Eating well with diabetes

A few simple things that genuinely help — and some proper food worth looking forward to. Nothing to count, nothing to download, nothing to give up entirely.

Five things that make the biggest difference

These are the things nearly everyone working in this area agrees on, from NHS doctors to independent researchers. If you only do the first one, that's still worth doing.

  1. A short walk after your biggest meal Ten to fifteen minutes, starting within about half an hour of finishing. Round the garden, up the road, or even just about the house.

    Why it works so well for you in particular: normally sugar needs insulin to get out of your blood and into your muscles. But when a muscle is working, it can pull sugar in without waiting for insulin at all. Walking after a meal opens a second door — one that doesn't depend on the insulin you inject. That's why a short walk can do more than it has any right to.
  2. Change what you have for breakfast This is where the biggest gain is. Toast, cereal, porridge and fruit juice all turn to sugar very quickly, first thing, when you're least able to handle it. Eggs, or plain full-fat Greek yoghurt with a few berries, instead. Still a proper breakfast — just a different one.
  3. Protein at every meal — aim for a palm-sized piece Eggs, fish, chicken, meat, cheese.

    Why this matters more now, not less: from around sixty onwards we lose muscle steadily unless we deliberately eat enough protein and keep using it. That muscle is what keeps you steady on your feet — and it's also where most of your blood sugar gets stored and burned. So more muscle means better blood sugar and fewer falls. One thing, two benefits, and the reason protein sits so high on this page.
  4. Half the plate vegetables, and about a third of your usual potato, rice, pasta or bread They don't have to disappear. Just have noticeably less, and fill the space with vegetables and plenty of butter.
  5. Nothing sweet to drink, and a decent night's sleep Fruit juice and squash raise blood sugar as fast as fizzy drinks — sometimes faster. And one poor night's sleep pushes your levels up the whole of the next day.

How this actually works

This is the part worth understanding, because once you have it you won't need anyone's list. You'll be able to look at any food at all and work it out yourself.

Only one thing in food raises your blood sugar much: carbohydrate.

Carbohydrate means sugar — but it also means starch, and that's the bit that surprises people. Bread, potatoes, rice, pasta, cereal, flour, and anything made with them, all get turned into sugar by your body within about half an hour. As far as your blood is concerned, a slice of bread and a spoonful of sugar are doing a fairly similar job.

Protein and fat barely move it at all. Meat, fish, eggs, cheese, butter, cream, olive oil — these are not the problem, and never were.

So the only question you ever need to ask

“How much sugar or starch is in this?”

That one question explains everything else on this page. It's why you can eat as much broccoli as you like but a potato counts. Why cheese is a free snack and a biscuit isn't. Why the fruit juice is worse than the actual fruit. And why you can add almost anything you fancy to a pot of yoghurt — except the sweet things.

Why the butter is allowed

Most of us were told for forty years that fat was the thing to cut. For blood sugar, that turns out to be aimed at the wrong target — fat doesn't raise it. Sugar and starch do.

The fat is doing three real jobs here:

If you take the fat out, the food gets dull and nobody keeps it up. So please don't skip it — the butter on the cabbage is part of the plan, not a lapse from it.

How much, exactly

No scales needed for most of it — your own hand is the measure, and it's already the right size for you. Where a number genuinely helps, it's given.

Half the plate — vegetablesBroccoli, cabbage, cauliflower, green beans, courgette, spinach, salad, peppers, mushrooms, leeks, tomatoes. Butter and olive oil on them encouraged.
Your palm — proteinAbout the size and thickness of your palm, not counting fingers. Roughly 100–150g, or a piece the size of a pack of cards.
A cupped handful — the starchy onePotato, rice, pasta, bread. Around 2 egg-sized potatoes, or 3 heaped tablespoons of cooked rice or pasta, or 1 slice of bread.
Your thumb — butter or oilAbout 15g, or a heaped teaspoon. This is what makes food taste of something and keeps you full.

