Staying well hydrated is important for maintaining good health and wellness. But for those who have diabetes — a chronic condition in which your blood sugars are too high — there are certain dietary changes you’ll need to make that can limit your choices of what to drink.
“Having diabetes means you need to try to eat a healthy, balanced diet. If you don’t, then the medications don’t work as well as they could, and you may need more medications,” says Dr. Kathleen Wyne, an endocrinologist at the Ohio State University Wexner Medical Center in Columbus.
A Diabetes-Friendly Diet
With both types of diabetes, regulating what you eat and drink is an important part of the health-maintenance equation.
The focus should be on healthy eating and portion control.
“Healthy eating means avoiding high-fat meals, such as fried foods, concentrated sweets and animal fats,” says Wyne. And portion control means eating smaller amounts.
Overall, people with diabetes should be looking to:
— Monitor portion size.
— Eat less fast food.
— Cook at home more often so they can manage what they’re eating and keep portion sizes in check.
— Manage the ratio of fat, carbohydrates and protein in their diet.
— Limit salt intake.
— Limit intake of added sugars.
[SEE: Can You Reverse Type 2 Diabetes?]
Why Sugary Drinks Are Especially Harmful
The American Diabetes Association recommends zero-calorie or low-calorie drinks. The main reason is to prevent a spike in blood sugar.
“In the long term the spikes in glucose from the simple sugars play a key role in developing the complications such as heart disease, stroke, kidney disease, eye disease and nerve damage,” Wyne says.
The challenge with drinking beverages that contain high levels of sugar is the speed with which those sugars enter the bloodstream and the spikes they can cause. Liquids are broken down by the digestive system quickly — faster than food — and the sugars contained in sugary coffees, energy drinks or regular sodas find their way into your bloodstream very quickly. Drinking such beverages with food can help slow their ability to enter the bloodstream and give your body time to catch up in processing the sugars, but you still have to think about the overall total carbohydrates you’re ingesting.
“You should avoid sugared drinks because they cause a rapid rise in the blood glucose level,” Wyne says. “This can lead to dehydration and, possibly, to diabetic ketoacidosis,” a dangerous condition that occurs when blood sugar levels soar, causing the body to use fat for fuel. When fat burns, that creates a byproduct called ketones. These ketones build up in the blood, and if left untreated, they can become fatal.
The key is to opt for beverages that don’t contain added sugar and to limit your intake of natural sugars. You have to take care to limit your intake of such sweet drinks, “even juices that are 100% from fruits,” says Dr. Richard Seidman, chief medical officer of L.A. Care Health Plan, the largest publicly operated health plan in the U.S. “They’re high in fast-acting carbohydrates much like sugars, and a cup of soda or juice will have the equivalent of six teaspoons of sugar.”
Staying away from any sugary beverage such as cola, ginger ale, sweet tea and lemonade is key, agrees Jill Weisenberger, a Virginia-based registered dietitian nutritionist and author of “Prediabetes: A Complete Guide” and “Diabetes Weight Loss: Week by Week.”
“It doesn’t offer much in the way of nutrition other than hydration,” she says. “It’s high in calories, high in carbohydrates and jacks up blood sugar.”
And while diet sodas don’t contain calories or sugar, they have been linked to increased risk of obesity and heart disease in some studies. Certainly, they’re a better option than their high-sugar counterparts, but you should still be seeking to limit your intake of diet sodas.
In short, avoid or limit these drinks if you have diabetes:
— Sodas
— Fruit juices.
— Sweetened and flavored coffees and teas.
[Read: Foods and Drinks Linked to Anxiety.]
The Best Drinks for Diabetes
Water
Your best bet for staying hydrated throughout the day, Seidman says, is by sipping plain water. But not everyone enjoys the taste of tap or bottled water, and it may seem boring sometimes.
If plain water doesn’t do it for you, why not reach for mineral or seltzer water? The bubbles are fun and some varieties contain sugar-free flavors that add no calories, just a fruity taste. Just check the label first, as some brands can contain higher levels of sodium than others.
A simple mix of plain water with a slice or two of citrus, a couple of muddled berries or mint leaves can be a lot tastier and inviting without adding too much sugar or many calories. You could also add basil, lavender or cucumber, Weisenberger says, or give ginger water a try.
Unsweetened herbal tea
The world is your oyster when it comes to herbal teas. Steeping a cup of hot or iced herbal tea adds lots of flavor to water and provides excellent hydration with no sugar or calories. Best to make your own at home to ensure it’s sugar-free. Or try ginger tea.
Plain coffee or black or green tea
In their unadulterated states, coffee and tea are calorie-free and generally get the green light for inclusion in a healthy diet, though you do need to be aware of their caffeine content.
