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A comprehensive guide to the best type 2 diabetes diets for 2022

How you eat can have a huge influence on your blood sugar levels and therefore, your type 2 diabetes. While there isn’t a single type 2 diabetes diet plan that suits everyone, there are different approaches worth considering depending on your budget, lifestyle, and health goals.
Annabel Nicholson
4/1/2022
20
min read
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Quick summary

  • No two people will have the same reaction to a certain food, which is why there isn’t a fixed type 2 diabetes diet.
  • Everyone eats and reacts to food differently, so it's important to find the approach that suits you—arm yourself with the knowledge to make your personal type 2 diabetes diet plan.
  • The diets listed in this article are just a starting point—how you ultimately decide to eat is up to you and what works for your body.
  • When thinking about the best type 2 diabetes for you, it might be helpful to also consider your budget, lifestyle, and health goals as these will influence how easily you’re able to sustain a new way of eating.

Before we get started we want to be clear about something: there isn’t a single best diet for type 2 diabetes because everyone is unique. And everyone eats differently, reacts differently, and ultimately lives differently. But, here at Habitual we believe in science and even more importantly, we believe that you, the person living with type 2 diabetes, should have access to that science and understand how to harness it for the best possible outcome. 

There’s been a real uptick in scientific research exploring how diet can be used to manage type 2 diabetes. In part, this is thanks to the world-changing DiRECT trial but it also comes at a time of general renewed interest in the food we eat, where it comes from, and how it makes us feel.

You might find it takes a few different attempts to find the way of eating that suits you. We’ve listed eating styles in this article that have substantial evidence behind them—you may choose to try one or all of them, or perhaps you find a completely different way of eating. Nutrition is so important but it’s also very personal and one of the hardest things to get to the bottom of. We hope that the information here will help you on your way to creating your own personal type 2 diabetes diet. 

A word on the science

Type 2 diabetes management and, in particular, remission, via diet is a fairly new discovery. Research is continuing at a rapid pace as we continue to understand how diet alone can have this incredible impact on the condition, but most of the reputable studies don’t go further than a year or two, so do keep that in mind. Nutritional research is hard to conduct because there are so many factors out of the researcher’s control (our body’s have a mind of their own). Ultimately though, the world is waking up to the benefits of managing conditions such as type 2 diabetes through diet and this is only going to continue expanding. It’s only in recent years that type 2 diabetes was even discovered to be reversible and already, people with type 2 diabetes are making this their reality. As more research is carried out, the more we’re going to understand how to help millions of people beat type 2 diabetes 💪

Also, don’t forget that, just because a paper reports high levels of weight loss, remission, or any other outcome, that doesn’t mean that the approach used there will absolutely work for you. The best diet is the one that fits into your lifestyle—and that includes your dietary preferences, budget, whether you’re cooking for your family, and so much more. So don’t feel you have to take the results of a single study at face value.

The best diets to help manage type 2 diabetes

Low-carb diet

Carbohydrates have a tougher time than they deserve in the world of weight management, but if you have type 2 diabetes, it pays to understand the impact of carbs on your blood sugar levels. We already have a couple of articles exploring the role of carbohydrates so do check them out:

Scientific studies suggest that a low-carb diet might:

  • Help manage diabetes by keeping blood sugar levels stable (and therefore also reducing cravings) and reducing the body’s need for insulin.[1-3]
  • Support entry into type 2 diabetes remission—one study reported 25% of participants entering remission following a low-carb diet.[1]
  • Lead to weight loss, an important tool in the management of type 2 diabetes.[1,3]
  • Lower the risk of cardiovascular disease, which people with type 2 diabetes are at risk of developing.[3]

Diet composition

The definition of a low-carb diet varies but, in general, a low-carb way of eating aims to reduce daily carbohydrate consumption to 130g.[4] For context, a medium-sized slice of white bread contains 15-20g carbohydrate and a large jacket potato could on average contain 46g.[5]

46.4% of participants lost at least 5% of their body weight while following a low-carb diet

Saslow et al., JMIR Diabetes

Considerations

There’s a huge amount of variation in how people respond to different diets and the low-carb diet is no different. Research has shown that a low-carb diet can help some patients reach remission, but not everyone.[1,3] That being said, following a low-carb diet can help you on your weight loss journey without being too restrictive, which is a positive if you’re wary of making drastic dietary changes. It's important to note as well that reducing the number of carbs you generally consume will help keep your blood sugar steadier—fewer carbs means less glucose hitting your bloodstream, helping blood sugar levels remain stable and reducing the body’s need for insulin. If you’re looking to ultimately gain control of your blood sugar levels and reduce, or even stop, your medication, a low-carb diet is an easier and feasible entry-point into managing type 2 diabetes with diet. 

