Diabetes is a condition that affects the levels of glucose (sugar) in your blood. It happens when the body is either unable to produce insulin, a hormone that regulates blood sugar levels, or when insulin isn’t working properly.
There are two main types of this condition, type 1 diabetes and type 2 diabetes. Type 2 is more common than type 1 and in the UK around 90% of all adults with diabetes have type 2. It is estimated that there are 3.9 million people with diabetes in the UK.
A greater number of people will have blood sugar levels above the normal range, but they will not be high enough to receive a diagnosis of diabetes. Sometimes this is referred to as prediabetes. If your levels are above the normal range, you will be more at risk of developing the full-blown condition.
On this page we will look into type1 and type 2 diabetes and explore in more depth what role nutrition and diet has in managing the condition. We will also explore how support from a suitably qualified nutrition professional can help you regulate blood sugar levels and minimise symptoms.
On this page
The body uses glucose as fuel, so it’s important that we obtain glucose from our diet and that it can be used by the body’s cells. If you have diabetes, this glucose is unable to enter the body’s cells, raising blood sugar levels. This happens for one of two reasons:
- The body can’t produce insulin, the hormone necessary to unlock cells and regulate blood sugar levels (type 1 diabetes).
- The body can’t provide enough insulin, or the insulin is not working as it should (type 2 diabetes).
Sugar molecules are relatively big so if there are too many in the blood stream, the narrow blood vessels in our nerves, eyes and kidneys can become damaged. This can lead to conditions such as kidney disease or blindness.
Type 1 diabetes
Also known as insulin-dependent diabetes, type 1 diabetes occurs when the body’s immune system attacks the cells that produce insulin so they no longer work. Without this insulin, blood sugar levels increase which can cause harm to the body’s organs.
This type usually develops before the age of 40 and will require regular insulin injections. If you have been diagnosed with type 1 diabetes you will need to learn how to inject yourself with insulin and how to monitor your blood sugar levels. You will also need to pay close attention to your diet and activity levels. What you eat has a direct effect on your blood sugar levels, so eating a balanced diabetic diet is key.
The most common symptoms of type 1 diabetes are:
- excessive thirst
- more frequent urination
- frequent episodes of thrush
- blurred vision
- slowly healing cuts/wounds.
If you are concerned about any symptoms, you are advised to see your GP who will be able to carry out diagnostic tests. Type 1 diabetes can develop very suddenly, over weeks or even days.
If you are diagnosed with type 1 diabetes, your doctor will explain your treatment and refer you to a specialist diabetes care team. This type requires insulin treatment, either in the form of injections or a pump. If you have injections, you will need to inject yourself (or have a friend/family member inject you) throughout the day. The amount/frequency will depend on your blood sugar levels. You will be able to monitor these levels yourself, using a finger prick blood test. Your care team will give you more information about doing this.
Insulin pump therapy is an alternative to injections and involves having a small device attached to you by a piece of tubing. The tubing has a small needle at the end and is inserted under the skin. This pump provides a constant flow of insulin into the bloodstream (you can control the rate). This means you don’t have to inject yourself, but you will still need to monitor your blood sugar levels closely. Insulin pump therapy isn’t suitable for everyone, so it’s important to speak to your doctor about your options.
Type 2 diabetes
The symptoms for type 2 diabetes are the same as type 1, however they can be less sudden and therefore less obvious. Because of this, some people can go years without realising they have diabetes. This type occurs when the body stops producing enough insulin, or when the cells stop reacting to insulin.
Often, this form of diabetes is associated with obesity. If you carry excess fat around your stomach area, your risk of diabetes is greater. This is thought to be because abdominal fat releases chemicals into the body that can upset the body’s metabolic and cardiovascular systems.
While there is no cure for type 2 diabetes, you may be able to control symptoms by regular blood sugar monitoring, being a healthy weight, switching to a balanced diet and exercising regularly. The condition is progressive however and you may eventually require medication or insulin injections.
This form of diabetes affects pregnant women, typically during the second or third trimester. Risk of developing gestational diabetes is increased if you are overweight. Women affected by gestational diabetes won’t have had diabetes before they got pregnant and it usually goes away after the baby is born. Your doctor will discuss with you the best way to manage symptoms to ensure a healthy pregnancy and birth.
Living with diabetes
As there is no cure for diabetes, it is considered a lifelong condition. This means that once you are diagnosed, you will have to take care of your health to help manage symptoms and avoid future complications.
Looking at the foods you eat and ensuring you have a balanced diet is very important when you have diabetes. The foods you eat will directly affect your glucose levels. There is no need for you to cut out any food groups however, as long as you make healthy choices you can enjoy a varied diet.
It is important to eat regularly and to include carbohydrates like pasta and whole grains, along with lots of fruit and vegetables. If you have type 2 diabetes and are overweight, you may be recommended to lose weight to improve symptoms.
Drinking alcohol can cause high or low glucose levels, depending on how much you consume. It can also affect your ability to monitor your blood sugar levels and carry out your insulin treatment. If you do decide to drink, be careful to stay within the recommended daily amounts and don’t drink on an empty stomach.