The ones people most often get wrong

ItemWhat to buy or useHow much
Greek yoghurt Full-fat, plain, unsweetened. The label should say around 4–5g sugar per 100g or less. Avoid anything marked low-fat, 0%, "fruit", or with a fruit layer — those have far more sugar. About 150g, a large serving spoonful
Berries Raspberries, blackberries, strawberries or blueberries — fresh or frozen. These are the lowest-sugar fruits. Grapes, bananas and dried fruit are much higher, so keep those occasional. A small handful — roughly 8–10 raspberries, or 12–15 blueberries, or 3 strawberries
Nuts Almonds, walnuts, pecans, brazils or hazelnuts. Plain or lightly salted, not honey-roasted or coated. Cashews are higher in carbohydrate, so less often. A small cupped handful, about 30g — roughly 20 almonds or 8 walnut halves
Bread, when you have it Seeded wholemeal or a dense rye. White, and most supermarket "brown", behave almost the same as sugar. 1 slice, not 2
Dark chocolate 85% cocoa or higher. At 70% there's roughly twice the sugar. 2 small squares, about 20g
Sausages Check the front of the pack for the meat percentage — 90% or more. The cheaper ones are largely rusk, which is bread. 2 sausages
Cheese Any real cheese — cheddar, stilton, brie, feta. Avoid processed slices and spreads. A piece about the size of 2 thumbs, roughly 30–40g

What you can add to things

This is where people get needlessly gloomy. Almost nothing is off limits as an addition — because almost none of it is sugar or starch. Take the yoghurt as the example.

Your pot of Greek yoghurt

All of this is fine, and makes it a proper breakfast: pumpkin, sunflower, chia or flaxseeds · chopped walnuts, almonds, pecans or hazelnuts · a small handful of berries · cinnamon · a few drops of vanilla extract · desiccated or flaked coconut · unsweetened cocoa powder · a little grated lemon or orange zest · a spoonful of double cream if you want it richer · a scrape of smooth peanut or almond butter (the kind with no added sugar).

Only these are the problem: honey · maple syrup · granola or muesli · a fruit layer or compote · dried fruit and raisins · jam. All of those are sugar, and that's the only reason they're out.

The same logic applies everywhere. Pile whatever you like onto a salad — cheese, olives, avocado, bacon, seeds, mayonnaise, olive oil. Put a cheese sauce on the cauliflower. Roast the vegetables in goose fat. None of it counts, because none of it is sugar or starch.

Free — add these to anything, they never count

Fruit — how it fits

Fruit isn't banned, it just varies enormously. The rule is the same one: how much sugar is in it.

BestFine — one, not twoNow and then
Raspberries, blackberries, strawberries, blueberries.

Lowest in sugar and highest in fibre. A small handful most days is fine.
An apple, a pear, a plum, a satsuma, a kiwi, a few cherries.

Best eaten with a meal or after it, rather than on their own.
Banana, grapes, mango, pineapple, melon.

Much higher in sugar. A few grapes rather than a bunch, half a banana rather than a whole one.

Two exceptions worth knowing. Dried fruit — raisins, dates, dried apricots — is fruit with the water taken out, so the sugar is concentrated into a much smaller mouthful. And fruit juice is the sugar of several pieces of fruit with none of the fibre that would have slowed it down, which is why it acts almost exactly like a fizzy drink.

Shop-bought things that catch people out

None of these are forbidden — just check the label, because the sugar isn't obvious:

A day of proper food

None of this is diet food. All of it is meant to be enjoyed.

Breakfast

Scrambled eggs — 2 or 3 — with butter, and smoked salmon or mushrooms alongside.

Or — 150g plain full-fat Greek yoghurt with a small handful of berries and a few chopped walnuts. Or a 3-egg mushroom and cheese omelette. Or 1 kipper with a poached egg.

Lunch

One tin of mackerel or sardines on a big salad, with olive oil and lemon.

Or — a ploughman's: a 40g piece of cheddar, 2 slices of ham, pickle, a few tomatoes, half an apple, and 1 slice of seeded bread. Or a large bowl of chicken soup with a tablespoon of cream stirred through.

Dinner

One or two chicken thighs with mushrooms and buttered greens.

Or — a salmon fillet with lemon butter and green beans. Or a portion of cottage pie with cauliflower in the mash. Or 2 good sausages with onion gravy and buttered cabbage.

If you're peckish between meals

A piece of cheese. A small handful of nuts. A pot of plain Greek yoghurt. A few olives. A boiled egg. A slice or two of cold meat.

All of these are fine and none of them will send your levels up much.

To drink

Water, tea, coffee. As much as you like.

If you take sugar in tea, going from two spoons to one, then to none over a few weeks, works far better than stopping all at once.