“Caffeine is OK in moderation,” Wyne says. “The key is not to drink so much that you get dehydrated.” And don’t put a lot of milk, cream or sugar in any of these, rather use just a tiny splash of skim milk and skip the sugar entirely. “People tend to forget about this when they order coffee drinks at coffee shops,” Wyne says. Ordering those flavored and specialty coffees can mean a mega-dose of sugar and calories.
Functional beverages
There is a new trend emerging with beverages that provide more than hydration or wet your palate. Functional beverages are available to help with gut health, immunity or blood sugar regulation.
GOOD IDEA is a flavored sparkling water that has been formulated with amino acids and chromium picolinate, a mineral that helps insulin do its job in your body. Like most other sparkling waters, GOOD IDEA is a 0 calorie, 0 carbohydrate drink but with a potential health advantage for people with diabetes. Clinical trials show drinking GOOD IDEA with food reduces after meal blood sugar by an average of 25%.
[READ: Best Snacks for Diabetics.]
Drinks to Have in Moderation
The following drinks contain carbohydrates, so remember to count them toward your daily carb intake.
Low-fat milk
A glass or two of low-fat milk each day is generally considered a safe option for people with diabetes because the fat and protein in the milk helps offset the rate at which the sugars in it are absorbed. Low-fat dairy products are a good source of vitamin D and calcium, which are important nutrients that should be part of any healthy diet.
Keep in mind that a cup of milk will contain about 12 grams of carbohydrate, so this will need to be calculated into your carb allotment.
Smoothies
Smoothies can be delicious and packed with nutrients and immunity-boosting good stuff, but they can also contain a lot of calories and natural sugars from the fruit. Just be mindful of how much you’re drinking and your overall daily calorie and carbohydrate counts.
Smoothies can also be an excellent way to squeeze some extra fiber into your diet while staying hydrated.
Weisenberger warns against gulping smoothies down in place of solid food: “People tend to drink them faster than they would a meal, so the blood sugar addition is more of a spike,” she says. For an adult with Type 2 diabetes who wants healthy smoothies, she says, “pick wholesome ingredients. Make the base a nonfat, Greek yogurt or nonfat cottage cheese.”
Berries are a good fruit choice, she adds, and using frozen fruit lets you get more flavor by avoiding dilution from ice.
Soup
Soups that are broths contain a lot of water and can be low-carb, nutritious and delicious. Chicken soup with low-sodium chicken broth, or vegetable soups such as split pea, minestrone or bean are among the many options for people with diabetes. Please note, they will contain and vary in the amount of carbohydrate.
Tomato or vegetable juice
Tomato juice is nutrient-rich but does contain some carbohydrate, so you will need to watch your portion size. A one-cup serving of tomato juice contains 9 grams of carb. Tomato juice is high in sodium but Weisenberg suggests you can opt for a lower-sodium version or mix regular and low-sodium tomato juice for a bit more taste.
Drinking Alcohol and Diabetes
Though alcohol is OK for people with diabetes to drink, it must be consumed in moderation because it contains a lot of calories. “Alcohol can have a mild effect to lower glucose, but that’s often more than offset by the carbs in the drink,” Wyne says.
“Contrary to popular belief, alcohol itself does not turn to sugar but it will have a delayed effect on the stability of your blood sugar levels,” Seidman adds. Because of this effect, “drinking alcoholic beverages may increase the risk of having a low blood sugar later on for some people, especially if they take insulin or other glucose lowering medications.” Therefore, he says “it’s important to discuss the risk of alcohol and low blood sugar with your health care provider.”
Wyne notes that you “should never take a dose of insulin for the calculated carbs in the drink because of this offset of the alcohol on the liver that can lower the glucose level.” Also, if you’re planning to drink hard alcohol, such as shots of tequila or martinis, “then I recommend eating before going out,” she says, as the food in the stomach will help absorb some of the alcohol and slow the release of sugars into the blood stream.
Weisenberger adds these cautions for those with diabetes: “People will often mix alcohol with very high-caloric and high-carbohydrate juices and sodas. Also, whenever we drink, we loosen up some and lose some of our inhibitions, so we’re most likely to overeat.”
What’s more worrisome, depending on your medications, Weisenberger emphasizes, “is when high alcohol intake — or even just average alcohol intake for some people with diabetes — can cause low blood sugar,” particularly several hours after you’ve had a lot to drink in the evening. “You can have a low blood sugar in the middle of the night and not be aware.”
If you’ve recently been diagnosed with diabetes, be sure to speak with your doctor about recommended dietary changes. Seidman also recommends working with a registered dietitian to make sure you’re getting adequate nutrition and eating right for your situation.
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What to Drink If You Have Diabetes originally appeared on usnews.com
Update 10/10/23: This story was previously published at an earlier date and has been updated with new information.
