Diabetes diet myths, busted

Diabetes can be a tricky condition to understand and manage, especially because there’s no one-size-fits-all treatment plan. At the same time, diet plays an important role in managing diabetes for everyone with the condition. That’s because a healthy eating plan is key to keeping blood sugar levels in check.

Unfortunately, there are a lot of myths and misconceptions floating around about the “right” way to eat when you have diabetes. It can be confusing at best and misery-making at worst.

“The most common myth is that there is a ‘diabetes diet’ — but there is no such thing,” says Lucille Hughes, D.N.P. She’s the director of the diabetes education program at Mount Sinai South Nassau in Oceanside, New York. “It’s a matter of eating to promote health and teaching people how to mindfully count carbohydrates. We all should eat that way.”

Indeed, when a panel of experts reviewed several healthy eating plans, they concluded that all of them could help people manage diabetes. (The list of diets they looked at included the Mediterranean diet, vegetarian and vegan diets, low-fat and low-carb approaches, and Paleo and DASH plans.) The report also highlighted a few eating habits the plans have in common that do help manage diabetes:

• They emphasize non-starchy vegetables and whole foods over highly processed foods
• They minimize added sugars and refined grains (like white flour, white rice and white bread).¹ 

Let’s take a closer look at the most common and stubborn diet myths related to the condition — and the truth behind them. This can help make eating easier and more enjoyable when you have diabetes.

Myth: Consuming sugary foods and drinks causes diabetes

Fact: If you develop diabetes, it’s likely that your body is naturally inclined toward it in some way. “Type 2 diabetes is hereditary,” Hughes says. “So someone is born with the predisposition. And somewhere along the way, something causes that gene to wake up and cause diabetes.” Getting older and being overweight, for instance, are two factors that raise a predisposed person’s risk of developing diabetes.

Myth: All carbohydrates are off-limits if you have diabetes

Fact: Eliminating carbs would mean no nutrient-rich fruits and vegetables. That’s not in the best interest of your health. “Carbohydrates are the key source of energy for our bodies. So we don’t want to eliminate them,” Hughes says. “What matters is how many carbohydrates you have at each meal and what a serving size looks like.”
The amount of carbohydrates that’s right for you depends on a few things, including:

• Your body type
• The type of diabetes you have
• Your age
• Your level of physical activity
• The medications you’re taking

Myth: You can never eat dessert again

Fact: Yes, you can. “The key is to plan for it,” Hughes says. One way might be to avoid starchy carbs with your dinner and save those carbs for dessert.

Myth: Fruit is bad for diabetes

Fact: All fruits are made mostly of carbohydrates, and for that reason, they can be tricky for some people with diabetes. But eating fruit is still doable.

“For some people, fruit can raise blood sugar quickly,” Hughes says. That’s why experts tend to tell people with diabetes to avoid fruit juices, she says — unless it’s needed to treat very low blood sugar. Otherwise, fruit can be enjoyed in a portion-controlled fashion. Ideally, it should be paired with a source of protein (such as a hard-boiled egg) or fat (such as nuts) to slow the rise in blood sugar.

Myth: Alcohol is a no-go if you have diabetes

Fact: As long as you plan for alcohol and enjoy it carefully, it can still be part of your lifestyle. It’s best to have that glass of wine, beer or cocktail with food. That helps reduce the risk of low blood sugar, Hughes says. The American Diabetes Association also cautions that drinking alcohol while taking certain medications (such as insulin or sulfonylureas) can result in low blood sugar. This is especially the case on an empty stomach. Talk with your doctor about the best way to drink alcohol safely.²

Myth: You can eat as much protein and fat as you’d like

Fact: “Nobody can eat as much protein and fat as they want,” Hughes says. Like all foods, proteins and fats have calories. There are four calories per gram in protein, and nine calories per gram in fat. Eating too much of either one could lead to gaining unwanted pounds. That wouldn’t be good for managing your diabetes.

Myth: Artificial sweeteners don’t affect blood sugar

Fact: It depends on the artificial sweetener or sugar alcohol. (Sugar alcohols are used in some low-calorie sweeteners.) “Some sugar alcohols can affect blood sugar and also cause gas, bloating and diarrhea,” Hughes says. But others may not. Your doctor can help you figure out which sweeteners are best for you. And be sure to consider the actual nutritional content of the food with the artificial sweetener in it, Hughes adds. “The number of carbs in the item is more important than the source of the sugar.”

Myth: If you’re taking diabetes medication, you can eat whatever you want

Fact: “It’s not an all-or-nothing thing,” Hughes says. “The meal plan is important and should be centered around the patient and the medications they’re taking.” In other words, it’s best to tailor your diet to your personal health status and medications.

The bottom line

Yes, there are some general diet guidelines that are good to follow for all people with diabetes. But ultimately, the best way to eat when you have diabetes is to figure out what’s right for you and go with that. If that feels overwhelming, remember: You don’t have to find the answers on your own. Your doctor and diabetes care team are there to help guide you throughout your journey to good health.

¹Evert AB, Dennison M, Gardner CD, et al. Nutrition therapy for adults with diabetes or prediabetes: a consensus report. American Diabetes Association, Diabetes Care, May 2019, 42(5): 731-754.

²American Diabetes Association. Alcohol & diabetes. Accessed June 13, 2022.