Food & Fitness

There are a lot of snack options out there for people with diabetes. Fruit is just one option. Snacks can be an important part of a diabetes meal plan. For some people, smart snacking a few times a day may help keep blood glucose levels stable. Snacking also keeps you feeling satisfied, so you are less likely to overeat at your next meal.

However, many people think of high-fat, high-sugar foods when they hear the word “snack”. Unhealthy snack foods like cookies, candy, and chips are dense in calories and offer minimal nutritional value. But there are still lots of snack options that can help curb hunger while adding a nutritious energy boost to your day – without sabotaging efforts to prevent or delay diabetes.

It is best to think of snacking as an opportunity to fit more nutrients into your day. Nutrient-rich foods like fruit, vegetables, whole grains, and low-fat dairy are all good options. These foods are lower in sodium, calories, and fat when compared to most salty snacks and sweets. They will also fill you up and help to curb your hunger until your next meal.

Many of us tend to overeat when we snack. In addition to choosing healthy foods, controlling portion size is also important. Check out the list of healthy snack ideas below. 

• 10 baby carrots with 2 tablespoons fat-free ranch dressing for dipping
• Cucumber slices with ¼ cup guacamole
• A serving of any non-starchy veggie and 1/3 cup hummus for dipping
• 1 6-ounce serving of non-fat yogurt
• 3 cups light popcorn
• 5 small whole wheat crackers and one piece of light string cheese
• 1 ounce of unsalted nuts (for example, dry roasted almonds, raw cashews, raw walnuts, or unsalted mixed nuts).
• 2 rice cakes topped with light cream cheese or another light spreadable cheese
• 1 piece of 100% whole wheat toast with 1 tablespoon peanut butter or trans-free margarine
• 1 small granola bar
• 1 packet of sugar-free instant oatmeal
• A small bowl of whole grain cereal with ½ cup of skim milk
• Half of a turkey sandwich made with 100% whole wheat bread, lean deli turkey, mustard, and any non-starchy veggies you want

Note that the portion sizes given above may need to be adjusted to fit with your meal plan. Fruit is also always an option when it comes to snacking. For more diabetes-friendly ideas that include carbohydrate counts, check out our snacking page.

Below is a list of risk factors that increase one’s risk for developing type 2 diabetes:

• People with impaired glucose tolerance (IGT) and/or impaired fasting glucose (IFG)
• People over age 45
• People with a family history of diabetes
• People who are overweight
• People who do not exercise regularly
• People with low HDL cholesterol or high triglycerides, high blood pressure 
• Certain racial and ethnic groups (e.g., Non-Hispanic Blacks, Hispanic/Latino Americans, Asian Americans and Pacific Islanders, and American Indians and Alaska Natives)
• Women who had gestational diabetes, or who have had a baby weighing 9 pounds or more at birth

Some of these risk factors you can change, while others you don’t have much control over. Your husband has a strong family history of diabetes since both of his parents have diabetes. He is also getting older, so that increases his risk as well. One resource we have that you may want to check out is our diabetes risk test. This might be a good conversation starter to get him talking about what you can do together to prevent diabetes.

It’s great that he is not overweight, but there a few other things he can be doing to minimize his risk. Exercising regularly is important, as is eating a healthy diet. Together, these two lifestyle changes can help him maintain a healthy weight and muscle mass. Exercise and healthy eating can also help keep his cholesterol and blood pressure under control. 

A lot of people ask if eating too much sugar can increase their risk for developing diabetes. The answer is not so simple. Type 2 diabetes is caused by a combination of genetics and lifestyle factors. Being overweight does increase your risk for developing type 2 diabetes, and a diet high in calories from any source (whether sugary foods or high fat foods) contributes to weight gain. Research has shown that drinking sugary drinks is linked to type 2 diabetes as well. The American Diabetes Association recommends that people limit their intake of sugar-sweetened beverages to help prevent diabetes.