Keto diet

Fat is making a come-back as the tide turns on low-fat dietary advice. As researchers debate the idea that natural fats are actually not to be feared, the keto diet is another option for people with type 2 diabetes looking to gain control over their blood sugar.

Scientific studies suggest a keto diet might:

  • Support weight loss–one study reported a 12% reduction in body weight in 6 months.[6]
  • Help reduce, or stop, the requirement for medication to manage type 2 diabetes.[7]
  • Lead to greater rates of remission than if following a low-fat diet.[8]
  • Help with appetite control and improved renal function.[9,10]
  • Lower the risk of cardiovascular disease, which people with type 2 diabetes are at risk of developing.[3]

Diet composition

The keto diet is one that puts fat at centre-stage with carbohydrates making up just 10% of daily calories, protein makes up 20%, meaning the remaining 70% is all about fat. Eating a high-fat diet switches the body’s metabolism into a “fat-burning state” known as ketosis (not to be confused with diabetic ketoacidosis!). When in ketosis, the body uses fat to fuel the body rather than glucose (from carbohydrates).

Considerations

While there is good scientific evidence supporting the keto diet as a potential dietary tool for managing type 2 diabetes, it can be a difficult eating pattern to follow and care is required to follow it closely to keep the body in ketosis. There are also arguments against its sustainability as a long-term eating approach, and if you do transition back into a non-keto way of eating, it's important to reintroduce carbs carefully, so as to avoid blood sugar spikes and weight gain. That being said, the high fat content of the diet can make it appealing for people put off by the ‘restrictive’ nature of eating for weight loss (we’re looking at you, cheese). While low-carb diets are often linked to type 2 diabetes management, the keto diet is actually still quite a novel approach. Evidence supporting the keto diet in the short-term (6-12 months) is moving in the right direction but more research is needed to explore the long-term impact of a high-fat diet on general health and wellbeing.

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Veganism

By 2023, it's estimated that 16 million people in the UK will be vegan or vegetarian.[9] Vegan (or plant-based) diets are by their very nature good for us. Rich in dietary fibre, antioxidants, and micronutrients, and low in saturated fat, the list of the beneficial effects plant-based eating has on general health and wellbeing is ever-growing.

Scientific evidence suggests a vegan diet might:

  • Encourage weight loss as they tend to be lower in calories than animal-sourced foods.[12,13]
  • Reduce blood sugar levels as a result of a limited intake of animal products and refined foods, replacing them with vegetables, fruits, wholegrains, and nuts.[13,14]
  • Lower the risk of cardiovascular disease, which people with type 2 diabetes are at risk of developing.[15] 

Diet composition

A vegan diet is one that excludes animal food products. Think cheese, milk, yoghurt, meat, fish, eggs, poultry, and so on.

Considerations

There’s no doubt that turning vegan can be incredibly beneficial for health—but while it is becoming easier to follow a vegan diet, it can still be tough to maintain when you’re eating out or travelling. In some cases, you may have to opt for the less healthy option just because it's the only vegan option. The picture painted around veganism is one of health but a lot of vegan foods do contain high levels of added sugars and are highly processed. To be sure of what you’re eating, consider buying foods that are naturally vegan rather than processed to be vegan. You may also need to consider extra supplements (or making sure you eat a wide variety of plants) if following a vegan diet as it can be easy to miss out on essential nutrients such as vitamin B12, calcium, and iron. 

Total diet replacement (TDR)

In a paper published at the end of 2021, researchers hailed low-calorie meal replacement diets, such as TDR, as the most effective method for weight loss and type 2 diabetes remission.[16] It's important to note that the researchers behind this paper were not investigating diet and blood sugar control. Instead, they wanted to find out which diet aided the greatest amount of weight loss because, as we know, weight loss and type 2 diabetes remission are very closely related. TDR is the dietary method used in the leading DiRECT research trial, which showed the world that up to 60% of type 2 diabetes is reversible.[17]

Scientific evidence suggests total diet replacement might:

  • Be the best dietary approach to achieve type 2 diabetes remission—it’s been shown to be effective for 46-61% of people recently diagnosed. [17,18]
  • Lead to the greatest amount of weight loss with people losing 6.6kg more on average compared to low-calorie food-based diets.[16] 
  • Quickly get blood sugar levels under control.
  • Reduce or remove the need for medication to manage blood sugar levels.

