Everything you need to know about diabetic neuropathy

From nebraskamed.com

Around 50% of people with diabetes will go on to develop neuropathy, but sometimes its start is barely noticeable. "Not many people recognise it as a complication," says endocrinologist Shubham Agarwal, MBBS. "Many diabetic neuropathy symptoms start with a loss of sensation. Unfortunately, unless a provider asks about it, it can go unnoticed for a long period of time."

Early warning signs

Diabetic neuropathy typically happens in two ways:

1. Negative symptoms: A total loss of sensation in affected areas.
2. Positive symptoms: May include tingling and “pins and needles” sensations, pain, increased sensitivity to touch and muscle weakness.

"The most common symptoms that patients should be aware of is either some kind of loss of sensation in their feet – that is how it typically begins – or symptoms of numbness or tingling," Dr. Agarwal says.

In advanced cases, the loss of sensation may result in balance issues and a higher risk of falls. This occurs because the feet do not effectively send signals to the brain.

Types of diabetic neuropathy

Although often seen in both feet, beginning at the toes and moving upwards, diabetic neuropathy can show up in different forms:

• Peripheral neuropathy: The classic form affecting the feet, characterized by sensation changes on both sides of the body.
• Autonomic neuropathy: Affects internal organs, like the heart and digestive system. "Our organs are supplied by nerves,” Dr. Agarwal says. “The heart gets impulses and information from various nerve receptors to dictate the rate at which the heart should be beating.” This can lead to blood pressure issues and even paralysis of the stomach muscles (gastroparesis).
• Focal neuropathy: A rare type where single nerves are affected. This may cause symptoms like electrical sensations running down a leg or pain or paralysis of the eye muscles.

Prevention and risk factors

The biggest risk factor is – poorly controlled diabetes over time. "The single most important thing is being very proactive in getting diabetes under control sooner than later. That is the best way to prevent it," Dr. Agarwal says.

For Type 1 diabetes patients, screening usually starts after five years of having the condition. Type 2 diabetes patients should be screened when they are diagnosed. This is because the condition may have been “brewing in the background,” Dr. Agarwal says.

Treatment options

“Treatments for diabetic neuropathy are not the usual pain medications like Tylenol," Dr. Agarwal says. Instead, treatment often involves drugs originally developed for depression or mood disorders, such as:

• Duloxetine
• Venlafaxine
• Gabapentin
• Pregabalin

These drugs help by adjusting the brain chemicals that act like traffic controllers for pain signals. By modulating these chemicals, they help block some of the pain messages from damaged nerves from reaching the brain. This makes the pain more manageable.

Essential self-care practices

Daily foot care is crucial once neuropathy develops. Because a lack of sensation can mask injuries or infections, Dr. Agarwal strongly recommends:

• Checking your feet daily.
• Thorough drying between toes.
• Regular nail care.
• Proper footwear (potentially including specialized diabetic shoes).
• Immediate attention to any cuts or injuries.

"The biggest concern with neuropathy is that there is a certain amount of sensory loss," Dr. Agarwal says. "If you stub your toe or step on a nail, or have bacteria or fungus growing in there, not having enough sensation in the feet means you might not know that something's going on and potentially going to spread inwards."

Working with your doctor

Effective management involves clear communication with your providers. To help, you can:

• Record symptoms and onset in detail.
• Share past treatment information.
• Ask about prevention and progression.
• Discuss lifestyle changes.

Early recognition and intervention can help manage diabetic neuropathy effectively and reduce its impact on your quality of life.

https://www.nebraskamed.com/health/conditions-and-services/diabetes/everything-you-need-to-know-about-diabetic-neuropathy

Review: Artificial intelligence is shaping the future of diabetes care

From news-medical.net/news

The global incidence and prevalence of diabetes continue to rise, increasing rates of associated disability and mortality while imposing a substantial economic burden. Despite advancements in medical technology, diabetes management faces persistent challenges, including a shortage of specialists, uneven distribution of healthcare resources, and low patient adherence, all contributing to suboptimal glycaemic control.

A new review (doi: https://doi.org/10.1016/j.hcr.2024.100006) published in the journal Healthcare and Rehabilitation reveals how artificial intelligence (AI) is bringing major changes to diabetes care. By analysing data from blood sugar levels, medical history, and even retinal scans, AI tools can now predict diabetes subtypes, identify high-risk patients, and tailor solutions to individual needs—improving accuracy, reducing healthcare costs and addressing critical gaps in diagnosis, treatment, and daily management.