However, there is not a specific amount of sugar he should limit himself to in order to prevent diabetes. Overall, he should focus on making healthy food choices and controlling portion sizes. This means filling his plate with more fruits, vegetables, lean meats, and whole grains and limiting sugary drinks, sweets, fatty meats, and unhealthy snack foods.

For more about making healthy food choices, visit the What Can I Eat? section of diabetes.org.

It is okay to treat yourself once in a while, but you should always try to keep portions under control and avoid overeating. I wouldn’t suggest eating anything “mindlessly”. Eating too much of anything, whether you have diabetes or not, can have serious consequences.

When you have diabetes, there are just a few foods that you can eat in larger portions without having to worry too much about your blood glucose. This includes certain raw, non-starchy vegetables such as:

• Spinach
• Cucumbers
• Mushrooms
• Broccoli florets
• Salad green
• Zucchini
• Yellow squash
• Radishes

All of these raw veggies have less than 5 grams of carbohydrate per cup. So, you can eat quite a bit without raising your blood glucose too much. They also have other benefits because they are high in vitamins, minerals, and fiber.

Another food that is high in fiber and a good option for snacking is popcorn. You can eat 3 cups of (popped) popcorn for just 15 grams of carbohydrate. This is a relatively large portion size. Just be careful not to add extra butter and salt! Try air popping it yourself or buy light versions of microwave popcorn. There are also 100-calorie bags in stores now.

This is a very common question among people with diabetes. The truth is, there is not a standard amount of carbohydrates that will work for everyone with type 2 diabetes. If you have diabetes, we recommend following an individualized meal plan that will help you meet your diabetes goals. Your healthcare provider can help you set these goals, which might include losing weight, improving your A1C, lowering your blood pressure and/or lowering cholesterol levels.

If you haven’t set up an individualized meal plan yet, 45-60 grams of carbohydrate per meal is a place to start. However, some people may need more and some people may need less.

Find a time to work with your healthcare provider to set up a meal plan that takes your preferences into account and can help you achieve your diabetes goals. Ask about how many carbohydrates to include at each meal and whether or not to include snacks. Your provider may suggest using the diabetes plate method to start or they may have you try carbohydrate counting. It may also be helpful to work with a registered dietitian (RD) when learning to plan meals.

This really depends on the type of insulin your doctor has prescribed to you. There are more than 20 types of insulin sold in the United States. These insulins differ in how they are made, how they work in the body, and how much they cost.

In order to control blood glucose, it’s essential to balance the insulin you take with the food you eat. If you take an insulin bolus and you wait too long to eat, it can cause a hypoglycemia, which can be very dangerous. If you take an insulin bolus and you eat less than expected, that can also cause hypoglycemia. So, it’s very important to be familiar with the way your insulin works and how to balance it with food.

Three important characteristics of your insulin to know include the onset, peak time, and duration.

• Onset is the length of time before insulin reaches the bloodstream and begins lowering blood glucose.
• Peaktime is the time during which insulin is at maximum strength in terms of lowering blood glucose.
• Duration is how long insulin continues to lower blood glucose.

There are different types of insulin which vary in how quickly they work, when they peak, and how long they last.

• Rapid-acting insulin, such as insulin lispro (Eli Lilly), insulin aspart (Novo Nordisk), or insulin glulisine (Sanofi-Aventis), begins to work about 5 minutes after injection, peaks in about 1 hour, and continues to work for 2 to 4 hours.
• Regular or Short-acting insulin (Humulin R, Novolin R, ReliOn Regular) usually reaches the bloodstream within 30 minutes after injection, peaks anywhere from 2 to 3 hours after injection, and is effective for approximately 3 to 6 hours.
• Intermediate-acting insulin (Humulin N, Novolin N, and ReliOn N) generally reaches the bloodstream about 2 to 4 hours after injection, peaks 4 to 12 hours later, and is effective for about 12 to 18 hours.
• Long-acting insulin (ultralente) reaches the bloodstream 6 to 10 hours after injection and is usually effective for 20 to 24 hours. There are also two long-acting insulin analogues: glargine and detemir. They both tend to lower glucose levels fairly evenly over a 24-hour period with less of a peak of action than ultralente.

