Best Diet Plans for People with Diabetes, Reviewed by Experts

Diabetes is a chronic condition that impacts
metabolismⓘ
The processes in the body that convert and use energy, for example, digesting food or using your muscles.

. It affects how your body transforms and uses energy. More than one-third of Americans (133 million) are living with diabetes or prediabetes.

The development of diabetes is related to multiple factors, such as family history, weight, age, exercise habits, and diet habits.

The treatment and management of diabetes also includes multiple factors such as diet and lifestyle modifications.

In this article, we discuss popular diets that have evidence behind their benefits in people with diabetes. We interviewed registered dietitians and diabetes educators to get expert recommendations on the best diets for people with diabetes. 

Best diets for people with diabetes in 2024

• Mediterranean diet
• Low-carb diet
• DASH diet
• Portfolio diet

Eating healthy with diabetes

There’s no one-size-fits-all diet recommendation for people with diabetes. What works for one person may not work for another. Your specific health history, chronic diseases, lifestyle, and environment can impact how your body responds to one
eating pattern ⓘ
Also know as a diet or dietary pattern, what people eat and drink on a regular basis.

vs. another. 

The American Diabetes Association (ADA) says a healthy eating plan includes

:

• Fruits and vegetables
• Lean meats and/or plant-based sources of protein (legumes, soy, nuts, and seeds)
• Less added sugar
• Less processed foods (also known as whole foods)

How to get started

Eating healthy doesn’t have to be overwhelming. The ADA has a few tips and an easy method to get started on managing your blood sugar through your diet. Using the Diabetes Plate Method is an easy way to make sure each meal is balanced and encourages the following on each plate

:

• Half of your plate as non-starchy vegetables like broccoli, leafy greens, salad greens, and okra
• One-fourth of your plate as a lean protein such as chicken, turkey, eggs, and fish
• One-fourth of your plate as carbohydrate foods like whole grain rice, quinoa, and starchy vegetables such as potatoes and butternut squash
• Water or a zero-calorie drink to accompany your meal

The ADA also has tips for eating healthy on the go and making

The diets we discuss in this article all have some of the basic elements of a health-promoting diet for people with diabetes. Each diet has its benefits and drawbacks, but what’s important is finding the diet you can stick to that meets your lifestyle and health goals. 

Risks of low blood sugar

Hypoglycemia, or low blood sugar, can be a medical emergency if you don’t act on it. People with diabetes are at risk of hypoglycemia, especially people who have type 1 diabetes or who are taking insulin or other blood sugar–regulating drugs. Symptoms of low blood sugar are sweating, shaking, confusion, dizziness, and hunger. People with very low blood sugar can feel weak, have seizures, or faint.

Diabetes medication can cause low blood sugar. Also, the timing of physical activity and your eating patterns can lead to low blood sugar. People who are changing their diets should consult with their health care team beforehand to support balanced blood sugar levels.

People should work with their health care team to understand how their bodies respond to certain foods, activities, and stressors and how that impacts their blood sugar regulation. Ultimately, a supportive health care team can recommend a sustainable lifestyle—like diet, physical activity, exercise, mental health, and rest—that supports healthy blood sugar regulation. 

“Remaining healthy while having diabetes is such an individualized thing. It’s important to get help from a certified diabetes educator to help you tailor a plan that works for you and your lifestyle. Sometimes it feels as if you are all alone in the journey, but it’s important to remember that many knowledgeable people are waiting to help.”

—Jalinn Nobis-Wichman, registered nurse and certified diabetes care and education specialist (CDCES) at OSF HealthCare in Pontiac, Illinois

Best diet plans for people with diabetes, reviewed by experts

Mediterranean diet

How does the Mediterranean diet work?

The Mediterranean diet is based on the eating patterns of various Mediterranean cultures in the early 1960s: Cretan, Greek, and southern Italian.