Diet composition

TDR is a low-calorie diet that replaces the day's food with nutritionally-complete powdered meals. Each TDR meal is just 200 calories while containing all the vitamins, minerals, and nutrients the body needs. Calories total 800-1200 each day, with around four TDR meals being consumed. These meals come in the form of shakes, soups, and porridges. It’s important to only use meals labelled as ‘total diet replacement’ rather than ‘meal replacements’ as these don’t contain all the nutrients needed to keep the body healthy for the entire 3 month duration. TDR diets are normally followed for about 3 months before food is gradually reintroduced, so unlike the other diets on this list, TDR is more of a tool to achieve better blood sugar control, weight loss, and potentially remission… but you will need to adopt a healthy long-term way of eating after completing TDR.

Low-calorie, total diet replacements help 46-61% of people recently diagnosed with type 2 diabetes reach remission

Churuangsuk et al., Diabetologia

Considerations

At first glance, TDR might seem like a daunting, or even extreme, decision but there’s no doubt that it's a powerful weight loss method and behaviour change tool. As with every way of eating, it's not for everyone, but TDR is clinically proven to be the safest and most effective method for people needing to lose 10-15kg.[19] It’s important to bear in mind that TDR shouldn’t be treated as a quick fix, however. Yes, it’s an effective way to lose weight but maintaining that weight loss in the long-term requires commitment to behaviour change. It’s not easy and requires a lot of dedication and motivation but the fact is, it works. 

Alternative ways to manage type 2 diabetes with diet

Flexible eating

Not a diet as such but a strategy to help you find a sustainable way of eating that can be adjusted as necessary. Including short bursts of low-carb/keto/veganism alongside ongoing exercise could help maintain weight loss, blood sugar control, and motivation while off-setting difficulties such as a lack of diversity in what you can eat, cost, preparation time, and so on. It’s also possible to use TDR meals sporadically as nutritionally-complete meal replacements alongside plates of food. For example, you could have two TDR meals a day and prepare a healthy plate of food for your evening meal, or you could have a TDR soup at lunchtime.

Fasting and time-restricted eating

Two popular ways to manage weight loss without being too restrictive in what you’re eating. Reducing the number of hours in a day that you eat (and fasting for the rest) can effectively support weight loss, with one study reporting a weight loss of up to 13% of baseline weight.[20] Rather than eat your meals and snacks within a 16 hour window (7am-11pm), you could restrict your eating period to 8 hours (1-9pm). Alternatively, periods of fasting, like the 5:2 diet, have been shown to achieve similar weight losses as continuously restricting calorie intake.[21,22] The 5:2 diet involves reducing food intake to 500-700 calories for 2 days each week. Further research is needed to determine whether intermittent fasting can be effective for type 2 diabetes remission but it could be a good starting point if you’re looking to regain control of your weight.

Things to consider when choosing a type 2 diabetes diet

Finding the way of eating that suits you and your type 2 diabetes will require some thought and it may even take you a few goes to find the right way for you. As you look at the different options, you might find it helpful to consider your personal circumstances as they will help determine which method is best for you.

Budget 💰

Whether you want to stick to your current budget, save money on your food spend, or can afford to spend a little extra to get started, it’s important to know what your financial limits are. To get the most out of a new way of eating, you need to follow it as closely as possible. Some methods might call for slightly more expensive or luxurious ingredients, so you need to make sure you have the financial capacity for that. A good place to start is to work out how much you spend (roughly) on food each week/month.

Lifestyle 😎

Think about your day-to-day life, such as your work schedule, hobbies, family, free time—all of these will influence how you cook and eat. If you're non-stop all day, you might want to find a way to eat healthily that doesn't take up loads of time. Or perhaps you have the time to prepare a freshly cooked meal at the end of each day. Will it be hard to cook a separate meal for your family or could they join you a few nights a week? Think about what’s important to you, how much time you honestly have, and what you’re willing to do to achieve your health goals.

Goals 🏆

Talking of goals… if you have type 2 diabetes, you might have any one of a number of goals. Perhaps you want to lose weight, come off your medication, or want to reverse your condition. Maybe you want to reduce the daily symptoms of type 2 diabetes or just feel better, more like yourself, or in control. Do you want to reach your goal as quickly as possible? Are you happy to work towards it gradually? Some ways of eating, such as low-carb, might help you gain some control over your blood sugar levels while total diet replacement will lead to rapid weight loss. There are a lot of factors affecting what your health goal might be and how you get there, and the food you eat will be a big driver in finding success.

So, there we go—our pick of the best ways to manage type 2 diabetes through diet. Take your time, enjoy the process of trying new things, and please do consult your doctor before beginning a new diet or eating plan.

References

[1] Saslow, L.R., Summers, C., Aikens, J. E., Unwin, D. J. (2018). Outcomes of a digitally delivered low-carbohydrate type 2 diabetes self-management program: 1-year results of a single-arm longitudinal study. JMIR Diabetes 3(3):e12. Accessible here.