AI isn't just a tool; it's a partner in care. For example, AI can detect early signs of eye damage from diabetes in retinal images as accurately as specialists, which is critical for preventing blindness."

Dr. Ling Gao, principal investigator of the study, Central Laboratory at Shandong Provincial Hospital

The research highlights several breakthroughs:

- Early Complication Detection: AI predicts risks like kidney disease and heart issues by spotting patterns humans might miss.

- Personalized Treatment: Smart systems adjust insulin doses in real time, cutting dangerous blood sugar swings.

- Diet and Exercise Guidance: Apps analyse meals via photos and suggest recipes, while AI coaches recommend workouts based on location and health data.

Notably, AI even outperformed traditional methods in some areas. "For instance, CT scans analysed by AI could screen for osteoporosis in diabetes patients as effectively as specialized bone density tests," adds Gao. "Wearable devices like smart glucose monitors and socks that detect foot infections further showcase AI's potential to keep patients healthy at home."

However, challenges remain. "AI models need diverse data to avoid biases," emphasizes senior author Dr. Zhongming Wu, a professor in basic and translational studies of endocrine and metabolic diseases, at Affiliated Hospital of Endocrinology and Metabolism, Shandong First Medical University. "A tool trained based on just one population might fail elsewhere."

Additionally, issues like data privacy and the "black box" nature of some AI decisions require careful handling.

The study calls for stronger collaboration between tech developers, doctors, and policymakers to ensure AI tools are safe, fair, and accessible. "AI is a powerful ally in diabetes care, but human oversight remains essential," notes Gao. "While AI won't replace human clinicians, it empowers them to make faster, smarter decisions—ultimately transforming diabetes from a one-size-fits-all disease into a condition managed with precision and foresight."

Source:

KeAi Communications

Journal reference:

Ma, S., et al. (2025). Artificial intelligence and medical-engineering integration in diabetes management: Advances, opportunities, and challenges. Healthcare and Rehabilitation. doi.org/10.1016/j.hcr.2024.100006.

https://www.news-medical.net/news/20250226/Review-Artificial-intelligence-is-shaping-the-future-of-diabetes-care.aspx

Mushrooms ‘could be used to treat diabetes’

From telegraph.co.uk 

Edible fungi have ‘remarkable potential’ to help people with the Type 2 condition, a study finds

Eating mushrooms could help people manage Type 2 diabetes, a study has suggested.

Researchers at Semmelweis University in Budapest found that edible fungi were rich in chemicals that helped improve sensitivity to insulin, a key problem for diabetics.

“Our study reveals the remarkable potential of natural compounds in mushrooms to address key metabolic pathways,” said Dr Zsuzsanna Németh.

Type 2 diabetes affects around 5.8 million people in the UK and is commonly caused by being overweight and eating an unhealthy diet.

The condition can increase the risk of heart disease, stroke, kidney disease, vision loss and amputations.

A healthy body produces the hormone insulin in the pancreas in response to eating, using it to turn the sugars in food into energy.

However, in some people, cells develop resistance to the hormone and stop responding correctly.

This is called insulin resistance and leads to elevated levels of sugar in the bloodstream, because it has not been converted.

Dr Németh said: “As interest grows in non-pharmacological approaches to disease prevention, this opens up exciting possibilities for using edible medicinal mushrooms as complementary agents in diabetes management.”

Previous studies have shown fungi to contain medically important components such as polysaccharides, terpenoids, phenols, and heterocyclic amines. 

Mushroom extracts “have anti-diabetic, anti-hyperlipidemic, anti-inflammatory, antioxidant, cardioprotective, anti-osteoporotic, and anti-tumour effects”, the Semmelweis team wrote in their study.

They found that polysaccharides – different types of sugar – in the white button mushroom can boost good gut bacteria in the human body.

Sugars in the lion’s mane mushroom are an antioxidant, while the shiitake mushroom has chemicals linked to reducing blood glucose levels and anti-inflammatory effects.

The researchers wrote: “Edible mushrooms, including medical mushrooms, are an important part of nutrition. They are a good source of fibre, vitamins, amino acids, and trace elements, but the most investigated are the water-soluble composites: polysaccharides.

“Polysaccharides have complex effects on the human body. They favourably modulate the intestinal microbiota, glucose, and lipid homeostasis, as well as the immune system, the combined effect of which can reduce insulin resistance.

“These effects make mushrooms, especially medicinal mushrooms, a potential part of complementary therapy for obesity and related diseases, such as Type 2 diabetes.”