It was first studied because these populations were found to have longer life spans and low rates of chronic diseases, some cancers, and obesity. The Mediterranean diet is actually a lifestyle that encourages regular physical activity and plenty of plant foods such as fruits, vegetables, whole grains, beans, nuts, and seeds.

There’s no calorie counting in the Mediterranean diet. Instead, it emphasizes eating certain proportions of food groups. The diet is proposed as a pyramid, with plant foods at the base of the pyramid and red meats at the top, eaten infrequently. Olive oil is the main source of fat in the diet, and dessert is typically fresh fruit. Alcohol in the form of wine is also included in low to moderate amounts with meals.

Our expert take

The Mediterranean diet is recommended by the Centers for Disease Control and Prevention (CDC) and the American Heart Association (AHA) for people managing diabetes, and our Reviews Team found a fair amount of evidence supporting these recommendations. A 2020 review of studies found that the Mediterranean diet decreased the risk of developing type 2 diabetes by up to 23% in healthy adults and 52% in older adults with a high risk of heart disease.

Kimberly Gomer, RD, in Miami, Florida, highlighted that the plant foods and whole foods in the Mediterranean diet can be beneficial for people with diabetes, but some aspects of the diet may work against some people. For example, the Mediterranean diet encourages drinking wine in moderation, but some people may need to abstain from alcohol altogether to benefit blood sugar regulation.

The Mediterranean diet can be good for people who want to make dietary changes without having to look closely at nutrition labels to count calories or carbs. The flexibility can work for some, but if you do better with more structured recommendations, such as daily serving goals or nutrient limits, you may want to consider other diet options we detail below. 

Why the Mediterranean diet works for diabetes

According to the CDC, the Mediterranean diet can improve insulin resistance because of its emphasis on plant foods and its restriction on processed foods. Plant foods add fiber to the diet, can reduce inflammation, and typically contain healthy fats that can help with blood sugar and weight management.

Studies have found that the Mediterranean diet successfully decreases
hemoglobin A1c (HbA1c)ⓘ
A blood test that measures your average blood sugar levels over the previous three months. HbA1c levels are often used to diagnose and monitor type 2 diabetes.

levels compared to low-fat or low-carb diets. Researchers think this is because of its anti-inflammatory actions, effects on hormones that regulate digestion and sugar control, and the effects on gut bacteria.

Low-carb diet

How does the low-carb diet work?

The low-carb diet involves limiting the amount of carbohydrates (carbs) in the daily diet to decrease insulin and improve metabolic health. Depending on the source of the carbohydrates, the recommended daily carb limit can be 20 g per day and up to 130 g per day. Less than than 50 g of carbs per day is considered a “very low” carb diet, which can also be considered the ketogenic (“keto”) diet.

Insulin and diabetes

Insulin is a hormone that the pancreas secretes in response to food intake. It signals for the body’s cells to take in sugar from the blood for energy. People with type 2 diabetes have cells that require increasing amounts of insulin to take in sugar from the blood.

This is called insulin resistance.

The goal of diabetes treatment is to restore proper insulin signaling and reduce high levels of sugar in the blood.

Carbohydrates are broken down into sugar that the body uses for energy. Eating high amounts of carbohydrates means that there’s a large supply of sugar for the body’s cells. If regularly unused, this supply of energy can turn into weight gain or insulin resistance. The low-carb diet supports the body’s metabolism and weight management by reducing the amount of carbs consumed. 

Our expert take

Low-carb diets have been found to be better than low-fat diets at helping people lose weight and sustain weight loss, but the challenge with the low-carb diet is sticking to it.

“One of the things that makes managing diabetes hard is that we ask most people to limit their carbohydrates each meal,” said Nobis-Wichman.

Carbohydrates are a macronutrient—a nutrient that is found in large amounts in most diets. It can be a challenge to avoid or limit them without understanding the nutritional breakdown of typical foods. To better understand your carb intake, you can start by looking at nutritional labels or by using food-tracking apps like Noom, Cronometer, or MyFitnessPal. The U.S. Department of Agriculture (USDA) also maintains a searchable food database that includes carb counts of common foods. 