There are also some mixed insulins. In addition, insulin can vary in strength, so it's important to know the strength of the insulin you've been prescribed.

Insulin shots are most effective when you take them so that insulin starts to work when glucose from your food begins to enter your blood. For example, regular insulin works best if you take it 30 minutes before you eat.

If you are confused about how your insulin works, it is best to ask for clarification from your healthcare provider. Your pharmacist should also be able to answer questions. For extra help with meal planning and balancing food and insulin, you may want to consider working with a certified diabetes educator or a registered dietitian who has experience in diabetes. Additional resources that may be helpful are our Diabetes Forecast articles A User’s Guide to Insulin and Back to Basics: Insulin.

A vegetarian diet is a healthy and safe option for people with diabetes. It should be well-planned, including a mix of vegetables, fruits, beans, whole grains, nuts, meat substitutes, and low-fat dairy products (if you choose to include dairy).

It is also important to remember that portion control is still important when following a vegetarian diet with diabetes. Knowing what an appropriate portion looks like on your plate helps you keep your carbohydrate and calorie intake in check, which helps with blood glucose and weight control.

You can find several pages on vegetarian meal planning in our vegetarian diets section. This includes a page full of meal ideas for different types of vegetarian diets.

Another free resource for diabetes-friendly recipes is Recipes For Healthy Living. This ADA website is updated monthly with new recipes, a meal plan, and other cooking tips and videos. Every month, our one-day meal plan includes at least one vegetarian meal and snack. In addition, we include several vegetarian recipes. You can search for vegetarian recipes from the Recipes landing page. To get our monthly e-newsletter when new recipes are available, sign up now.

Beyond all the health and safety concerns about alcohol, if you have diabetes and are on diabetes medications that lower blood glucose or insulin, you need to practice caution. The action of insulin and some diabetes pills (sulfonylureas and meglitinides (Prandin)), is to lower blood glucose by making more insulin available. So, you should not drink when your blood glucose is low or when your stomach is empty.

Alcohol can cause hypoglycemia shortly after drinking and for 24 hours after drinking. So, having a glass of red wine around dinner time is fine to do, but check your blood glucose before you drink and eat either before or while you drink.

If you choose to drink, we recommend women have no more than 1 drink per day and men have no more than 2 drinks per day. One drink is equal to 12 ounces of beer, 5 ounces of wine, or 1-1.5 ounces of hard liquor.

Red wine does not need to be counted in your meal plan as a source of carbohydrates, but you should know that alcoholic drinks provide extra calories in your diet. A glass of wine typically has about 100 calories. To avoid taking in a lot of extra calories from alcohol, it’s important to watch portion size when drinking and to follow the recommendation above.

Many people think desserts are off limits if you have diabetes. However, you don’t have to deprive yourself of your favorite sweets. We all know that candy, ice cream, cakes, cookies, and other baked products are typically dense in calories, carbohydrates, and fat. It’s important for all of us to save sweets for special occasions, and to keep portions small – especially if you have diabetes. 

It is easy to overindulge when it comes to sweets. Sometimes, “building in” the portion size can help keep you from over-eating. This may mean pre-cutting your brownies or cake into small, reasonable portions. You can also try making mini versions of your favorite desserts like mini cupcakes or mini tarts. If you are looking for recipes and tips on how to do this, you may be interested in our article Tiny (but tasty) Treats.

Always choose dessert recipes that provide nutrition information so you have the portion size, calories, and carbohydrates in a serving. This will make meal planning easier for you. The best dessert recipes will be fruit-based and/or include some whole grains. Check out the links below for some dessert recipes that meet the American Diabetes Association guidelines:

Chocolate Berry Parfait

Mini Peach Crisps

Gluten-Free Quinoa Chocolate Chip Cookies

Interested in receiving diabetes friendly recipes like the ones above on a monthly basis? Sign up for our free Recipes for Healthy Living E-newsletter and you’ll receive a new set of recipes (desserts, plus other courses!), a sample meal plan, and other meal planning tips each month.