The research was published by the international Journal of Molecular Sciences.

https://www.telegraph.co.uk/news/2025/02/25/mushrooms-could-be-used-to-treat-diabetes/

Broccoli sprout compound can help fend off type 2 diabetes

From newatlas.com

The antioxidant sulforaphane, which is found in broccoli sprouts in high concentrations, can improve blood sugar levels in some people with prediabetes, according to new research. The findings suggest a need to personalize the treatment of the condition, a precursor to type 2 diabetes.

Broccoli is a nutrient-dense food with proven health benefits. Previous research has found that it can help prevent cancer, maintain heart and digestive health, and improve blood sugar levels in type 2 diabetics.

                     Prediabetics who took broccoli sprout extract had improved fasting blood sugar                                                                                  levels

Depositphotos original modified by DALL-E

A new study led by researchers from the University of Gothenburg in Sweden found that one of the vegetable’s standout compounds, the antioxidant sulforaphane, also improved blood sugar levels in people with prediabetes, the precursor to type 2 diabetes (T2D).

“The treatment of prediabetes is currently lacking in many respects, but these new findings open the way for possible precision treatment using sulforaphane extracted from broccoli as a functional food,” said Anders Rosengren, a professor in the University’s Department of Neuroscience and Physiology and the study’s corresponding author. Rosengren was the corresponding author in previous research on the effect of sulforaphane on blood sugar control in type 2 diabetics. “However, lifestyle factors remain the foundation of any treatment for prediabetes, including exercise, healthy eating, and weight loss.”

                                                    Insulin resistance is a feature of prediabetes           

Depositphotos

Prediabetes is characterized by higher-than-normal blood sugar levels but not so high that they warrant a diagnosis of T2D. It usually occurs in people who have a degree of insulin resistance or whose pancreatic beta cells aren’t making enough insulin to keep blood sugars in the normal range. Current treatment of prediabetes is directed at modifying lifestyle factors such as improving diet and increasing physical activity. In some cases, medication is used to lower blood sugar levels.

A common way of screening for prediabetes is by measuring a person’s fasting blood glucose level, which is blood sugar unaffected by food and/or drink. A normal fasting glucose is usually below 5.6 mmol/L (100 mg/dL), while a level above 7.0 mmol/L (126 mg/dL) typically indicates diabetes. In prediabetics, fasting glucose levels usually sit between these two values. For the present study, 89 individuals with an impaired fasting glucose of between 6.1 and 6.9 mmol/L were recruited. Participants were overweight or obese, had an average age of 63 and an average fasting blood glucose of 6.4 mmol/L. Sixty-four per cent of participants were male.

The participants were randomized to receive broccoli sprout extract (BSE), a concentrated form of the bioactive compounds found in broccoli, particularly sulforaphane, for 12 weeks. Neither the participants nor the researchers knew who was in which group. Broccoli sprouts can contain up to 100 times more sulforaphane than mature broccoli. Only 74 participants completed all stages of the study; 15 (nine in the BSE group and six in the placebo group) dropped out due to gastrointestinal side effects, including nausea and vomiting, reflux, and diarrhea.

At the end of the 12 weeks, the BSE group had a greater average reduction in fasting blood glucose than those receiving placebo, with a mean difference of 0.2 mmol/L between the groups. A particular clinical subgroup of 13 participants had a “pronounced response” to BSE: those with mild obesity, low insulin resistance, and reduced fasting blood glucose levels. Their average reduction in fasting blood glucose was 0.4 mmol/L. The researchers called these participants ‘responders.’

The researchers used stool samples collected from participants before and after treatment with BSE or placebo and analyzed their gut microbiome. The 13 ‘responders’ were found to have a significantly different gut microbiome composition at baseline that – interestingly – didn’t change after treatment. Eleven of them belonged to the clinical subgroup mentioned in the preceding paragraph. Belonging to this sub-group, in combination with the difference in gut bacteria, produced the largest reduction in fasting blood glucose in response to BSE treatment: 0.7 mmol/L.

            The study's findings suggest personalized treatment of prediabetes is warranted

Depositphotos

While the study’s full cohort didn’t reach the primary outcome the researchers hoped for – a 0.3 mmol/L reduction in fasting blood sugar – they said their findings were important nonetheless.

