Every new year, the top resolution is to lose weight. As a diabetic, you may want a diet to not only lose weight but manage your diabetes, which includes stabilizing blood sugar levels and reducing cardiovascular disease. I review six types of diets and list the pros and cons of each one and why they may be good for diabetics.  

Mediterranean

The Mediterranean diet is based on the meals of people living near the Mediterranean Sea, including Greece, France, Spain, and Italy. It centers on fruits, vegetables, and whole grains. It also focuses on healthy fats such as olive oil, nuts, and fish. They limit red and processed meat and eat fruit more than sweets.  

• Why it may be good for diabetics: may reduce heart disease, which is a high risk for diabetics

• Pros: focuses on healthy fats and may reduce the risk of heart disease, inflammation, and cancer

• Cons: there are no dietary guidelines; not designed for weight loss; and some dietary restrictions may be challenging, especially with reducing red meat and sugar

Dash

The Dash diet (Dietary Approaches to Stop Hypertension) lowers high blood pressure. It focuses on fruits, vegetables, lean proteins, and whole grains and reduces high-sodium foods. Sweets, added sugars, and saturated fats are limited.

• Why it may be good for diabetics: Diabetics are at high risk for high blood pressure and heart disease

• Pros: recommended by the National Heart, Lung, and Blood Institute (NHLBI), American Heart Association, and the National Institutes of Health 

• Cons: Not designed for weight loss and some may find reducing sodium intake hard to maintain

Intermittent Fasting

Intermittent fasting means switching between fasting and eating on a regular schedule. There are three categories:

1. Time-restricted eating: limiting your daily food intake to a shorter period, for example, 10 AM to 5 PM
2. Alternate-day fasting: fasting every other day
3. Modified alternate-day fasting: very low-calorie consumption (500-700 calories) on fasting days

• Why it may be good for diabetics: may promote weight loss, lower insulin requirements, and improve insulin sensitivity

• Pros: does not restrict foods and may boost longevity

• Cons: going long without eating can cause low blood sugar; you may feel excessive hunger, low energy, and sleep disturbances

Vegetarian/Vegan

A vegetarian diet eliminates meat, poultry, and fish. Instead, it focuses on fruits, vegetables, whole grains, legumes, nuts, and seeds. If you’re vegan, you also don’t eat animal products like dairy and eggs.

• Why it may be good for diabetics: may help manage blood sugar, lower cholesterol, lower blood pressure, and improve insulin sensitivity

• Pros: may aid in weight management; reduces food costs; is high in fiber; and is low in saturated fats

• Cons: increased nutrient deficiency risks such as low iron, calcium, zinc, omega-3 acids, and protein

Low-Carb

I focus on two of the most popular low-carb diets, paleo and keto, which eliminate grains. The difference is that keto is more restrictive in that you can only eat around 20 – 50 grams of carbs a day. You can also eat dairy, but not fruit. Paleo is a little more flexible because you can eat more carbs (100-150 grams for weight loss), and fruits like berries, but not dairy.

• Why it may be good for diabetics: promotes weight loss and manages blood sugar levels. Paleo eliminates gluten and dairy, which many type 1 diabetics are allergic/sensitive to

• Pros: boosts satiety and focuses on whole, unprocessed foods

Even though low-carb diets are excellent for weight loss and stabilizing blood sugar levels, there are many cons, especially with keto.

Cons for paleo and keto:

• Risk for low blood sugar
• Very restrictive and can be difficult to sustain
• Many people increase egg, cheese, and meat consumption instead of focusing on healthier fats like fish, avocado, and nuts

Keto Cons

• Keto is low in fiber and can cause constipation
• May cause the “keto flu” which is withdrawal symptoms from carbs. Symptoms include headache, low energy, and cravings
• Diabetics with kidney disease need to limit protein, so a high-fat/protein diet may not be right for them
• Risk for Diabetic Ketoacidosis (DKA) occurs when the body doesn’t produce or have enough insulin and breaks down fat as fuel. This makes the blood acidic, which can lead to DKA and be deadly if not treated. You can test ketones using test strips available at most pharmacies

Diabetes Plate Method

The Diabetes Plate Method promotes portion control and balanced meals. You fill a 9-inch plate with 1/2 nonstarchy vegetables, 1/4 carbs, and 1/4 protein. Drink water or a non-calorie beverage.

• Why it may be good for diabetics: created for diabetics

• Pros: reduces guesswork and is easy to use

• Cons: does not consider that there are days you may need extra carbs such as for exercise; there is no guidance on salt and sugar intake; and may be difficult for vegetarians

A Diabetic Dietician Can Help

Consider discussing your options with a diabetic dietician to determine which diet would work best for you. Also, try different diets. Be a diabetic detective and see how you feel. Is your blood sugar better? Is your blood pressure stable? Have you lost weight? In contrast, you might find you can’t follow a particular diet. I like meat, so I can’t be a vegetarian. On the other hand, Paleo is best for me because it eliminates two foods I am allergic to, gluten and dairy. It also makes weight loss easier for me. However, a tremendous disadvantage is that sometimes it’s not sustainable. It’s hard to give up grains and high-carb foods that are healthy, like sweet potato and mango. I fall off the wagon more times than I’d like to admit.

Conclusion

Which is the best diet for diabetics? No doubt, the one you can stick to. Analyze which will help you maintain a healthy blood sugar range and weight. You should also examine if it is heart-healthy and helps with blood pressure. Consider each and discuss with a diabetic dietician.

Quote

“Both children and adults like me who live with type 1 diabetes need to be mathematicians, physicians, personal trainers, and dietitians all rolled into one.” – Mary Tyler Moore