Getting Real About Diabetes Food Advice

Updated February 5, 2016


Most diabetes food plans sound healthy. Eat vegetables, fruits, unsaturated fats, whole grains, nuts, fish, things like that. But is that advice realistic? Many people can’t afford, can’t find, or don’t like most of these foods. Then what?

I’m thinking about this because I’m writing a chapter on diabetes for a book called Where There Is No Doctor. It’s for lay health workers in poor countries. Diabetes is swamping their world, partly because of sugary foods coming in from the outside.

Even though new foods aren’t the whole story, we do need to address what people should be eating. The mainstream food advice given in rich countries may not apply there. (We’ll leave aside the question of how good that advice is.)

For example, in Southeast Asia, vegetables are easy to get. You can just pick them. But in drier places like most of Africa and Haiti, vegetables (except for some roots) are impossible to find.

Most people agree fish and nuts are good for people with diabetes, but they are often far too expensive for most readers of Where There Is No Doctor.

While thinking about this, I wondered how realistic this advice is for most of our readers here. Are you able to afford the recommended foods? Can you easily find them, prepare them, and enjoy them? What strategies for picking foods might work better for you?

Take fruit, for example. “Eat fruit” is great advice for well-off people in California, where I live. We can choose year-round from berries and melons and all kinds of fruits without too high a glycemic load. But berries and melons can be too expensive for many Californians.

For some people in other places, “fruit” means apples and oranges, if that. That’s all there is, or all they can afford. And apples can really rocket your blood glucose if you eat too much of them.

In some places, the only vegetables are frozen or canned, much of the year. There’s nothing wrong with those, but they might not be attractive or tasty to your family. What do you do?

Money is a big part of food choices, but dietitians and patients often don’t discuss it. The best food choice if you have $2 for today, and maybe nothing for tomorrow, is different from the best choice if you have twenty food dollars every day of your life. If you’re short of food and down to $2 in cash, spending your money on an organic apple would make no sense at all.

I wonder how practical barriers like money, preparation time, and food preferences affect your diabetes eating plan. If you can’t get or don’t want the variety of foods experts recommend, is there a diabetes-healthy way to eat more simply and cheaply?

The U.S. government has some advice for Americans at its site called They start with planning: make a budget, find recipes, make a shopping list, clip coupons, etc. They go on to more specific advice, but still leave many questions unanswered.

Nurse Practitioner Anita H. King answers some of these questions in this article. But for Where There Is No Doctor, we need more. It’s not like there are supermarkets full of good food everywhere.

Do you have suggestions? Any ideas might help. Advice from readers in other countries will be extra-appreciated.

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  • Cazza

    Eat insects. And offal. C.f. Man vs. Wild. Great for you.

  • Redneck Angel

    I read Ms.King’s article although she almost lost me in the second paragraph with: “…foods that are packed with nutrition can be both affordable and simple to prepare.” as one more example of party-line health professional advice from people who don’t have a clue but want to believe that if only we made a few simple changes, life (w/diabetes) would be great! Later she goes on to say; “Your entire family can participate(by switching to & buying..”lean meats or other low-fat sources of protein, whole grains and legumes, vegetables, fruits, and low-fat dairy products. Avoid concentrated sweets..”)&…” eating more nutritious foods..”. I guess she hasn’t heard about the experiments with ‘more nutritious’ menus in schools has gone? Kids bought or brought their own–even if lunch was only a candy bar & a soda! And yes, there would be plenty of ‘portion control’ as there won’t be enough money, no matter how carefully budgeted, to buy much.

  • Ferne

    I have difficulty eating because food doesn’t interest me and I’m not hungry. It’s no fun to cook and I find my self eating the same foods for so many meals. My husband does most of the cooking so trying to help him with choices is difficult and not much fun. He does like to try new recipes but then it’s not always the best for my blood sugar. So many foods that dieticians recommend raises my blood sugar and I have other issues of not being able to eat certain foods. Oh, life is interesting. At least I have my exercise taken care of, thanks to Jan.

  • Consuelo

    I did not read King’s article yet. But in regards to your chapter for the book, I would have to say that it is difficult to do so without knowing the broad range of food products available in those regions. Certainly it is always more difficult for the poor, especially in arid areas to have access to healthier food. But sometimes there are some wild plants, whose leaves, stalks, or roots may be eaten. They may have formed part of the diet at some time, but their consumption no longer widespread for many reasons, including a shift to more “modern” products. It may be that in some cases it is possible to encourage a come back of these types of foods.

    Of course, the real problems are the systemic faults that allow such poverty that prevents humans from nourishing themselves adequately and those that bring about illnesses such as diabetes because of the type of diet followed despite resources and level of education.

  • robbiedunc

    I have been able to reverse T2D that I have had for 15 years by avoiding all fruits and other glucose creating products like sugar and many vegetables. I have eliminated vegetable based oils and stick with saturated fats for eating and cooking; and I eat high fat proteins along with my leafy green veg. My A1c is down to below 5.5% from 7.5% and rising while my cholesterol levels are down into normal ranges. I have been taken off two or three diabetes drugs. I look for frozen veg as it tends to be cheaper, offal is great flavour (just make a bunch of pate from chicken livers) and it’s cheap – only $3 for enough liver to make two pots. Beef brisket is inexpensive and full of good fats while bacon and eggs is an inexpensive and satisfying meal at any time. I feel great and I certainly am not returning to the old way of eating.


    I can only speak to what’s available in my area, the upper Midwest. Eating smart means shopping smart, and sometimes making compromises. International shipping of fresh produce has really changed the game when it comes to availability. For example we are currently being offered a variety of “summer” produce originating in South America. So if you’re willing to ease up on the “buy local” mantra a bit you can expand your choices. However you have to be cautious, especially when your grocer buys produce on the “spot market” (i.e. getting it cheap when it’s nearing the end of it’s shelf life). You have to watch price *and* quality. Recently I laughed when they were selling cauliflower for $4.99 per head. It wasn’t organic, hand raised specialty food, either. Just plain old cauliflower. I didn’t buy. This week, there was a special, two heads for $2.99, and the quality was very good. These I bought. I know we’re encouraged to shop with a list and stick to it, but I also add the caveat, if it’s not good or priced right, don’t get it. On the other hand, if you spot a bargain, go for it. Some fresh fruits and veggies are almost always embarrassingly cheap. Celery, root vegetables, and surprisingly, bananas. Bananas are on the high glycemic side, but they are packed with protein, vitamins, minerals, and healthy fats at a fraction of the price of most other fruit. For example, apples are currently $1.99 per pound. Grapes, $2.09. Oranges, $1.50 EACH. But bananas run 39-49 cents per pound. And in any situation, buying fresh, whole produce is generally cheaper and far superior product to anything canned, frozen, or pre-cut. You do have to invest time and effort into preparation, but cooking your own food is a skill any diabetic will benefit from. And that’s just the produce isle. Don’t get me started on the over-priced, deceptively labeled mess that is the gourmet bakery section.

  • rita

    There is a free downloadable cookbook Good and Cheap where you can eat for $4.00 a day. Go to to download a copy.