And the things you'd miss

Two squares of dark chocolate and a proper cheeseboard are both fine and should stay. Giving up everything you enjoy does not work and never has — what happens at breakfast every single morning matters far more than what happens on a Saturday night.

Alcohol needs real care, and this is the bit people don't know. A small glass of wine — 125ml — is fine, but always with a meal, never on an empty stomach. While your liver is busy dealing with alcohol it stops releasing the emergency sugar it would normally use to catch a low, so it can't rescue you while you sleep. The effect can last well into the night.

So if you've had a drink: test before bed, and have a starchy snack as well — a slice of toast, a couple of crackers with cheese, or a yoghurt — even if the reading looks fine. The test only tells you where you are now, not where you're heading.

If your blood sugar goes low

Worth reading now rather than when you need it. A low — a "hypo" — usually means a reading below 4.

It can feel like: shaking, sweating, going pale, a thumping heart, sudden hunger, tingling lips, anxiety, confusion, irritability, blurred vision, or feeling wobbly and vague. Left longer it can cause slurred speech and behaviour that looks like drunkenness.

One thing to know as we get older. These warning signs can fade with age and after many years on insulin — so a low can arrive with much less notice than it used to. If you're noticing them less than you once did, tell your nurse. That is important information and usually means a dose needs changing.

What to do:

  1. Take something sugary straight away — 4 or 5 glucose tablets, or 150ml of pure fruit juice (a small carton), or 4 jelly babies.
  2. Wait 15 minutes, then test again.
  3. Still under 4? Have the same amount again and wait another 15 minutes.
  4. Once you're back above 4, if your next meal is more than an hour away, have a slice of toast, a small banana, or a couple of biscuits to keep it steady.

Always keep something sugary within reach — in your handbag, by the bed, and in the car. This is the one situation where the sugary thing is exactly right.

If you can't help yourself

This is the one situation you cannot manage alone, so show this bit to whoever you live with, or a neighbour, and keep a copy by the phone.

If you become too drowsy or confused to eat or drink safely, or can't be woken, they must:

  1. Not put any food or drink in your mouth. You could choke.
  2. Roll you onto your side into the recovery position.
  3. Give glucagon if you have it and they've been shown how.
  4. Ring 999 — straight away if there's no glucagon or they don't know how to use it, if you haven't come round within 10 minutes of it, or if you'd been drinking alcohol.

Two things worth sorting now, while you're well. Ask your nurse whether you should have glucagon at home — there's a nasal powder as well as an injection, and the nasal one is far easier for someone untrained to give. And carry something that says you have diabetes and take insulin: a card in your purse, or a bracelet.

If you drive

Because you take insulin, these are the law rather than suggestions.

You must tell the DVLA if you have two or more severe hypos in a year, if you have even one while driving, or if you start to lose the warning signs.

Four recipes worth cooking

Breakfast · 5 minutes

Proper creamy scrambled eggs

The version that stops you missing toast. The trick is low heat, and taking them off before they look ready.

You need

How

  1. Beat the eggs with a fork. Don't salt them yet.
  2. Melt the butter in a small pan over low heat — lower than feels right.
  3. Add the eggs and stir slowly and constantly with a wooden spoon. It takes three to four minutes and can't be rushed.
  4. While they still look a little too loose, take the pan off the heat completely. They carry on cooking.
  5. Stir in the cream, season, and eat straight away.

To make it a proper meal: 2 slices of smoked salmon on the side, or a handful of mushrooms fried in butter first.

Dinner · 25 minutes · Serves 2 · Freezes well

One-pan creamy chicken and mushroom

One pan, very little fuss, and it tastes like something you'd order out.

You need

How

  1. Season the chicken well. Brown it skin-side down in the butter over medium heat until properly golden — about 6 minutes. Turn it, give it 3 more, then lift it out.
  2. In the same pan, soften the onion for about 4 minutes, then add the mushrooms and cook another 5. Let them take on real colour rather than just softening.
  3. Add the garlic for 30 seconds, then the cream and mustard. Stir up all the brown bits from the bottom of the pan — that's where the flavour is.
  4. Put the chicken back, turn the heat low, and let it bubble gently for 10 minutes until cooked through — no pink in the middle.
  5. Serve with green beans or buttered cabbage.
Dinner · Makes 4 portions · Comfort food

Cottage pie with a lighter mash

Nothing is missing from this one. The cauliflower disappears completely into the potato.