You may also be interested in our cookbook The Big Book of Diabetic Desserts.

Completely replacing the sugar with an artificial sweetener in a dessert recipe can be tricky. When you use sugar in cookies, cakes, and other desserts, it not only provides sweetness, but it also provides structure, texture, color, and it helps to retain moisture in the product after baking. Other sweeteners (both artificial sweeteners like Splenda and those that provide calories like agave nectar) do not have all of the same properties as sugar, so the final baked product may look and taste different.

There are several different artificial sweeteners that you can buy in stores under various brand names. Often, replacing just half the sugar in a recipe with an artificial sweetener still gives an acceptable final product, while slightly lowering carbs and calories. However, aspartame is one artificial sweetener that should not be used in baking or cooking because it loses its sweetness at high temperatures.

Some brands of artificial sweeteners offer pre-packaged “baking blends”. These are usually about half-sugar and half-artificial sweetener, so they have fewer calories and carbohydrate. They usually provide substitution directions on the package. Because replacing the sugar in a recipe can be complicated, it may be easiest to find a recipe that has already done the substitution for you and provides all of the important nutrition information.

There are a lot of breakfast options that are quick, easy, and healthy. Try to incorporate a few different food groups into your breakfast meal each day. If you have diabetes, it’s important to keep your carbohydrate intake in check as well. Below are several well-balanced energizing breakfast ideas.

• 6 ounces of light, non-fat yogurt with one cup of berries (add 2 tablespoons of chopped nuts or add 2 tablespoons of granola if it fits with your plan)
• 1 piece of whole wheat toast, 1 tablespoon of unsalted peanut butter, and ½ of a grapefruit 
• Smoothie made with non-fat yogurt and berries, sweetened with artificial sweetener if desired 
• ½ cup of cottage cheese with 1 cup of fresh fruit
• Small bowl of whole grain cereal with ½ cup low-fat or fat-free milk, with a side of fresh berries or melon
• 1-2 packets of instant oatmeal (sugar-free) or plain quick oats made with hot water (stir in chopped walnuts or almonds, cinnamon, or dried fruit if desired)
• 1-2 scrambled eggs cooked in the microwave – sprinkle on some low-fat cheese, add some salsa, and wrap in a whole wheat tortilla (you can also use just egg whites or egg substitute for less fat and cholesterol)
• Heat up leftovers from last night’s healthy dinner
• 1 whole-wheat waffle with trans-free margarine sprinkled with cinnamon and sugar-free syrup, plus a side of low-sodium turkey sausage and a 4-ounce glass of 100% juice
• Breakfast sandwich made with a whole wheat English muffin, one poached egg, and one slice of reduced-fat cheese
• 1 egg white omelet made with sautéed bell peppers, onions, and mushrooms, drizzled with hot sauce.

You can also add a cup of coffee to any of the options above. Coffee (without sugar or cream) is very low calorie and does not provide carbohydrates.

Note that depending on your diabetes meal plan, the portions and options in the meals above may need to be adjusted. You can also find some additional breakfast ideas right here on diabetes.org.

Below is the subtraction rule that can be used by those with diabetes who are advanced carbohydrate counters or are on intense insulin management:

If a food has 5 or more grams of dietary fiber per serving, subtract half the grams of fiber from the total grams of carbohydrate in a serving.

Read on for an explanation of why you only subtract half of the fiber and for examples of how to use the subtraction rule.

Fiber is found naturally in all plant foods - whole grains, fruits, nuts, beans, and vegetables. Soluble and insoluble fibers are two types of fibers that can occur naturally in these foods. Sometimes, companies also add other types of fiber to foods during processing.

So, there are several different types of fiber, but not all fibers raise blood glucose to the same extent. Manufacturers are not required to list the amount of each type of fiber in the foods they produce. Usually, just the total grams of dietary fiber are given on the nutrition label.

