Myth or Fact: Diabetes Nutrition, According to a Registered Dietitian

Ahead of the launch of The Educated Kitchen, a new series that will feature different registered dietitians, Eva Tulchinsky, M.S., RDN, who appears in the first two episodes, is tackling one of the most persistent myths in diabetes care: that carbohydrates are off the table.

Tulchinsky said this is a myth. Carbohydrates are one of the body’s primary energy sources, and the American Diabetes Association recommends minimally processed, high-fiber carbohydrates such as whole grains, legumes, fruits and vegetables as part of a healthy diabetes eating pattern. Fruit specifically is not off-limits either, she said. It offers vitamins, minerals, antioxidants and fiber, and simply needs to be paired thoughtfully within a meal.

Pairing matters, and so does portioning

Tulchinsky confirmed, with a caveat, that pairing carbohydrates with protein or fat can help stabilize blood sugar. That combination slows the initial glucose spike, but the type and amount of carbohydrate still determines what happens after that initial rise.

For portioning without measuring or weighing food, Tulchinsky recommends a simple visual guide: filling half a 9-inch plate with nonstarchy vegetables and splitting the rest between carbohydrates and protein. She also offers hand-based estimates, noting that a palm is roughly 3 ounces of protein, a fist is about a cup, and knuckles represent roughly half a cup.

Skipping meals and “diabetic” labels can backfire

Tulchinsky said skipping meals to control blood sugar is a myth. She compares it to a Monopoly system where carbs are saved up for one meal at the end of the day. Eating consistent carbohydrates across meals and snacks instead helps keep blood sugar moderate throughout the day.

She’s also skeptical of products marketed as diabetic-friendly or sugar-free, noting that sugar-free doesn’t mean carbohydrate-free or calorie-free. She encourages patients to read the full nutrition label, including carbohydrates, fiber and sugar content, rather than trusting the front-of-package claim.

Small amounts of sugar can still fit

Tulchinsky said small amounts of sugar can fit into a diabetes-friendly diet. Rather than focusing on restriction, she emphasizes building meals with strong nutrient content.

Weight isn’t the only factor in Type 2 diabetes

Finally, Tulchinsky pushed back on the idea that weight is the sole driver of Type 2 diabetes. While weight and adiposity play a role, she said the condition is multifactorial, shaped also by age, sex, genetics, physical activity and other metabolic factors.