Eating well for Type 2 diabetes

What are the symptoms?

Symptoms of diabetes may include:

• increased thirst
• increased urination
• headaches
• blurred vision.

Am I at risk?

There is no relationship between having coeliac diseaseA condition where a person is unable to eat gluten as it makes their body attack itself. and developing Type 2 diabetes.

Type 2 diabetes has a strong genetic link and some people are more at risk of developing Type 2 diabetes.  You are more likely to develop Type 2 diabetes if you: 

• are overweight
• have high blood pressure of if you’ve had a heart attack or stroke
• have a close family member (parent, brother, sister) who has Type 2 diabetes
• had diabetes when you were pregnant (gestational diabetes).

What is the treatment?

Diet and lifestyle measures may be enough to control Type 2 diabetes.  Some people may also need to take medication.

What should I eat?

The diet for those with Type 2 diabetes follows the same healthy eating guidelines as recommended for the general population.  This also applies to people with coeliac disease.

The most important thing is to continue on your gluten-freeWhen a food has less than 20 parts per million (ppm) of gluten so it is safe for people with coeliac disease to eat. diet whilst choosing foods that are low in fat (especially saturated fat), high in fibre, with plenty of starchy foods, fruits, vegetables and pulses.  Evidence suggests that glutenA protein that is found in the cereals wheat, barley and rye. free breads have the same effect on blood glucose as the gluten-containing varieties.

Ten top diet tips for managing both conditions

1. Eat three meals a day.  Eat something at breakfast, lunch and dinner and try not to skip meals.  This will help control your appetite and your blood glucose levels.

2. Include gluten-free starchy carbohydrate foods at each meal.  Those highlighted in bold have a low glycaemic index and can help with blood glucose control:

• gluten-free breads (especially multigrain / seeded varieties), pasta and crackers
• naturally gluten-free grains such as rice (all types), rice noodles, polenta (cornmeal), buckwheat, millet, quinoa
• starchy vegetables such as new potatoes, sweet potatoes, yams, cassava (tapioca), plantains
• breakfast cereals (listed in the Food and Drink DirectoryOur annual Directory of gluten-free food and drink which manufacturers voluntarily submit to. ), buckwheat flakes.

The amount of carbohydrate you eat is important to control your blood glucose levels and will also depend on your age, weight and activity levels.

Choose high fibre varieties of starchy foods such as gluten-free wholegrain cereals, including brown rice, breakfast cereals and buckwheat flakes.  Several gluten-free pastas and breads now have added fibre.

3. Cut down on the amount of fat you eat, particularly saturated fats.  Fat is the greatest source of calories, so eating less fat will help you lose weight if you need to.

• Use less saturated fat by having less butter, margarine, cheese and fatty meats.
• Choose lower fat dairy foods such as skimmed or semi-skimmed milk, low fat or diet yoghurts (avoid those with fibre), reduced fat cheese and lower fat spreads.
• Grill, steam or oven bake instead of frying or cooking with oil or other fats.
• Swap creamy sauces and dressings for gluten-free tomato based sauces instead.

4. Eat more fruit and vegetables.  All fresh, frozen, canned and dried fruits are naturally gluten-free.  Aim to eat at least five portions a day.  One portion is a banana, an apple, a slice of melon, two plums, a handful of grapes, a tablespoon of dried fruit, a small glass of fruit juice, three heaped tablespoons of vegetables or a cereal bowl of salad.

5. Include more pulses (peas, beans and lentils) – these are naturally gluten-free.  Try adding them to stews, casseroles, soups and salads.

6. Eat more fish – all plain fish is naturally gluten-free.  Oily fish such as mackerel, sardines, salmon and pilchards, can help keep your heart healthy – talk to your healthcare team about how much you should eat.

7. Limit sugar and sugary foods. Eating sugar is not forbidden when you have diabetes, but constantly eating or drinking foods and drinks that are high in sugar does not help blood glucose control.  Choosing sugar-free, no added sugar or diet squashes/fizzy drinks can be an easy way to reduce the sugar in your diet. 

8. Reduce salt in your diet.  We should all aim to have 6g or less of salt each day.  More than this can raise blood pressure, which can lead to stroke and heart disease.  Reduce the amount of processed foods you eat as these are usually high in salt.  Try flavouring foods with herbs, spices, ground pepper and Worcestershire sauce which are all gluten-free.

9. Drink alcohol in moderation. Wine, spirits, cider, sherry, port, liqueurs and gluten-free beers are suitable. Beers, lagers, stouts and ales need to be avoided.   Remember alcohol can add extra calories.  Never drink on an empty stomach, as alcohol can make hypoglycaemia (low blood glucose levels) more likely to occur when taking certain diabetes medication and/or insulin.

10. Avoid diabetic food and drinks – they are often expensive, contain just as much fat and calories as ordinary versions, can have a laxative effect and will still affect your blood glucose levels. 

Regular activity also helps to control blood glucose levels, as well as body weight.  If you have been inactive for a period of time or are thinking of trying a new activity, it would be worth checking with your doctor beforehand.  Simple changes such as taking the stairs rather than the lift or escalator, or getting off the bus one stop earlier and walking the rest of the way home, gardening and doing the housework are all ways in which you can increase your activity level each day.

Your dietitianAn expert in food and nutrition. can provide you with individual support in maintaining a gluten-free diet, along with sensible eating advice for helping to control your blood glucose and weight control.