[2] Page, K.A., Seo, D., Belfort-DeAguiar, R., et al. (2011). Circulating glucose levels modulate neural control of desire for high-calorie foods in humans. J Clin Investig 121(10):4161-9. Accessible here.

[3] Taylor, R., Ramachandran, A., Yancy Jr, W.S., Forouhi, N.G. (2021). Nutritional basis of type 2 diabetes remission. BMJ 374:n1448. Accessible here.

[4] Low-carb diet and meal guide. Diabetes UK. Retrieved 21 July 2021. Accessible here.

[5] Carbohydrate reference list. Diabetes UK. Retrieved 21 July. Available here

[6] Hallberg, S.J., McKenzie, A.L., Williams, P.T., et al. (2018) Effectiveness and safety of a novel care model for the management of type 2 diabetes at 1 year: an open-label, non-randomized, controlled study. Diabetes Ther 9:583-612. Accessible here.

[7] Athinarayanan, S.J., Adams, R.N., Hallberg, S.J., et al. (2019) Long-term effects of a novel continuous remote care intervention including nutritional ketosis for the management of type 2 diabetes: a 2-year non-randomized clinical trial. Front. Endocrinol. 10:348. Accessible here.

[8] Goldenberg, J. Z, Day, A., Brinkworth, G. D. et al. (2021). Efficacy and safety of low and very low carbohydrate diets for type 2 diabetes remission: systematic review and meta-analysis of published and unpublished randomized trial data. BMJ 372:m4743. Accessible here.

[9] Gibson, A.A., Seimon, R.V., Lee, C.M.Y., et al. (2014) Do ketogenic diets really suppress appetite? A systematic review and meta-analysis. Obes Rev 16(1): 64-76. Accessible here.

[10] Unwin, D., Unwin, J., Crocombe, D., et al. (2021) Renal function in patients following a low carbohydrate diet for type 2 diabetes. Curr Opin Endocrinol Diabetes Obes 28(5): 469-479. Accessible here.

[11] UK Diet Trends 2021. Finder. Retrieved 5 May, 2021. Accessible here.

[12] Mishra S., Xu J., Agarwal U., Gonzales J., Levin S., Barnard N.D. (2013). A multicenter randomized controlled trial of a plant-based nutrition program to reduce body weight and cardiovascular risk in the corporate setting: the GEICO study. Eur J Clin Nutr 67(7):718-24. Accessible here.

[13] Barnard, N.D., Cohen, J., Jenkins, D.J.A., et al. (2006). A Low-Fat Vegan Diet Improves Glycemic Control and Cardiovascular Risk Factors in a Randomized Clinical Trial in Individuals With Type 2 Diabetes. Diabetes Care 29(8):1777–1783. Accessible here.

[14] Tackle diabetes with a plant-based diet. Physicians Committee for Responsible Medicine. Retrieved 5 May, 2021. Available here.

[15] Vegan diet could control blood sugar for people with type 2 diabetes. University of Leicester. Retrieved 5 May, 2021. Accessible here.

[16] Churuangsuk, C., Hall, J., Reynolds, A., et al. (2021). Diets for weight management in adults with type 2 diabetes: an umbrella review of published meta-analyses and systematic review of trials of diets for diabetes remission. Diabetologia 65:14-36. Accessible here.

[17] Lean, M.E.J., Leslie, W.S., Barnes, A.C., et al. (2018). Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial. Lancet 391(10120):541-551. Accessible here.

[18] Taheri, S., Zaghloul, H., Chagoury, O., et al. (2020) Effect of intensive lifestyle intervention on bodyweight and glycaemia in early type 2 diabetes (DIADEM-I): an open-label, parallel-group randomised controlled trial. Lancet 8(6):477-489. Accessible here.

[19] Astbury, N.M., Aveyard, P., Nickless, A., et al. (2018). Doctor referral of overweight people to low energy total diet replacement treatment (DROPLET): pragmatic randomised controlled trial. BMJ 362:K3760. Accessible here

[20] Welton, S., Minty, R., O’Driscoll, T., et al. (2020). Intermittent fasting and weight loss: Systematic review. Can Fam Physician 66:117-25. Accessible here.

[21] Davis, C.S., Clarke, R.E., Coulter, S.N., et al. (2016). Intermittent energy restriction and weight loss: a systematic review. Eur J Clin Nutr 70:292-9. Accessible here.

[22] Rynders, C.A., Thomas, E.A., Zaman, A., Pan, Z., Catenacci, V.A., Melanson, E.L. (2019). Effectiveness of intermittent fasting and time-restricted feeding compared to continuous energy restriction for weight loss. Nutrients 11:2442-64. Accessible here.

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