Diabetes - Type 2

This Food Fact Sheet explains how to manage type 2 diabetes through healthy eating, physical activity and blood glucose monitoring. It offers practical advice on balanced meals, carbohydrate intake, weight management and the potential for remission.

What is type 2 diabetes?

Diabetes is when glucose (the primary energy source for your body's cells) in your blood is too high. Type 2 diabetes happens because your pancreas doesn’t produce enough of the hormone insulin (that helps glucose enter body cells to be used) and/or the insulin that is produced does not work correctly (insulin resistance).

Why is it important to have control over your blood glucose?

If you have type 2 diabetes, nutrition and lifestyle support can help manage blood glucose which reduces your risk of complications. Diabetes education should be made available to you and you should ask your GP to see a registered dietitian.

How can you eat with this in mind?

For some people with type 2 diabetes, remission is possible. If you are living with overweight or obesity, and it is safe to do so, weight loss of approximately 15kg (33lbs), soon after diagnosis can put type 2 diabetes into remission. This does not mean you are ‘cured’ but it may reduce or remove medications for diabetes and mean there is a lower cardiovascular (heart and blood vessel) risk.      

If you have type 2 diabetes and are living with obesity or overweight, your GP or dietitian may recommend a very low-calorie diet. This is a proven treatment for type 2 diabetes remission for some people. It can involve a diet of soups and shakes of approximately 800 kcals a day. Speak with your registered dietitian and healthcare team to find out if this is suitable for you.

Over the years there have been many different diet suggestions for diabetes. However, a Mediterranean-style diet has the strongest evidence for improving blood glucose control and heart health. This includes:

• Reducing salt intake (less than 6g a day)
• Eating oily fish twice a week
• Increasing wholegrains, fruits and vegetables, fish, nuts and legumes (pulses)
• Reducing red and processed meats
• Reducing refined carbohydrates and sugar-sweetened beverages
• Replacing saturated fats with unsaturated fats
• Limiting alcohol to less than 14 units per week

If this is not suitable due to personal, cultural, or practical reasons, a registered dietitian can help tailor an individualised eating plan.

Foods labelled ‘suitable for people with diabetes’ have no special benefit for people with diabetes. Artificial sweeteners are safe and may be recommended as part of your usual healthy, balanced dietary pattern, especially if you are trying to reduce your intake of added sugars.

Which foods affect your blood glucose level?

All carbohydrates are broken down into glucose, which the body uses for energy. Starchy foods (such as bread, rice, pasta, yam, chapattis, potatoes and cereals), sugary foods and drinks all contain carbohydrates and can raise blood glucose levels in varying amounts. Fruit (fructose) and milk (lactose) also contain natural sugars. Dried fruit and fruit juices contain higher concentrations of sugar.

Spreading the amount of carbohydrates you eat evenly across the day and reducing portion sizes can help improve blood glucose control. When planning meals, consider reducing carbohydrates by increasing vegetables and protein.

Aim for a balanced plate:

• 1/4 carbohydrates (wholegrains where possible)
• 1/4 protein
• 1/2 vegetables

This reduces the effect on blood glucose levels. Some examples include:

• Chicken, rice and vegetables
• Ackee and Saltfish with baked plantain, avocado and tomato
• Paneer with 1 chapatti, raita and salad
• Egusi Soup with fufu, boiled green beans and spinach

If you’re considering a lower carbohydrate diet, speak to a registered dietitian or other healthcare professional first, as it may not be suitable or your medication may need adjusting.

The effect on blood glucose depends on:

• the amount and type of carbohydrate you’ve had
• physical activity levels
• how much insulin your body produces and uses
• diabetes medication
• alcohol intake
• emotional wellbeing

What are blood glucose targets?

Some people with type 2 diabetes use a blood glucose monitor or a continuous glucose monitor (CGM), most will have their HbA1c (a blood test measuring your average blood glucose levels) checked by their GP or practice nurse at least once a year.

A target HbA1c of 48mmol/mol or below is often recommended, but this should be agreed with your healthcare team. It may be higher if you experience low blood glucose levels or have other health conditions.

Does being active help  type 2 diabetes?

Being active is an important part of a healthy lifestyle and helps:

• Manage blood glucose by helping your insulin to work more effectively
• Reduce cholesterol and protect against heart-related problems
• Reduce and manage weight
• Support your mental wellbeing

• You should aim for 150 minutes of moderate activity (such as brisk walking, cycling, or dancing) or 75 minutes of vigorous activity (like running, swimming, or sports) each week. Include strengthening exercises that work all major muscle groups (e.g. yoga, Pilates, or weights) twice a week. Short bursts of movement have been shown to help lower blood sugar- try 10–15 minutes of activity after meals.Choose activities that fit your lifestyle, as this makes it easier to maintain a routine.

Top tips

• Blood glucose management helps reduces the risk of complications.
• If you are living with overweight or obesity, losing weight is the most important thing you can do.
• Type 2 diabetes remission may be possible with weight loss.
• A Mediterranean-style diet has the strongest evidence for glucose control and heart health.
• Aim for at least 150 minutes of moderate activity a week.
• Working with a dietitian can support sustainable lifestyle, diet and activity changes.