Due to these labeling rules and the different blood glucose responses from different types of fiber, the best we can do is estimate. The rule above is used to account for the fiber that does not affect blood glucose. Here are some examples of how to use it:

• A granola bar has 6 grams of fiber and 20 grams of total carbohydrate per serving. Half of 6 is 3, so (20 total grams of carbohydrate) - (3 grams of fiber) = 17 grams of carbohydrate
• A bowl of cereal has 3 grams of fiber per serving and 25 grams of total carbohydrate per serving. In this case, you would not subtract anything. You would count the full 25 grams in your meal plan because there are less than 5 grams of fiber per serving.

Actually, honey and regular sugar have about the same amount of calories and carbohdyrates per serving, so they will cause a similar rise in blood glucose when you have diabetes. Other caloric sweeteners like brown sugar, powdered sugar, and maple syrup are in the same boat. You don’t need to avoid these sweeteners completly, but we recommend that people with diabetes use them sparingly and in small portions. Below you will find a comparison of the various sweeteners:

1 tablespoon honey = about 64 calories, 17 grams of carbohydrate

1 tablespoon packed brown sugar = about 52 calories, 13 grams of carbohydrate

1 tablespoon white or granulated sugar = about 49 calories, 13 grams of carbohydrate

1 tablespoon maple syrup = about 52 calories, 13 grams of carbohydrate 

1 packet of artificial sweetener = about 4 calories,

One difference between sugar and honey is that honey has a slightly lower glycemic index. Glycemic index is a tool that can be used in diabetes meal planning. Having a lower glycemic index means that regular sugar will raise blood glucose a little faster than an equal amount of honey. However, the rate at which these sweeteners increase blood glucose can change depending on what foods they are eaten with and several other factors.

You probably noticed that a packet of artificial sweetener has significantly less carbohydrates and calories than the others. When meal planning, it may be easier to control blood glucose if you use artificial sweeteners to sweeten foods and drinks. There are several different artificial sweeteners that you can buy in stores: stevia, aspartame, acesulfame-K, saccharin, or sucralose. Artificial sweeteners are very low-calorie and have fewer carbs than honey or sugar. Learn more about artificial sweeteners right here on diabetes.org.

Maltitol is a type of sugar alcohol. Sugar alcohols are reduced-calorie sweeteners, commonly used to sweeten sugar-free foods. Products that contain sugar alcohols are an option for people with diabetes. These foods may be lower in calories than the original version, and  often have less carbohydrate which can be helpful for managing blood glucose levels.

There are several sugar alcohols, in addition to maltitol, that you might see on the ingredient list of food labels:

• erythritol
• hydrogenated starch hydrolysates
• isomalt
• lactitol
• mannitol
• sorbitol
• xylitol

On average, sugar alcohols contain about half the calories of regular sugar. They also have less of an effect on blood glucose than other carbohydrates. However, the effect can vary so it is difficult to know how sugar alcohols will affect blood glucose levels every time. Some people can use the following tip to estimate how much carbohydrate to count in their meal plan when a food that has MORE than 5 grams of sugar alcohols per serving.

If a food has more than 5 grams of sugar alcohols:

1. Subtract ½ the grams of sugar alcohol from the amount of total carbohydrate.
2. Count the remaining grams of carbohydrate in your meal plan.

For Example:

Let’s say you eat 1 serving of angel food cake and each serving has 25 grams of total carbohydrate but 12 grams are sugar alcohols. One serving of angel food cake should be counted as 19 grams carbohydrate in your meal plan (25 – 6 = 19).

Note: This tip is useful for those who are intensively managing their diabetes with insulin or advanced carbohydrate counting.

Low-sugar versions of baked goods can be a good option to satisfy your sweet tooth. However, be aware that sugar alcohols can have a laxative effect or may cause other gastric symptoms in some people, especially in children.

If you are sensitive to sugar alcohols, you can still fit in a small serving of regular sweets on occasion. In fact, some people prefer to use the regular version of a food and cut back on the serving size instead of buying the sugar-free version.

