Are You Ready to Try a Plant-Based Diet?

The benefits are many, particularly for people with diabetes.

Bowl filled with spinach, romaine, chickpeas, carrots, quinoa, kidney beans and kale.

Medically reviewed in November 2022

Updated on November 1, 2022

If you’ve read anything about healthy eating plans for people with diabetes, you’ve probably seen the term “plant-based diet.” But what does it mean?

It’s simple: It means the lion’s share of your plate features vegetables, legumes, beans, fruit, and whole grains.

Here’s what you need to know about a variety of plant-based diet options and how they might work for you as part of your diabetes care plan.

You have options
If you’re curious about following a plant-based diet, there are several types to choose from, all of which will help you manage your diabetes:

  • Vegans eliminate animal products completely; their diets are 100 percent plant-based.
  • Lacto-ovo vegetarians eat eggs and dairy products, but no meat, fish, or poultry.
  • Pescatarians give up meat and poultry but still eat fish.
  • Semi-vegetarians, or flexitarians, still eat animal products, but only in small amounts. Both the Mediterranean diet and the DASH (Dietary Approaches to Stop Hypertension) diet qualify as semi-vegetarian and are recommended by the American Diabetes Association and highlighted in the USDA’s Dietary Guidelines for Americans 2020-2025.

Plant-based diets offer benefits
Switching to a balanced, plant-based diet changes the mix of nutrients you consume every day. This should help your overall health and your diabetes in several ways.

For one thing, vegetarian and vegan diets are naturally high in fiber, which helps lower blood sugars and decreases the need for prescription medications for people with type 2 diabetes. Some research has found that these diets are even more effective for controlling blood glucose than counting carbohydrates, a traditional approach for people taking insulin.

You’ll also likely be eating fewer animal products, a major source of saturated fat, which increases your risk of cardiovascular disease. Reducing or eliminating saturated fat is associated with lower blood pressure and cholesterol levels.

People who follow vegetarian diets tend to eat fewer overall calories than meat-eaters do, as well. In studies that compare vegetarian or vegan diets to conventional diabetic diets, participants on the plant-based diets often lose more weight.

There are potential downsides to consider
Plant-based diets can increase your risk of deficiency for a few important nutrients.

Vitamin B12 is found mostly in animal products. Though it’s present in some dairy items, fermented beans and vegetables, certain mushrooms, and other plant-based foods, B12 deficiency among vegetarians and vegans is common. If your healthcare provider (HCP) has prescribed you metformin, you’re already at risk of a B12 deficiency, as the drug reduces levels of the vitamin. Among other issues, B12 deficiency may cause mental and visual disturbances, as well as mouth ulcers and problems with motor control.

Omega-3 fatty acid intake tends to be lower in vegetarians and vegans than in people who eat more animal products, but omega-3 fatty acids offer several protections to people with diabetes. They lower risk of cardiovascular disease and retinopathy and improve kidney function. Your HCP may recommend that you take a vegetarian-friendly, algae-based omega-3 supplement to make up for your reduced intake.

Iron, vitamin D, and calcium deficiencies are also common among vegetarians and vegans, but their effect on diabetes specifically isn’t clear. Talk to your HCP or dietitian about whether you need to take supplements.

Despite some potential dietary deficiencies that can be managed with supplements, a plant-based diet can help you control your diabetes and could even prevent complications.

Article sources open article sources

Harvard Health Publishing. Is a vegetarian or vegan diet for you? April 12, 2014.
American Diabetes Association. 4. Lifestyle Management: Standards of Medical Care in Diabetes—2018. Diabetes Care 2018;41(Supplement_1):S38–S50.
Benson G, Hayes J. An update on the Mediterranean, vegetarian, and DASH eating patterns in people with type 2 diabetes. Diabetes Spectr. 2020;33(2):125-132.
U.S. Department of Health and Human Services, U.S. Department of Agriculture. Dietary Guidelines for Americans 2015–2020. 8th ed. Last updated August 24, 2021.
U.S. Department of Health and Human Services, U.S. Department of Agriculture. Dietary Guidelines for Americans 2020–2025. December 2020.
McMacken M, Shah S. A plant-based diet for the prevention and treatment of type 2 diabetes. J Geriatr Cardiol. 2017;14(5):342-354. 
Barnard ND, Cohen J, et al. A low-fat vegan diet improves glycemic control and cardiovascular risk factors in a randomized clinical trial in individuals with type 2 diabetes. Diabetes Care. 2006;29(8):1777-83. 
Barnard ND, Katcher HI, et al. Vegetarian and vegan diets in type 2 diabetes management. Nutr Rev. 2009;67(5):255-63.
Pavitasari A, Farapti F, et al. Fiber Intake and Vegan Lifestyle Behaviour on Blood Glucose Control in Type 2 Diabetes Mellitus Patients: A Case-Control Study. Curr Diabetes Rev. 2022 Aug 10. Epub ahead of print.
Yokoyama Y, Nishimura K, et al. Vegetarian diets and blood pressure: a meta-analysis. JAMA Intern Med. 2014;174(4):577-587.
MedlinePlus. Vegetarian diet. Reviewed October 10, 2020.
Pawlak R. Vegetarian diets in the prevention and management of diabetes and Its complications. Diabetes Spectr. 2017;30(2):82–88.
Kahleova H, Matoulek M, et al. Vegetarian diet improves insulin resistance and oxidative stress markers more than conventional diet in subjects with type 2 diabetes. Diabet Med. 2011;28(5):549-559.
Kim J, Ahn CW, et al. Association between metformin dose and vitamin B12 deficiency in patients with type 2 diabetes. Medicine (Baltimore). 2019;98(46):e17918.
European Association for the Study of Obesity. Vegan diets boost weight loss, lower blood sugar in adults with overweight or type 2 diabetes. ScienceDaily. ScienceDaily, 7 May 2022.
Rizzo G, Laganà AS, et al. Vitamin B12 among Vegetarians: Status, Assessment and Supplementation. Nutrients. 2016 Nov 29;8(12):767. 
Chapman LE, Darling AL, Brown JE. Association between metformin and vitamin B12 deficiency in patients with type 2 diabetes: A systematic review and meta-analysis. November 2016. 42(5): Pages 316-327.
Watanabe F, Yabuta Y, et al. Vitamin B12-containing plant food sources for vegetarians. Nutrients. 2014 May 5;6(5):1861-73. 
Gov.UK. Metformin and reduced vitamin B12 levels: new advice for monitoring patients at risk. Published June 20, 2022.

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