitable for certain groups of people and that, for diet composition in general". Overall, the ADA recommends people with diabetes develop "healthy eating patterns rather than focusing on individual macronutrients, micronutrients, or single foods". They recommend that carbohydrates in a diet should come from
whole food sources such as "vegetables,
legumes, fruits, dairy (milk and yogurt), and whole grains"; highly refined foods and sugary drinks should be avoided. For type 2 diabetics, the focus of a vegetarian or vegan diet should be maintaining a level of caloric intake that results in fat loss, adequate protein consumption, adequate consumption of compounds that are most
bio-available in animal products (i.e.
vitamin B-12,
iron,
creatine), and
whole food carbohydrate sources that are lower in glycemic index. The
Academy of Nutrition and Dietetics maintains that well formulated vegetarian and vegan diets can be healthy and nutritionally adequate for people of all ages. The
American Diabetes Association notes that the use of vegetarian or vegan diets for diabetes have had inconclusive results in the literature. This includes avoidance of such foods as potatoes cooked in certain ways (i.e.: boiled and mashed potatoes are higher
GI than fried) and bread. Lower glycemic index carbohydrate sources include vegetables, legumes, and whole grains that contain higher fiber content and are digested and absorbed into the blood stream more slowly than refined carbohydrates.
High fiber diet The
ADA recommends a level of fiber intake consistent with the Dietary Guidelines for Americans 2015–2020 (minimum of 14 g of fiber per 1,000 kcal). However, there is some evidence that higher intakes (daily consumption of 50g of fiber and higher), can result in small improvements in blood sugar levels. The ADA cautions that higher intakes may cause digestive issues such as "flatulence, bloating, and diarrhea." Another possible sign of nocturnal hypoglycemia is morning hyperglycemia, which actually occurs in response to blood sugar getting too low at night. This is called the
Somogyi effect. In relation to type 2 diabetes, eating most food earlier in the day may be associated with lower levels of overweight, obesity and other factors that reduce the risk of developing type 2 diabetes. The
ADA notes that several studies have shown benefit of
intermittent fasting on blood sugar control. • They may be expensive • They may contain high levels of fat • They may confer no special benefits to people who have diabetes
NICE (the National Institute for Health and Clinical Excellence in the
United Kingdom) advises doctors and other health professionals to "Discourage the use of foods marketed specifically for people with diabetes".
Alcohol The
ADA recommends that people with diabetes limit alcohol consumption as recommended by the Dietary Guidelines for Americans (up to one drink per day for women and up to two drinks per day for men). Consumption of alcohol above this amount may lead to
elevation in blood sugar. Consumption of alcohol also puts diabetics at increased risk of
hypoglycemia. The ADA states that this may be due to the "inhibition of
gluconeogenesis, reduced hypoglycemia awareness due to the cerebral effects of alcohol, and/or impaired counterregulatory responses to hypoglycemia." This puts diabetics who take insulin or other
anti-hyperglycemics at risk of night time or fasting hypoglycemia. Consuming food with alcohol reduces this risk of hypoglycemia. ==History==