“My dad was diagnosed with type 2 diabetes 15 years ago,” says Vancouver-based dietitian Joy Zhuang. “As a grumpy Chinese father, he wouldn’t listen to his own daughter’s suggestions—until I became a certified diabetes educator. Now my suggestions are accompanied with a playful ‘I told you so!’” Zhuang’s food-based tips may not sound revolutionary or even surprising (eat your veggies, Dad!). What is surprising is how immediately and powerfully food affects our bodies. A diet high in fruits and vegetables, whole grains, nuts, soy, and legumes has a direct, measurable effect on glucose levels and insulin production. Current research suggests that plant-based or vegan dietary patterns can improve blood sugar, body weight, and blood lipids. Adding low glycemic index (GI) veggies and pulses (beans, lentils, and peas) also reduces the risk of heart attack—particularly in adults living with type 2 diabetes. Take soybeans, for example. They’re a common, versatile, and relatively inexpensive protein substitution. They’re also high in lysine, leucine, isoleucine, phenylalanine, calcium, and phosphate, all of which have been shown to help increase glycemic control and insulin sensitivity. Dietitian Ann Besner, senior manager of Diabetes Canada’s PAD (People Affected by Diabetes) Program, says plant-based diets can be higher in protein and fibre and lower in saturated fat than the average diet. “This type of diet has been shown to contribute to better blood sugar management and decreased body weight and blood fats, and lower risk of incidents related to coronary heart disease.” Before we dive into the reasons a plant-based dietary pattern (not a strict diet) can be a healthier way to manage diabetes, let’s uncover the silent stigma.
The shame that shrouds diabetes
Diabetes isn’t caused by a “bad diet,” eating too many sweets, or consuming too much food.
“Type 2 diabetes, in particular, is often shrouded in guilt and shame because it’s perceived to be a condition that is avoidable,” says Besner. “Because it is often connected with overweight or obesity, people with diabetes may be blamed for the condition (‘if only you ate less and moved more, you could have avoided developing diabetes’). This is not the case.”
Unhealthy eating doesn’t cause diabetes, but it can worsen the symptoms and progression of the disease.
Knowing the signs
Discovery is a crucial first step. About 1.7 million Canadians live with type 2 diabetes and don’t even know it.
People who are asymptomatic, haven’t followed up on symptoms (which can include frequent urination, blurry vision, and extreme thirst), or don’t often use the health care system may not get a diagnosis until they’ve had it for years. This may mean they need more intensive treatments than if the disease had been caught earlier.
Getting the right care
“Because different people experience diabetes differently, it’s critical that management be individualized,” says Besner. “Diets, physical activity regimens, and medications—either alone or in combination—should be customized to each person. Medical history, treatment goals, food preferences, finances, employment, and/or school situation all need to be taken into account.”
Diabetes is a progressive condition, which means that treatment plans should evolve along with the disease. Behavioural modifications such as a plant-based diet may help with blood sugar control at first, but eventually more extensive treatments such as blood glucose monitoring or medication may become necessary.
What difference do plants make?
The increased soluble fibre in many plant-based foods such as Brussels sprouts, black beans, and root vegetables can slow carbohydrate absorption and bind glucose. This slower rate of absorption helps stabilize blood sugars.
In contrast, high amounts of refined sugar and carbohydrates spike glucose and cause the pancreas to produce extra insulin. Some of the extra glucose may be converted into triglycerides in the liver, and the fat may be shipped to the tissues.
Vegan or vegetarian diets are also typically higher in pulses such as barley, buckwheat, and quinoa. The high magnesium content of these whole grains helps regulate glucose, improves insulin sensitivity, and controls energy metabolism.
Finally, vegetarians and vegans tend to consume fewer saturated fats. Replacing these fats with high quality polyunsaturated fatty acids can increase insulin sensitivity and decrease the risk of type 2 diabetes. Since many meats contain more fat and calories, they may increase the risk of diabetes. In fact, some research suggests that red meat should be included in the list of diabetes risk factors.
But remember—“vegetarian” doesn’t always mean “healthy”
While a plant-based diet pattern is often higher in fibre, vitamins, and nutrients, it doesn’t guarantee weight loss or stable blood sugar levels. Even the cleanest, greenest prepackaged vegan or vegetarian foods can contain added sugars, fats, and refined grains.
Keep your eye on nutrition labels when you buy food—especially if diabetes runs in your family and you aren’t related to a diabetes expert like Joy Zhuang.
Laurie Pawlik-Kienlen is a freelance writer in Vancouver.
The healing power of plants
A vegetarian diet has been shown in some studies to be more beneficial in improving diabetes symptoms than traditional medication.
Supplements to support healthy blood sugar
- protein
- magnesium
- peppermint
- pharmaGABA
- quercetin
The type and amount of supplemental support depend on your health, eating patterns, and lifestyle. Since supplements can interact with medications, it’s important to create an individualized plan with your health care practitioner.
Nutty butters and veggie milkshakes
Eating enough protein is a concern for many new vegans. However, most of us eat far more protein than our body requires. Good sources of plant-based proteins include nuts, seeds, and most of their butters (such as cashew, tahini, almond, and Brazil) and vegetable milks (try soya, almond, and hempseed).
Diabetes definitions
Type 1 (insulin-dependent) diabetes is an autoimmune disease that generally develops in childhood or adolescence. The body can’t produce insulin and thus can’t regulate blood sugar. Insulin injections or an insulin pump is necessary to ensure the body has the right amount of insulin.
Roughly 10 percent of people with diabetes have type 1.
Type 2 diabetes, most commonly developed in adulthood, occurs when the body can’t properly use its own insulin—or not enough insulin is produced. Type 2 diabetes can sometimes be managed with healthy eating and regular exercise alone, but may also require medications or insulin therapy.
About 90 percent of people living with diabetes have type 2.
Laurie Pawlik-Kienlen is a full-time Vancouver-based freelance writer, alive contributor, and the author of Growing Forward When You Can’t Go Back (Baker House Publishing, January 2019).
Stephanie MacDonald
Heidi Fritz, MA, ND
Carime Lane
Joshua Duvauchelle