Understanding diabetes
Diabetes means your body cannot keep blood sugar in range on its own, either because it makes little or no insulin (type 1) or because insulin works less well and the pancreas cannot keep up (type 2). Gestational diabetes appears during pregnancy, and prediabetes means blood sugar is above normal but below the diabetes range.
Food is one of the main levers for blood sugar, and it also affects the long-term risks that come with diabetes: heart disease, kidney disease and nerve damage. A dietitian helps you eat in a way that fits your medications, your glucose readings and the foods you enjoy, without a list of forbidden foods.
How a dietitian helps with diabetes
Carbohydrates in context: how much, which kinds and when, paired with protein, fibre and vegetables to flatten spikes.
Carbohydrate counting and insulin-to-carbohydrate ratios if you take insulin, and preventing and treating low blood sugar.
Reading your meter or continuous glucose monitor (CGM) data to see how specific meals affect you.
Weight management, including support while you take a GLP-1 medication such as semaglutide, so you keep your muscle and eat enough.
Protecting your heart and kidneys: blood pressure, cholesterol and, if kidney function drops, protein, potassium and phosphorus.
What the evidence says
Diabetes Canada accepts a flexible range of carbohydrate intake and recommends several eating patterns, including Mediterranean, DASH, vegetarian and Portfolio. The best one is the one you can keep.
Health Canada's minimum for carbohydrate is 130 g a day for adults, the amount the brain uses. Most plans sit above that, and a lower-carbohydrate plan with insulin or a sulfonylurea needs supervision.
For most adults with diabetes, the targets are an A1C of 7% or less and blood pressure below 130/80 mmHg.
In the Diabetes Prevention Program, losing about 7% of body weight with more activity cut progression from prediabetes to type 2 diabetes by 58%.
In the DiRECT trial, close to half of the people who lost weight on a structured program were in remission from type 2 diabetes after one year.
Your nutrition care
Nutrition care for diabetes starts with a full assessment: your medical history, current medications, recent lab results, weight history and the way you actually eat. From there your Registered Dietitian builds a plan around your diagnosis, your treatment goals and the foods you like, and adjusts it at each follow-up as your results come in.
We see patients in person at our Ottawa and Gatineau clinics and by secure video across Ontario and Quebec, so you can keep appointments between medical visits without travelling. With your consent, we share the plan with your physician or specialist team so everyone is working from the same numbers.
Not sure where to start? Book a free initial consultation. We will go over your situation, answer your questions and tell you honestly whether nutrition therapy is likely to help.
Book NowQuestions about nutrition care for diabetes
Do I have to cut out carbohydrates?
No. The amount, type and timing of carbohydrates matter more than eliminating them. Pairing starches with protein, fibre and vegetables, choosing lower glycemic index options and spreading carbohydrates through the day all flatten glucose spikes. Lower-carbohydrate plans suit some people, but if you take insulin or a sulfonylurea they must be set up with your care team because of the risk of low blood sugar.
Can nutrition put type 2 diabetes into remission?
For some people, yes. Substantial weight loss, especially in the first years after diagnosis, can bring A1C back below the diabetes range without glucose-lowering medication. It does not happen for everyone, so we set realistic targets with you and your physician and adjust medications under medical supervision along the way.
I have prediabetes. Is it worth seeing a dietitian now?
Yes, this is the best time. In clinical trials, structured programs combining nutrition, activity and a modest weight loss of around 5 to 7 % of body weight cut the progression to type 2 diabetes by more than half.
Can you help me with carbohydrate counting or my glucose sensor data?
Yes. Our dietitians teach carbohydrate counting and insulin-to-carbohydrate ratios, and review your meter or continuous glucose monitor (CGM) readings to see how specific meals affect you. Any change to your medication doses is coordinated with your prescriber.
Can I see a dietitian for diabetes online?
Yes. We offer secure video appointments across Ontario and Quebec, as well as in-person visits at our Ottawa and Gatineau clinics. Online visits include the same assessment, plan and follow-ups.
Sources and guidelines
- Diabetes Canada Clinical Practice Guidelines (2018). Chapter 11: Nutrition therapy.
- Diabetes Canada Clinical Practice Guidelines (2018). Chapter 8: Targets for glycemic control.
- Diabetes Canada Clinical Practice Guidelines (2018). Chapter 26: Treatment of hypertension.
- Diabetes Prevention Program Research Group (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine.
- Lean et al. (2018). Primary care-led weight management for remission of type 2 diabetes (DiRECT). The Lancet.
- Health Canada. Dietary Reference Intakes tables.
This page is general information, not individual advice. Your dietitian sets your own targets. Daily intake figures for healthy adults are Health Canada's Dietary Reference Intakes.