Do You Know Your Macros?

Carbs aren’t the only nutrients that matter when you have diabetes.

Woman chopping vegetables while looking at a recipe on her laptop

Medically reviewed in October 2022

Updated on October 26, 2022

A healthy diet may be the most powerful tool you have to manage your diabetes. If you eat a balanced diet and pay attention to portion sizes at meals and snacks, you should see fewer spikes in your blood sugar.

For starters, it’s helpful to understand the main type of macronutrients—also known as macros—that constitute any diet: carbohydrates, protein, and fat. Dietary recommendations for people with diabetes mirror those for everyone else, with some key differences.

What to know about carbohydrates
Carbohydrates are the sugars, starches, and fiber found in foods. Your body transforms sugars and starches into glucose (also known as blood sugar) to give you energy. Fiber slows down that process, which helps the amount of glucose in your blood remain steady.

When you’re diagnosed with diabetes, your blood sugar levels are too high. Because the disease depends on so many factors and because every person is different, there’s no one recommended amount of carbs for everyone. Your medical team will help you determine what’s right for you.

Although carbs are often portrayed as forbidden, don’t worry: You won’t need to go on a low- or no-carb diet to control your diabetes. Instead, you’ll learn to focus on the type of carbs you eat.

Understanding the two main types of carbs
Carbohydrates come in two varieties, complex and simple. Complex carbs come from whole grains, starchy vegetables, and legumes.

Simple carbs are broken down quickly by the body. They appear in:

  • Foods with naturally occurring sugars, such as fruits, vegetables, and dairy products
  • Products that have added sugars, such as sweetened beverages and many processed foods, including bottled salad dressings

For people with diabetes, it’s particularly important to limit foods with those simple carbs, particularly refined carbs and added sugars.

If you use insulin at mealtime, your care team will help you learn how to count carbs—that is, to balance the amount of carbohydrates in a meal with the proper dose of insulin.

Protein is a key macronutrient
One of the main building blocks of the body, protein, is found in meat, fish, dairy products, nuts, and some complex carbohydrates. Scientists haven’t found any reason to restrict the amount of protein eaten by most people with diabetes. In fact, some research suggests that eating slightly more protein than usual may actually help people with type 2 to manage the disease. And the timing and pairing of protein may be key, too. Eating your protein before or along with complex carbs has been shown to help with post-meal glucose spikes. 

The one exception: If you have diabetic kidney disease, your recommended daily amount of protein will depend on your weight. Your medical team will advise you on the specifics.

When choosing protein, it’s advisable to select types that are lower in saturated fat. These include plant-based proteins (such as beans and legumes, nuts, and soy products like tofu), fish and seafood, skinless poultry, and low-fat dairy. Red meat and processed meats are often high in saturated fat, so it’s best to eat as little as possible or go for the leanest cuts you can find.

Some fat is beneficial
Our bodies need fat. It provides energy, helps us absorb certain vitamins, and helps insulate our bodies to keep us warm. Multiple studies have shown that a Mediterranean-style diet—rich in healthy fats from vegetables and fish—can improve your blood sugar control and your cholesterol levels.

What are these healthy fats?

  • Polyunsaturated fats, which can help lower total cholesterol levels, are found in foods such as walnuts and certain vegetable oils, including corn, soy, and sunflower oil.
  • Monounsaturated fats are arguably even better. They lower levels of the bad type of cholesterol, but not the good kind, and are found in foods including nuts and seeds, avocados, olives, and other types of oils, such as canola and olive oil. 

But too much of two types of fat can be harmful and can lead to cardiovascular disease, which is a particular risk for people with diabetes.

  • Saturated fats mostly come from meat, high-fat dairy products, and vegetable oils that are solid at room temperature. The American Heart Association recommends that people with and without diabetes should get about 5 to 6 percent of daily calories from saturated fats. For most of us, that’s about 13 grams per day. (A single slice of American cheese, for example, has 5 grams of saturated fat.)
  • Trans fats are made from vegetable oils by a process called hydrogenation and often appear in processed baked goods. They’re considered so unsafe that since January 1, 2021, food manufacturers have been forbidden to use them by the U.S. Food & Drug Administration. Some foods do contain naturally occurring trans fats, but usually in small amounts. It’s always important to read package labels carefully.

Watch your salt intake
Aside from adding flavor to food, sodium helps your body control its balance of fluids and keeps your muscles and nerves working properly. But too much can build up in your blood and lead to high blood pressure.

The American Heart Association recommends that you first work to limit your sodium to 2,300 milligrams per day, with the eventual goal being less than 1,500 milligrams per day. If you have hypertension as well as diabetes, your doctor may recommend a lower amount.
     
A note about calories
For overweight or obese people with diabetes, losing weight can lead to improvements in blood sugar levels, as well as in blood pressure and cholesterol. To achieve that, most people need to take in a net of 500 to 750 fewer calories a day, which equates to a weight loss of 1 to 1.5 pounds per week.

Your medical team will help you figure out a plan for calorie intake—as well as the right balance of macronutrients—that works for you and enables you to best manage your condition.

Article sources open article sources

American Heart Association. Saturated Fat. Published November 1, 2021.
Malaeb S, Bakker C, et al. High-Protein Diets for Treatment of Type 2 Diabetes Mellitus: A Systematic Review. Adv Nutr. 2019 Jul 1;10(4):621-633. 
Shukla AP, Iliescu RG, et al. Food Order Has a Significant Impact on Postprandial Glucose and Insulin Levels. Diabetes Care. 2015 Jul;38(7):e98-9. 
Joslin Diabetes. Carbs, Protein and Fats – Their Effect on Glucose Levels. July 8, 2021.
Ko GJ, Rhee CM, et al. The Effects of High-Protein Diets on Kidney Health and Longevity. J Am Soc Nephrol. 2020 Aug;31(8):1667-1679. 
Centers for Disease Control and Prevention. Losing Weight. Updated September 19, 2022.
USDA National Agricultural Library. I want to lose a pound of weight. How many calories do I need to burn? Accessed October 1, 2022.

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