Diet

Diabetes treatment essentially involves diet, physical activity and medication. Diet plays a very important role in diabetes management and theories surrounding the diet for people with diabetes have changed immensely over the years. People with diabetes can follow the same healthy eating pattern as somebody without the condition. This means:

  • Eating regular meals based on starchy carbohydrate foods. This helps to keep blood glucose levels stable.
  • Cutting down on the amount of fat that is consumed. This means reducing the intake of saturated fat and choosing monounsaturated fats. Also grilling, steaming or oven baking food instead of frying with oil and other fats.
  • Eating more fruit and vegetables. Consuming at least five portions of fruit and vegetables per day.
  • Limiting sugar and sugary foods. Sugar can be used in cooking and people with diabetes do not have to follow a sugar-free diet - however this should be as part of a healthy diet. It is advisable to use sugar-free, low sugar or diet drinks in preference to drinks with sugar as these can lead to blood glucose levels rising rapidly.
  • Using less salt. Eating too much salt can lead to high blood pressure. Herbs and spices should be suggested as alternatives.
  • Drinking alcohol in moderation. Two units of alcohol per day for women and three units for men. Alcohol on an empty stomach can lead to hypoglycaemia so should be avoided.
  • Not eating diabetic foods or drinks - these are of no more benefit to people with diabetes than normal foods. They tend to be expensive, can be high in fat and are unnecessary.

Resources

You will find here links to evidence-based resources which support this topic. You may also want to refer to information about the national service frameworks and strategies across the UK.

Some of the resources on this page are in PDF format - see how to access PDF files.

Guidelines and guidance

Department of Health (2006) Obesity care pathway and your weight, your health
This aims to be a comprehensive package of materials for health professionals as well as information to be given to patients. It includes the obesity care pathways for adults and children and tools which can help GPs raise sensitive issues of weight opportunistically.

Diabetes UK (2007) Position statement: 'Diabetic foods' and food labelling
A joint statement on 'diabetic foods' from the Food Standards Agency and Diabetes UK. This joint position statement calls for an end to the use of terms such as 'diabetic' or 'suitable for diabetics' on food labels because this may lead to misunderstandings regarding healthy eating.

ISPAD (International Society for Pediatric and Adolescent Diabetes): Clinical practice consensus guidelines 2009: Nutritional management in children and adolescents with diabetes
Chapter nine of the ISPAD guidelines is about nutritional management which the guideline describes as 'one of the cornerstones of diabetes care and education.' The chapter provides detailed guidance for children and young people.

NICE clinical guidelines (2006) Obesity:the prevention, identification, assessment and management of overweight and obesity in adults and children
This guideline (CG43) covers assessment of and care and support for people who need to lose weight as well as guidance for a range of professionals on support for improvement of diet and increase in physical activity. There are accompanying quick reference guides and information for the public, patients and carers.

The different UK countries have brought together  strategies, action plans and resources at:

Systematic reviews and evidence summaries

For more information about Cochrane Systematic Reviews, examples of which appear below, visit the page within this resource on the Cochrane Library.

Cochrane Review: Omega-3 polyunsaturated fatty acids (PUFA) for type 2 diabetes mellitus
This review aimed to determine the effects of omega-3 PUFA supplementation on cardiovascular outcomes, cholesterol levels and glycemic control in people with type 2 diabetes mellitus.

Cochrane Review: Dietary advice for treatment of type 2 diabetes mellitus in adults
This review aimed to assess the effects of type and frequency of different types of dietary advice for adults with Type 2 diabetes.

Cochrane Review: Long-term non-pharmacologic weight loss interventions for adults with type 2 diabetes
This review aimed to assess the effectiveness of lifestyle and behavioral weight loss and weight control interventions for adults with Type 2 diabetes.

Cochrane Review: Long-term non-pharmacological weight loss interventions for adults with prediabetes
This review aimed to assess the effectiveness of dietary, physical activity, and behavioral weight loss, and weight control interventions for adults with prediabetes.

Cochrane Review: Low glycaemic index, or low glycaemic load, diets for diabetes mellitus
There is controversy about how useful the glycaemic index (GI) is in diabetic meal planning. This review sought to assess effects of low glycaemic index, or low glycaemic load, diets on glycaemic control in people with diabetes.

Other resources

Diabetes UK: Food and diabetes
A range of advice and position statements on aspects of food and nutrition.

Diabetes UK (2005) Diabetes and obesity: a heavy burden
The report looks at the relationship between diabetes and obesity in detail, the extent of the problem and projections for the future.

National Library of Medicine MEDLINEplus: Diabetes: meal planning
This interactive multimedia  tutorial has been published by the Patient Education Institute in the USA. Apart from the text version it requires flash player to view and this can be downloaded from the tutorial.

Northern Ireland Audit Office (2008) Obesity and Type 2 diabetes in Northern Ireland
A quarter of all men and 23 per cent of women in Northern Ireland are considered to be obese, and around five per cent of the population over 20 years of age have type 2 diabetes. The report calls on the Department of Health, Social Services and Public Safety to expand its targets in relation to obesity management to focus on gender differences, children and socio-economic groupings and ensure appropriate surveillance of obesity risk factors.

There are separate resources lists for other specific aspects of treatment and lifestyle - see Treatment and lifestyle topics.