Exercising is strongly recommended for those with either type of diabetes as it lowers blood glucose levels. Like everyone, it is important to aim for 150 minutes of aerobic activity (of moderate intensity) a week. Before you start a new activity or fitness regime it is important to let your doctor or diabetes care team know. This is because physical activity affects your blood glucose levels so you may need to adjust your insulin treatment or diet to maintain a steady blood sugar level.
Monitoring blood sugar levels
A big part of living with diabetes involves the managing and monitoring of blood glucose levels. Usually this can be done through a skin prick test you can carry out at home. It’s important that you see your doctor for regular check ups and more thorough blood tests. Your doctor will also check your feet, nerves and eyes regularly as these can be affected by type 1 and type 2 diabetes.
Having diabetes does not mean you have to stick to a rigid, special diet. Having said this, what you eat will affect your condition. It’s therefore important to know what to eat and when to consume the right amount of glucose for the amount of insulin you’re taking.
Understanding these aspects of a diabetic diet can be tricky. This is where the help of a professional can come in handy. A nutrition professional trained in diabetic diets will be able to work with you and your specific needs to tailor a dietary plan.
Below we have some general healthy eating advice for those with diabetes, but remember to speak to your doctor or diabetes care team before making any drastic changes to your usual diet.
What should I be eating?
Food choice plays an important role in diabetes management, but you should be able to enjoy a varied diet with nothing being out of bounds. It is OK to treat yourself every now and then, but it’s important to be sensible and to consider your glucose levels.
In terms of what you should be eating, the following is a general guide (for more tailored advice, consult a suitably qualified nutrition professional).
Fruit and vegetables
Full of vitamins and minerals, fruit and vegetables are essential for a balanced diet. They are naturally low in calories and help to protect against heart disease and high blood pressure. You should aim to eat at least five portions of fruit and vegetables a day. One portion equates to roughly what you can fit into your cupped hand (i.e. one apple, one banana, a handful of grapes, three tablespoons of vegetables).
Carbohydrates found in starchy foods like bread, potatoes, pasta and rice are broken down into glucose. This glucose is then used by the body’s cells as fuel. Eating carbohydrates is an important part of a diabetic diet, however you are advised to opt for complex, whole grain/wholewheat varieties. Carbohydrates that are more slowly absorbed by the body will ensure your blood glucose levels remain unaffected and will keep you feeling fuller for longer.
Aim to have some starchy food every day, but keep an eye on how much you eat. Depending on your personal circumstances you may be advised to spread your intake during the day or reduce the amount you eat.
Dairy products like milk, cheese and yoghurt help to keep your teeth and bones strong as they contain calcium. Some varieties can be high in fat however, which can contribute to weight gain. If you have been advised to lose weight you may want to opt for lower fat varieties; be mindful of any extra sugar in low-fat products though. You should aim to eat around three portions of dairy a day.
Foods like fish, meat, eggs and pulses are rich in protein which is essential for building and repairing muscles. Oily fish also contain omega-3 fatty acids which have many benefits, including protecting the heart. Aim to eat some protein every day and oily fish twice a week.
Foods that are high in fat and sugar aren’t required by your body. Eaten in moderation however, they can be part of a balanced diet. When you have diabetes it is important to keep in mind the effect high-sugar foods/drinks will have on your condition. Sugary drinks in particular can raise your blood sugar levels quickly, so you are advised to stick to diet/low-calorie options. Foods that are high in fat can affect your weight, which is a contributing factor in type 2 diabetes. If you have been advised to lose weight, look for lower fat alternatives. For example you could replace saturated fats like butter and lard in your cooking for unsaturated fats like olive and vegetable oil.
Too much salt in your diet can be damaging to your health, leading to high blood pressure, heart disease and stroke. Keep an eye on your salt intake and try flavouring your foods with herbs and spices instead.
Carb counting and insulin adjustment
If you have type 1 diabetes (or have type 2 diabetes and are at a stage where you need to inject insulin) you may have heard about carbohydrate counting. As carbohydrates are converted to glucose in the body, it’s important to be aware of how much you’re consuming in your diet. In some cases, carbohydrate counting can be useful. This is when you count how much carbohydrates you eat and calculate the amount of insulin you’ll need.
If you want to find out more about carbohydrate counting, speak to a nutrition professional. They will be able to look at your personal circumstances and your insulin treatment to tailor a plan to suit you.
Getting professional support
Whether you have type 1 or type 2 diabetes, looking at what you’re eating is important. To ensure your diet is tailored to your lifestyle and your stage of diabetes, it is helpful to get professional advice. As well as offering general healthy eating tips, a nutrition professional will be able to put together a diabetic diet plan to help you manage your condition while enjoying a varied and balanced diet. The plan will take your individual circumstances into consideration, including your insulin treatment and any other health concerns.
If you have been recently diagnosed, this support and guidance can be invaluable, helping you navigate any dietary changes you need to make. Much of the public information about healthy eating and diabetic diets is generalised and doesn’t take personal circumstances into account. This is what a nutritional professional can offer - a tailored plan that suits you and keeps you healthy.
Content reviewed by dietitian, Jo Travers. All content displayed on Nutritionist Resource is provided for general information purposes only, and should not be treated as a substitute for advice given by your GP or any other healthcare professional.
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