You need

How

  1. Brown the mince properly, in two batches if the pan is small, so it colours rather than steams. Lift it out.
  2. Soften the onion and carrot in the same pan for about 8 minutes.
  3. Return the mince and stir in the purée, stock and Worcestershire sauce. Simmer uncovered for 25 minutes until thick.
  4. Meanwhile boil the potatoes and cauliflower together for about 15 minutes until both are soft. Drain them very well and let the steam escape for a minute — this is the step that matters.
  5. Mash with the butter and cream, and season generously.
  6. Spread over the mince, fork the top, scatter over the cheese, and bake at 200°C (180°C fan) for 25 minutes.

Freeze 3 portions in separate dishes. That's three evenings where nothing has to be decided.

Dinner · 15 minutes · Serves 1

Salmon with lemon butter and green beans

The quickest proper dinner here, and one of the best things you can eat.

You need

How

  1. Pat the salmon dry and season the skin well. That's what makes it crisp.
  2. Put it skin-side down into a cold non-stick pan, then turn the heat to medium. Starting cold is the whole trick.
  3. Leave it alone for 6 to 7 minutes while the skin crisps and the flesh turns pale from the bottom upwards. Turn it for 1 minute, then lift it out.
  4. Boil the beans for 4 minutes, drain, then toss them in the pan with the butter and a good squeeze of lemon.
  5. Pour the lemon butter over the salmon.

One chicken, three meals

Roast a chicken on Sunday. Sunday: a roast dinner. Monday: cold chicken with coleslaw or salad. Tuesday: simmer the carcass with an onion and a carrot for about an hour to make stock, then make soup with the last of the meat.

Three meals from one shop and one proper cooking session — which helps enormously on the days when cooking feels like too much.

Why the insulin has to come down first

This is the most important thing on the page to actually understand, rather than just follow — so here is the whole of it, plainly.

Your insulin dose was worked out to match the way you eat now. Insulin's job is to move sugar out of your blood and into your body. Someone worked out how much you need based on roughly how much carbohydrate you have in a day.

So if you eat noticeably less carbohydrate but keep taking the same amount of insulin, there is now more insulin than there is sugar for it to deal with. The insulin doesn't know that. It carries on doing its job — and pulls your blood sugar down too far.

That's the whole reason. It isn't caution for the sake of it, and it isn't about asking permission. Change the food without changing the dose and the sums no longer add up. Cutting the carbohydrate is the treatment — but the dose has to come down to meet it.

Which is why the specialists who do this properly lower the medication first, and accept blood sugars running a little high for a week or two while things settle. They would rather see you a bit high and safe than have you drop too low at home. Dr Sarah Hallberg, who ran one of the largest studies of this approach, was blunt about it: people who change the food without adjusting the medication first can get into trouble quickly.

Only your nurse or doctor can work out the new numbers, because they depend on which insulin you take, how much, and when. But now you know what you are asking them for, and why — which usually makes for a much better conversation than simply saying you'd like to eat differently.

Please read this bit

If you take insulin or tablets for your diabetes, these changes will bring your blood sugar down. That's exactly what we want — but it also means your dose may need to come down, and ideally before you start rather than after.

So please mention to your doctor or diabetes nurse that you're planning to eat this way. The specialists who do this with patients properly always lower the medication first and let the levels run a little high for a while, rather than the other way round.

Two things to check with your nurse before you start. First — if any of your other tablets are dapagliflozin, empagliflozin, canagliflozin, Forxiga, Jardiance or Invokana, say so before you cut down on carbohydrate. Those tablets work by making you pass surplus sugar out in your urine. That means your reading can look perfectly normal while your body is actually short of fuel — and when it's short of fuel it starts breaking down fat in a way that turns the blood acidic. It's called ketoacidosis, it's serious, and the normal-looking reading is exactly why it gets missed. Second — ask whether you should have ketone strips at home, and what number to test at.

Never stop your insulin — least of all on a day you're ill or off your food. It feels logical to take less when you're not eating, but illness does the opposite of what you'd expect: your body releases stress hormones that push blood sugar up, so you often need more insulin on a sick day even while eating almost nothing. Stopping it is the single thing most likely to turn a bad day into a hospital admission. If you're being sick, can't keep fluids down, have tummy pain, are breathing heavily or feel very drowsy, ring your surgery or 111 the same day.

Change things gradually. Rather than cutting carbohydrate all at once, reduce it by about a third for the first two weeks and see what your readings do. That gives your dose time to be adjusted alongside it.