Examples of carb content in typical foods

• Egg sandwich on a bagel: 89 g
• Ham and turkey sandwich on white bread: 31 g
• One medium apple: 30 g
• 1 cup of spaghetti pasta with sauce and meatballs: 64 g

Nobis-Wichman recommends that most of her patients consume 30–60 g of carbohydrates per meal. “Initially, this can feel very limiting. But I try to frame it as a carbohydrate budget, and the bank refreshes each meal. This gives people the freedom to decide how they want to ‘spend’ their carbs within that meal,” she said. 

Though carbs are limited in the low-carb diet, no guidelines exist around daily calorie limits. This can also work against people who are looking to manage their weight, diabetes, or other health conditions. 

Low-carb diets have been found to improve certain markers of heart disease, such as
triglyceridesⓘ
The concentration of digested fat compounds in the blood.

and
HDL cholesterolⓘ
High-density lipoprotein (HDL) cholesterol concentration in the blood. HDL cholesterol is sometimes called the “good” cholesterol that helps protect against heart disease.

, but their overall impact on heart disease risk is still unclear based on current research. When people eating low-carb diets add more protein to their diet, the increased protein can work against people managing chronic kidney disease.

Finally, it’s important to keep track of your micronutrients while on a low-carb or keto diet to make sure you’re getting the right amounts of vitamins and minerals for your health goals. 

Why the low-carb diet works for diabetes

Reducing carbs is a typical dietary strategy to manage either type 1 or type 2 diabetes. Fewer carbs mean less sugar in the blood to control, which allows the body to respond to blood sugar and insulin levels more effectively.

In addition, low-carb diets support weight loss, which helps with better blood sugar regulation.

Studies have found that eating low-carb diets for more than 12 months can reduce the amount of insulin, oral diabetes medications, and HbA1c levels in people with type 2 diabetes.

Reviews of research have also suggested that eating a low-carb diet for more than six months can also be a way to reverse diabetes, though more research is needed for its long-term effects.

DASH diet

How does the DASH diet work?

DASH stands for “dietary approaches to stop hypertension.” It was developed to reduce sodium, lower blood pressure, and support overall heart health. It’s recommended by the AHA and has more structured guidelines compared to the Mediterranean and low-carb diets. The DASH diet encourages vegetables, fruits, and whole-grain foods while limiting fatty meats, full-fat dairy, and foods with added sugars and sodium.

Your health care professional can tailor total daily calorie limits and sodium levels according to your health goals, age, gender, and health conditions.

The National Heart, Lung, and Blood Institute gives this following example of recommendations for a 2,000-calorie daily diet:

• Six to eight daily servings of whole grains (e.g., whole wheat bread, brown rice, and oats)
• Six or fewer daily servings of lean meats, poultry, and fish
• Four to five daily servings of vegetables (e.g., cabbage, broccoli, and carrots)
• Four to five daily servings of fruit (e.g., apples, cherries, and berries)
• Two to three daily servings of low-fat or fat-free dairy products (e.g., cheese, milk, or yogurt)
• Two to three daily servings of fats and oils that are low in saturated and trans fats (e.g., olive oil and avocados)
• A daily limit of 2,300 milligrams (mg) of
  sodiumⓘ
  A mineral found naturally in foods and in table salt. Sodium levels in the body contribute to blood pressure balance.
  

Nuts, seeds, beans, and peas are limited to four to five servings per week, and sweetened foods such as sodas and desserts are limited to five or fewer servings per week.

The DASH diet also recommends limiting alcohol, deep-fried foods, and packaged snacks, which can be high in fats, sodium, and added sugar.

Our expert take

Similar to the Mediterranean diet, the DASH diet encourages more servings of plant foods and whole foods. Although whole foods naturally contain sodium, processed foods (e.g., packaged snacks, canned foods, or instant frozen meals) and restaurant foods account for 70% of our sodium intake.

