Type 2 Diabetes Diet, Weight Loss and Exercise: A Practical Guide

This is general information about eating, weight and activity with type 2 diabetes — bring it along to plan a realistic approach with your GP or dietitian.

Lifestyle change is the foundation of type 2 diabetes treatment, and it should begin as soon as you are diagnosed. Medication may also be required, but medicine works best when combined with sustainable changes to eating, movement and weight. The aim is not to create a perfect lifestyle overnight — small changes you can continue for years are far more helpful than an extreme plan that lasts only a few weeks.

This is the detailed diet, weight-loss and exercise guide. For the overall picture — diagnosis, HbA1c, complications and the cycle of care — see our type 2 diabetes management guide, and for treatment options see the medications guide.

Weight loss and type 2 diabetes

If you are above your healthiest weight, losing even a relatively modest amount can help your body respond to insulin more effectively. A reasonable initial target is often a loss of 5–10% of your starting body weight.

This can improve:

• blood glucose
• blood pressure
• cholesterol
• mobility
• fatty liver
• sleep apnoea
• overall cardiovascular risk

For example:

• a person weighing 80 kg could initially aim to lose 4–8 kg
• a person weighing 100 kg could initially aim to lose 5–10 kg
• a person weighing 120 kg could initially aim to lose 6–12 kg

Some people who achieve and maintain substantial weight loss may achieve remission of type 2 diabetes. Remission means that glucose levels remain below the diabetes range without glucose-lowering medication for a period of time. It does not mean the underlying tendency towards diabetes has disappeared, so ongoing monitoring remains necessary.

What should I eat if I have type 2 diabetes?

There is no single diabetes diet, and you do not normally need to purchase special “diabetic” foods. Several eating patterns can work well, including Mediterranean-style diets, higher-fibre diets, lower-carbohydrate approaches and plant-forward diets.

The best plan is one that:

• is nutritionally balanced
• suits your preferences and cultural foods
• supports a healthy weight
• fits your work and family routine
• can be maintained over the long term

A simple plate guide

For most main meals, aim for approximately:

• Half the plate: non-starchy vegetables or salad
• One-quarter: lean protein such as fish, chicken, eggs, tofu, beans or lean meat
• One-quarter: a high-fibre carbohydrate such as brown rice, wholegrain pasta, legumes, corn, potato or wholegrain bread

Portion size still matters, particularly for rice, pasta, bread, noodles, potatoes and other carbohydrate-containing foods.

Choose higher-quality carbohydrates

Carbohydrates do not need to be eliminated completely. Instead, focus on both the type and the quantity you eat.

Choose more:

• wholegrain bread and cereals
• oats
• lentils, chickpeas and beans
• vegetables
• whole fruit
• brown or basmati rice
• high-fibre, lower-GI foods

Limit:

• soft drinks, energy drinks and cordial
• fruit juice
• sweets, biscuits and cakes
• highly processed breakfast cereals
• large portions of white bread, white rice, pasta or noodles
• frequent takeaway food
• heavily processed snack foods

Whole fruit is generally a better choice than fruit juice because it contains fibre and is more filling.

Reduce liquid sugar

Sugary drinks are one of the easiest places to make a meaningful change. Choose water, sparkling water, unsweetened tea or coffee whenever possible. Diet drinks do not raise glucose in the same way as sugar-sweetened drinks, although water should remain your main drink.

Include protein and fibre

Protein and fibre help meals feel more satisfying and may reduce sharp rises in blood glucose. Useful choices include eggs, fish, chicken, lean meat, Greek yoghurt, cottage cheese, tofu, beans and lentils, nuts and seeds, and plenty of vegetables and salads.

Choose healthier fats

Reduce saturated fats found in fatty meats, processed meats, butter, cream and many takeaway foods. Choose more unsaturated fats from olive oil, avocado, nuts, seeds and oily fish.

A note on getting help: an accredited practising dietitian can develop an eating plan that suits your preferences, working hours, cultural foods, medications and weight goals. Ask your GP at The Local Doctor whether you are eligible for a GP chronic condition management plan, which can give you Medicare-subsidised access to a dietitian.

Exercise and physical activity

Exercise helps your muscles use glucose more effectively and improves insulin sensitivity. It can also improve weight management, blood pressure, cholesterol, mood, sleep, strength and mobility, and cardiovascular health.

For most adults, the longer-term goal is:

• at least 150 minutes of moderate aerobic activity each week
• resistance or strength exercise on two to three days each week
• less prolonged sitting

You do not need to reach this target immediately. Someone who is currently inactive might begin with a 10-minute walk after dinner and gradually increase the duration and frequency. Walking for 10–15 minutes after meals can be a practical way to reduce sitting and improve post-meal glucose levels.

Speak with your GP before beginning vigorous exercise if you have chest pain, severe breathlessness, significant foot problems, advanced eye disease or other health limitations.

Putting it together with your GP

Diet, weight and activity work best as part of your overall diabetes plan — alongside HbA1c targets, blood pressure and cholesterol management, and medication where needed. Our GPs at Ivanhoe and Diamond Creek can help you set realistic goals, arrange a dietitian or exercise physiologist referral, and review whether medication should be part of your plan. Book a diabetes appointment to get started.

This page provides general patient education and does not replace individual medical advice. An eating or exercise plan should be tailored to your test results, medications, other medical conditions and personal circumstances. Do not start, stop or change a prescribed medicine without discussing it with your doctor.

References

• Type 2 diabetes — food, eating and activity — Diabetes Australia.
• Management of type 2 diabetes: A handbook for general practice — RACGP and Diabetes Australia.
• National Diabetes Services Scheme (NDSS) — Diabetes Australia / Australian Government.