Test more often at the start — before each meal and before bed for the first two weeks, and any time you feel odd. Write the numbers down and take them to your next appointment.

Please don't stop or change any medicine on your own.

Two things worth asking at your next appointment

Both of these are reasonable things to ask, and knowing why you're asking makes the conversation a much better one.

  1. “Have my GAD antibodies and C-peptide been checked?” Two simple blood tests, and it's worth knowing what each one shows.

    GAD antibodies show whether your own immune system is attacking the cells in your pancreas that make insulin. If it is, that's Type 1 — and it can begin slowly in later life, which is why it is sometimes taken for Type 2 for years.

    C-peptide shows how much insulin you are still making yourself. Your body produces it in equal amounts alongside your own insulin, so measuring it is a way of counting what your pancreas is still managing to do.

    Together they answer the question your team is currently undecided about — and it matters practically, not just on paper. If you are still making a fair amount of your own insulin, there may be real room to reduce what you inject. If you are making very little, then insulin stays essential, and knowing that saves you chasing something that was never on offer. A scan cannot show any of this, because it happens at a level far too small to see. Ask for the actual numbers rather than “they were fine”.
  2. “I'm cutting down on carbohydrates — can we lower my insulin first?” You now know exactly why this is the right way round, so you can say so. Putting it as a plan rather than a vague question tends to get a far better response — it shows you understand what you are changing and what it affects.

The short version

Do

  • Eat enough. Eating too little is a bigger risk than eating too much, and it's the mistake most people make when they start.
  • Walk after your meals. Ten to fifteen minutes. The best single thing on this page.
  • Have a palm-sized piece of protein at every meal. It protects your muscles and your balance.
  • Eat the butter and the olive oil. Fat is what keeps you full and makes food taste of something.
  • Keep to three meals a day. Regular and predictable is what works best alongside insulin.
  • Tell your nurse or doctor that you're eating this way, before you start.
  • Keep something sugary within reach at all times, for a low.
  • Keep the things you enjoy. Good cheese, dark chocolate, a glass of wine with dinner.

Don't

  • Don't change or stop any medicine yourself. Ever, and especially not insulin. That conversation belongs with your nurse.
  • Don't skip meals to bring your numbers down. On insulin that's how you end up with a low.
  • Don't start any supplements you've seen online without asking first. Several of them lower blood sugar, which sounds helpful but can be genuinely dangerous alongside insulin.
  • Don't cut carbohydrates drastically overnight. Reduce by about a third and give it two weeks.
  • Don't drink alcohol on an empty stomach, and test before bed if you've had a drink.
  • Don't drink anything sweet — juice and squash are the easiest thing to miss. Except when treating a low, when they're exactly right.
  • Don't aim for perfect. Breakfast every morning matters far more than any single meal out.

Who says so

None of this is one person's opinion. It's the part a very wide range of specialists land on independently — and the notable thing is that they disagree with one another about almost everything else. Some are NHS doctors, some are university researchers, some are outsiders who fell out with the medical establishment entirely.

I checked this properly rather than assuming, and it's worth showing you honestly.

AdviceWho backs it
Cut sugar and refined starchAll eight — though Taylor gets there by cutting calories overall rather than carbohydrate specifically
Lose fat from around the liver and middleAll eight
Move after mealsMost of them. Taylor is the exception — he asks people not to increase exercise while actively losing weight
Keep an eye on an actual numberMost of them, in different ways
Plenty of proteinSome, not all. Hallberg says adequate but moderate; Fung and Taylor don't advocate it
Strength workSome. Fung calls exercise “overrated” for weight loss; Taylor discourages it during the weight-loss phase
Sleep as a leverAttia, Brecka, Berg and Fung. The others simply don't discuss it
Fasting or a set eating windowFung yes. Bernstein prefers three regular meals. Attia tried it and publicly stopped, because it cost him muscle

Two things are backed by every single one of them — and those two are the top of this page. Where they part company is further down the list, and I've been careful not to lean on anything in that lower group.

The protein advice is the one place this page deliberately goes beyond the full consensus. That's a considered choice: at your age, protecting muscle and balance matters enormously, and the specialists who disagree were mostly treating younger people trying to lose weight fast.

If you'd like to look any of them up, or mention them to your nurse:

Every one of them is a working doctor or researcher who has published their results. None of them is selling anything you need to buy.