Lowering sodium in our diet can help reduce blood pressure, which is one of the factors that contribute to heart disease risk.

The DASH diet has been found to significantly lower blood pressure and help with the long-term management of high blood pressure.

Reducing processed foods means increasing whole, minimally processed foods. Since the DASH diet encourages more whole foods, it’s also been found to decrease
LDL cholesterolⓘ
The concentration of low-density lipoprotein (LDL) cholesterol in the blood. LDL cholesterol is sometimes called “bad” cholesterol because its high concentrations are associated with increased risk of heart attack and stroke.

levels, decrease the risk of heart failure, and decrease the risk of gout.

When combined with exercise, a weight loss program, and regular counseling sessions with a health care provider, the DASH diet can improve blood pressure in people with hard-to-treat or “resistant” high blood pressure.

Since there are many guidelines around daily servings, food choices, nutrient balance, and calorie limits, the DASH diet can be good for people who do better with planning structured diets. Meal preparation once or twice a week can be a good way to stay on track with a specific diet, but not everyone may have time for it. 

Why the DASH diet works for diabetes

Since the DASH diet recommends a fair amount of grain servings daily, it may result in a larger intake of carbohydrates, which can work against diabetes management. But the DASH diet’s emphasis on whole foods and limited sugars helps with blood sugar management, which is why it can still support people with diabetes. There’s limited but positive evidence supporting the DASH diet for both the management and prevention of type 2 diabetes and gestational diabetes.

The DASH diet has been found to decrease insulin resistance, inflammation, and glucose levels in the urine, which are markers that health care providers may monitor in people with diabetes.

In addition, a small study on older adults found that following a DASH diet combined with regular exercise for six months resulted in better insulin sensitivity and improved cognitive health. This study suggested possible benefits of the DASH diet combined with exercise on metabolic health (i.e., for diabetes management) and prevention of cognitive disorders like dementia.

Portfolio diet

How does the portfolio diet work?

The portfolio diet is a strategy developed to lower LDL cholesterol. It combines diet changes that have been found in research to lower cholesterol and gives people the option to add as many components as they’d like to their “portfolio,” or their diet. People “invest” as much or as little in each dietary pattern to build their cholesterol-lowering portfolio. Investing in each dietary pattern can reduce LDL cholesterol by 5%–10%, but if you invest in all of them, you can lower your LDL cholesterol by about 30%. For reference, cholesterol-lowering medications reduce cholesterol by 20%–60%.

Table 1 the portfolio diet

* Monounsaturated fatty acids

Our expert take

Unlike the DASH diet, which has more regimented recommendations for daily servings of food groups, the portfolio diet has more flexibility for people to gradually make dietary changes. Adding each dietary pattern to your diet slowly can support long-term changes that support a healthy lifestyle. In addition, the portfolio diet suggests lower daily intake goals when starting out so you can incorporate new foods into your diet without being overwhelmed. Lauren Kort, RD, in Miami, Florida, explained that small changes can still have positive effects on blood sugar. “Don’t let perfect be the enemy of good! You don’t have to completely change your diet to better control your blood sugar,” she said. 
Although the portfolio diet was developed to lower cholesterol, it has other heart and metabolic health benefits. One study showed that people who invested in more dietary patterns in the portfolio diet had lower risk of heart disease and stroke, better cholesterol, and lower inflammation.

Heart health and diabetes

There’s a reason why lifestyle and diet changes for diabetes can also benefit heart health, and vice versa. People with diabetes are twice as likely to have heart disease or a stroke compared to people who don’t have diabetes.

In people with diabetes, high levels of blood sugar over a long period of time can damage the heart and blood vessels, leading to a higher risk of heart disease.

Recommendations for better heart health, such as exercise, weight management, and eating more whole foods and plant foods, can also benefit metabolic health in people with diabetes.

