What Should People with Diabetes Eat and Avoid? Nutritional Principles

For people with diabetes (type 2 diabetes), diet plays a role just as important as medication in controlling blood sugar. A well-balanced meal plan helps maintain stable blood sugar levels, prevents sudden spikes and drops, supports weight management, blood lipids, and blood pressure, thereby reducing the risk of long-term complications. The good news is that patients do not need to follow overly strict restrictions; the key is to eat the right foods, in the right amounts, and in the right combinations. Below are general nutritional principles commonly recommended for your reference.

Key nutritional principles

The core goal of nutrition for people with diabetes is to control carbohydrate and sugar intake while slowing down the rate of sugar absorption into the bloodstream. Here are several principles commonly recommended by experts:

• Prioritize foods with a low glycemic index (GI): this group releases glucose slowly, helping blood sugar rise more gradually and steadily after meals.
• Control carbohydrate portions: you don't necessarily have to completely cut out rice or noodles, but you should reduce the portion size and choose whole grain, minimally refined options.
• Eat enough fiber: green vegetables, beans, and whole grains slow down sugar absorption, promote a feeling of fullness, and support digestion.
• Divide meals into smaller portions: eat regularly and avoid letting yourself get overly hungry before eating a large meal, which helps prevent sharp blood sugar fluctuations.
• Balance protein – fat – carbohydrates: combine vegetables, lean protein, and carbs in the same meal to make the meal slower in terms of blood sugar impact.
• Eat in a reasonable sequence: many recommendations suggest eating vegetables and protein first, followed by rice/carbs, which can help reduce post-meal blood sugar spikes.

What to eat

People with diabetes should increase their intake of food groups that are rich in fiber, less likely to spike blood sugar, and good for cardiovascular health:

• Green vegetables and non-starchy vegetables: cabbage/greens, water spinach, broccoli, Malabar spinach, cucumber, tomato – high in fiber, low in calories, and should make up the majority of each meal portion.
• Whole grains: brown rice, oats, whole wheat bread – have a lower GI and are richer in fiber compared to white rice and white bread.
• Lean protein: fish (especially fatty fish like mackerel and salmon), skinless poultry, eggs, tofu – provide protein with minimal impact on blood sugar.
• Legumes and nuts: black beans, mung beans, lentils, almonds, walnuts – rich in fiber, plant-based protein, and healthy fats.
• Healthy fats: olive oil, vegetable oil, avocado – support cardiovascular health when consumed in moderation.
• Low-sugar fruits consumed whole: guava, apple, grapefruit, dragon fruit – should be eaten whole rather than juiced to retain fiber and limit rapidly absorbed sugars.

What to avoid / limit

Besides choosing good foods, patients should limit groups that easily cause rapid blood sugar spikes or are unfavorable for metabolism:

• Sugar and sweets: candies, sweet soups (chè), ice cream – contain refined sugar that causes blood sugar to spike.
• Soft drinks, bottled juices, boba milk tea: liquid sugar is absorbed very quickly; replace them with plain water or unsweetened tea.
• Refined carbohydrates: large amounts of white rice, white bread, pho noodles, rice vermicelli – portions should be reduced, with whole grain options prioritized.
• Fried foods and high saturated fat foods: deep-fried foods, animal fat, organ meats – unfavorable for cardiovascular health, which is a common complication in diabetic patients.
• Fast food and processed foods: sausages, instant noodles, canned goods – often high in salt, fat, and refined carbs.
• Alcohol and beer: can cause unpredictable blood sugar fluctuations; if consumed, limit strictly and consult a doctor.
• Very sweet fruits and dried fruits: such as durian, jackfruit, longan, raisins – should be eaten in small amounts and counted toward total daily carbohydrate intake.

Important notes

A dietary plan is only effective when paired with a suitable lifestyle and proper monitoring:

• Personalized diet: energy needs and carbohydrate intake vary depending on weight, activity level, medications, and underlying health conditions.
• Do not skip meals to save blood sugar: skipping meals can cause hypoglycemia (low blood sugar), especially when taking blood sugar-lowering medications or insulin.
• Combine with physical activity: walking and regular exercise help the body utilize glucose better and support weight management.
• Monitor blood sugar: track your body's reaction to different foods to adjust your menu accordingly.
• Read food labels: pay attention to sugar, carbohydrate, and sodium content on packaging before buying.
• Drink enough water: prioritize plain water and limit sugary beverages.

Frequently asked questions

Can people with diabetes eat rice?
Yes. Patients can still eat rice, but should control the portion size, prioritize brown rice or mix in whole grains, and pair it with plenty of vegetables and lean protein to slow blood sugar spikes. For specific amounts, consult a doctor or nutritionist.

Should sweet fruits be completely avoided?
Not necessarily completely avoided, but you should choose less sweet fruits, eat moderate amounts, eat them whole instead of juicing, and count them toward your daily total carbohydrate intake. Limit very sweet or dried varieties.

Should artificial sweeteners or diet sugar be used?
Low- or non-caloric sweeteners can be a substitute for sugar in certain cases, but they are not a magic solution. You should consult your doctor to use them appropriately and avoid overuse.

Health note: this article is for reference purposes only and DOES NOT replace medical advice. Diabetic patients should consult their treating physician or nutritionist to obtain a diet suited to their specific condition, medications, and underlying health conditions.

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