This is a very common question among people with diabetes. The truth is, there is not a standard amount of carbohydrates that will work for everyone. If you have diabetes, we recommend following an individualized meal plan that works for you and helps you meet your diabetes goals. Your healthcare provider can help you set these goals, which might include losing weight, improving your A1C, lowering your blood pressure and/or lowering cholesterol levels.

If you have type 2 diabetes and haven’t set up an individualized meal plan yet, 45-60 grams of carbohydrate per meal is a place to start. However, some people may need more and some people may need less.

Find a time to work with your healthcare provider to set up a meal plan that takes your preferences into account and can help you achieve your diabetes goals. Ask about how many carbohydrates to include at each meal and whether or not to include snacks. Your provider may suggest using the diabetes plate method to start or they may have you try carbohydrate counting. It may also be helpful to work with a registered dietitian (RD) when learning to plan meals.

We recommend choosing whole grains over refined grains whenever possible. Unfortunately, most quick-cooking and commercially processed grits are not a good source of whole grains. The porridge-consistency grits you typically see on breakfast menus and in southern cooking are made from dried kernels of corn that have been chopped into bits. Often, the hull and germ of the kernels are removed when it is dried and ground into grit form.

They may be difficult to find, but there are some whole grain grits available now. If you cannot find whole grain grits in the store, there is always the option of ordering them online. Always check the packaging and nutrition facts to make sure your grits are made from a whole grain rather than refined grains.

Another issue with grits is that they are usually mixed with high-fat ingredients like cheese or butter to add extra flavor. Butter and cheese are both high in saturated fat and calories. Try using smaller amounts of trans-free margarine or reduced-fat cheese in their place when you choose to eat grits.

There are also a lot of other whole grain options out there, so don't be afraid to mix it up once in a while. All types of oatmeal – whether it’s steel cut oats, old fashioned, or quick-cooking oats are considered whole grain. 100% whole wheat bread or toast is also a great option, as is quinoa, brown rice, whole grain barley, popcorn, etc.

The American Diabetes Association does not have a specific recommendation when it comes to this product. Dreamfields uses a manufacturing process that is supposed to “protect” some of the carbohydrates in their pasta from being broken down and entering the blood stream. In theory, Dreamfields pasta should not raise blood glucose as much as traditional pasta, and it would also have a lower glycemic index. 

However, this product has not been tested in people with diabetes. If you choose to buy it, you should test it yourself, as individual responses can vary. If you count carbs, Dreamfields recommends that you start by counting 5 grams of carbohydrate for every 2 ounces of dry pasta (this should be about 1 cup of cooked pasta). You should monitor your blood glucose levels after and adjust carb counts (and insulin boluses if on insulin) as needed. Some individuals need to count a serving of Dreamfields pasta as 10-20 carbohydrate grams depending on their glycemic response. In other people, there may be no difference between Dreamfields and regular pasta.

Another issue to think about is cost. Usually, regular whole wheat pasta is a relatively low-cost food. Dreamfields Pasta will be more expensive because it is a specialty product. If you can afford it and you find that your body handles it better than regular pasta, it may be worth budgeting for. 

If not, whole wheat pasta is still a good choice for people with diabetes. Still, portion control is very important since whole wheat pasta is a carbohydrate food. Usually, 1/3 cup of cooked pasta has about 15 grams of carbohydrate. Always check the Nutrition Facts Label on different pasta products for a more exact serving size and the total carbohydrate count. If a 1/3 cup portion seems small when you measure it out, add bulk to your dish by mixing in some cooked non-starchy vegetables (bell peppers, onions, mushrooms, broccoli, or tomatoes) and lean meat (like chicken breast, lean ground beef, or soy-based crumbles).

*Note that sauces will also add carbohydrates, and sometimes fat, to your dish. Check the nutrition facts on the sauce you use to see how it will fit with your plan. We recommend avoiding cream-based sauces.