Compared to the Mediterranean diet and DASH diets that encourage more whole, minimally processed foods, the portfolio diet suggests some processed foods to help people more easily achieve their daily intake goals. Convenience foods like veggie burgers and enriched foods like plant sterol-added margarine (a butter substitute) are examples of processed foods that can help someone consume more plant-based proteins and plant sterols, respectively. These are easy substitutes that someone with diabetes can make in place of eating more red meat or butter-containing foods. 

But it’s important to consider that processed foods end up containing other added ingredients, such as sodium, that may work against some health goals. “The best diets [for people with diabetes] starts with getting rid of highly processed foods,” said Gomer. Health care professionals like registered dietitians can help you weigh the benefits and drawbacks of the portfolio diet according to your specific health goals and lifestyle. 

Why the portfolio diet works for diabetes

Because the portfolio diet is aimed at supporting heart health, there aren’t many studies on it directly benefiting people with diabetes. But, in postmenopausal women, the portfolio diet was found to decrease the risk of type 2 diabetes.

Again, adding more plant foods like nuts and seeds, plant-based proteins, and fiber to the diet has been shown to help with managing diabetes. Plant-based diets have been found to help improve HbA1c and prevent type 2 diabetes, heart disease, and complications of diabetes. For example, plant-based diets can help reduce pain in patients with
diabetic neuropathyⓘ
Nerve damage as a complication of diabetes.

.

Fiber is particularly encouraged for people with diabetes because of its benefits on blood sugar control. “Interestingly, fiber is found in a lot of carbohydrate foods like fruits, vegetables, and whole grains. Fiber slows down how our body digests carbohydrates,” said Kort. The viscous or “sticky” fiber in the portfolio diet is actually soluble fiber—a type of fiber that absorbs water and forms a gel that slows digestion. Soluble fiber found in foods like apples and okra can help control the rate at which carbohydrates are digested, which means a more controlled release of sugars into the bloodstream.

Options for diet plans for people with diabetes

You can get help with starting a new diet in many ways. Appointments with your health care team are one way to get professional recommendations tailored to you. We also reviewed healthy living apps, programs, and meal deliveries to understand how they can support people with diabetes or prediabetes outside of a clinic.

Noom Diabetes Prevention Program

Features

• For people who are at risk but not yet diagnosed with diabetes
• A 12-month program of diet, lifestyle, and habit change guidance
• May be covered by insurance plans 

Noom offers a Diabetes Prevention Program (DPP) for people who are at risk of diabetes but haven’t been diagnosed with it yet. The program offers support for healthy eating habits, physical activity, stress management, emotional eating, and better sleep, among other topics. It focuses on healthy weight loss and offers 24/7 support, a DPP coach, and weekly group sessions. 

About diabetes prevention programs

Medicare and private insurance plans may cover Diabetes Prevention Programs (DPPs) for people who are at risk of developing type 2 diabetes. A DPP is a 12-month health behavior change program that involves weekly group sessions that help you build habits to make healthy diet and lifestyle changes, control your weight, exercise more, and get support from peers.

You can be eligible for a DPP if you

:

• Are insured by Medicare or an insurance plan that offers DPPs to their members
• Had HbA1c between 5.7% and 6.4%, fasting blood glucose of 110–125 mg/dL, or two-hour blood glucose of 140–199 mg/dL in the previous 12 months
• Have a BMI of 25 or more or 23 or more if you’re Asian
• Haven’t ever been diagnosed with type 1 or type 2 diabetes or end-stage renal disease
• Haven’t participated in a DPP before

The first six months of Noom’s DPP focus on nutrition and physical activity, while the second half of the program focuses on topics like stress, sleep, and emotional eating. The program also has Noom’s program for behavior change, where users will learn the four stages of changing behavior to incorporate healthier habits. Noom DPP costs $129 for the 12-month program.

Noom Weight is the platform’s main offering and can help support people with diabetes as well. The program focuses on behavior change through daily lessons on nutrition and psychology and getting to know your diet through food tracking. The app also offers recipes and coaches for additional support. When starting a new diet to help control blood sugar, a program like Noom can help you make and keep those changes as a part of a healthy lifestyle. Noom Weight starts at $209 ($17.42 per month). Read our full review of Noom’s Weight program in our Noom review. 

Payment information

Noom accepts credit card payments through PayPal, Visa, Mastercard, Discover, and American Express. You may be able to get Noom’s Diabetes Prevention Program through private insurance. For example, people with CareFirst BlueCross BlueShield can sign up through CareFirst to receive the Noom DPP program free of cost. 

Nutrisystem D

Features

• Prepared meal delivery specialized for people with diabetes or prediabetes
• Choose from breakfast, lunch, dinner, and snack options
• Around 1,200–1,500 calories a day for weight loss

Nutrisystem offers a meal plan called Nutrisystem D for people who want to manage their diabetes or prediabetes with prepared meals. The plan was developed to help people lose weight and control their blood sugar. In a study funded by the company, people who ate the Nutrisystem D diet for more than six months lost an average of 16 pounds and decreased their HbA1c by 0.7%.

The meal delivery company offers three types of plans:

• Diabetes Basic: Non-frozen meals and snacks for five days a week, starting at $244.99 per month

Both plans also include the Nutrisystem weight loss app, NuMi, which has challenges, prizes, expert tips, and recipes to help people keep on track with their weight loss goals. 

Nutrisystem meals come as frozen and non-frozen deliveries. People who get the “women’s” plan get three meals and a snack, and people who order the “men’s” plan get three meals and two snacks a day. According to the website, Nutrisystem D is designed to be low-fat, low-calorie, and portion-controlled to help people with diabetes lose weight. 

Nutrisystem can be convenient for busy people trying to manage their diabetes through weight loss, but the program may not be for everyone. The monthly cost can be expensive over time. Also, people who are taking medications for diabetes should consult a health care professional about the low-calorie diet to reduce risks of low blood sugar while on the diet.

Payment information 

Nutrisystem accepts payment through credit cards (Visa, Mastercard, American Express, and Discover), PayPal, Venmo, and Google Pay. 

How we research and evaluate weight loss platforms

Based on our expert consultations, research, and testing, we determined the following factors to be essential for our readers when signing up for a weight loss platform:

• Education in nutrition and weight management
• Accountability through progress tracking
• Recommendations and tips for physical activity
• Access to clinical support
• Availability of mental health resources
• Ease of use of the app or website

We had all of our articles medically reviewed by an expert in the field to ensure the information was appropriate for our readers’ needs.

Special weight loss considerations for older adults

Before starting a weight loss program, you should always talk to your health care provider. Weight loss programs may not be the best option for everyone, and people with diabetes should be especially mindful of how their diet and lifestyle changes can impact their blood sugar. While there are certainly benefits to weight loss, these programs also pose unique potential risks for older adults.

Older adults are more at risk for experiencing bone and muscle loss due to calorie restrictions. Losing muscle mass and strength can also lead to other adverse effects like reduced physical function and overall quality of life. 

If you take insulin or other blood-sugar-controlling medications for diabetes, drastic changes to your diet can impact your blood sugar. If your blood sugar is too low, you can be at risk of fainting and complications of hypoglycemia. It is important to talk to your health care provider first so they can advise you on the best ways to reach your goals while accounting for your health history.

Weight loss programs can still be beneficial for older adults and people with diabetes. For example, studies have found that older adults participating in a dietary and exercise program improved overall quality of life and physical performance. William Cefalu, director of the NIDDK’s division of Diabetes, Endocrinology, and Metabolic Diseases, said that the most important factor in achieving remission from type 2 diabetes is weight loss

. You can weigh the benefits and risks with your doctor or health care provider.