“This trial shows that the response to sulforaphane-containing BSE in individuals with impaired fasting glucose differs based on the host pathophysiology and gut microbiota,” said the researchers. “Taken together, this indicates a need to personalize interventions in prediabetes, considering that many compounds have moderate overall efficacy but considerable impact in certain subgroups, and these findings represent a step towards precision treatment of prediabetes based on the individual pathophysiology and gut microbiota.”

One of the study’s limitations, namely that the 12-week treatment time didn’t allow for analysis of the long-term effects of BSE on blood sugar control, would need to be addressed in future studies. As would the small sample size.

For prediabetics who don’t like the taste of broccoli but still want to avail themselves of the potential blood-sugar-lowering effects of sulforaphane, a simple internet search for ‘sulforaphane supplements’ will direct you to retailers who sell the antioxidant in capsule form. Don’t go overboard, though – keep in mind the reason people dropped out of this study early.

The study was published in the journal Nature Microbiology.

Source: University of Gothenburg

https://newatlas.com/diabetes/broccoli-sulforaphane-prediabetes/ 

Is drinking olive oil good for you? A nutritionist weighs in

From houseandgarden.co.uk

The ‘liquid gold’ is a staple of the Mediterranean diet – but should you add a spoonful to your morning routine? 

After turmeric water, lemon water and apple cider vinegar, the new trend among the health-conscious seems to be drinking extra virgin olive oil in the morning on an empty stomach. A special elixir which, as videos and testimonials on social media assure, is capable of providing numerous heath benefits and can even help with weight loss. But do you really need to drink it to reap the rewards? La Cucina Italiana asked the biologist and nutritionist Concetta Montagnese, a researcher at the Institute of Food Sciences of the CNR.

The benefits of extra virgin olive oil

Concetta confirms that extra virgin olive oil (EVOO) is indeed a very precious and indispensable food with many beneficial effects. “Olive oil is a powerful anti-inflammatory ingredient, which helps fight cardiovascular diseases and diabetes. Rich in important monounsaturated fatty acids, including oleic acid, and polyphenols, particularly oleocanthal, it also contains a lot of vitamin E, which is beneficial for the immune system and the skin. Thanks to its antioxidant compounds, it helps cells stay younger,” the nutritionist explains. “Some studies have also associated high consumption of extra virgin olive oil with cancer prevention.”

Extra virgin or regular: Which olive oil is better?

For the most benefits, make sure to get extra virgin olive oil (EVOO). Extra virgin olive oil boasts a higher concentration of all the great vitamins and antioxidants.

Is a spoonful of olive oil a day good for you?

To benefit from its full effect, a consumption of more than 20 grams per day of olive oil is recommended, which is equivalent to more than two tablespoons. The effects seem to be stronger with increasing consumption. However, we know that extra virgin olive oil is a very calorific food (100 grams contain about 900 calories). “The Italian guidelines suggest consuming between 20 and 40 grams per day, from two to four tablespoons,” says Concetta, “because when we talk about a balanced diet, we must not only refer to the number of calories but also to the nutritional values and the composition of the food. Extra virgin olive oil contains 99% fat, but predominantly good fats, which help keep the body healthy and are also essential for the proper functioning of the metabolism. This precious food is therefore also indicated in cases of obesity and metabolic syndrome. If anything, its deficiency is harmful: EVOO is one of the cornerstones of the Mediterranean diet and cannot be replaced with any other type of food or condiment.”

Should you drink olive oil on an empty stomach for the most benefits?

Contrary to what social media may say, it is not necessary to drink extra virgin olive oil in the morning on an empty stomach. “To date, no study has shown that drinking oil in the morning is more effective than using it as a condiment in main meals. Its consumption throughout the day is certainly beneficial and keeps the body healthy, but more than taking it alone, combining it with certain foods can help improve the absorption of important bioactive compounds (for example, the antioxidants in tomatoes), with beneficial effects. It is somewhat fashionable to seek a magic potion for health, and thus prepare elixirs to consume in the morning or on an empty stomach, but it is enough to consolidate the healthy habits of the Mediterranean diet – and use the oil as a condiment, preferably raw, and in sautéing – to reap all the possible benefits.”

https://www.houseandgarden.co.uk/article/olive-oil-drinking-daily-benefits

USA: The dangers of fraudulent diabetes products and how to avoid them

From news-medical.net/news

As the number of people diagnosed with diabetes continues to grow, an increasing number of products marketed under the guise of "dietary supplements" or "over-the-counter drugs" promising to prevent, treat, and even cure diabetes are being sold illegally.

The U.S. Food and Drug Administration advises consumers not to use such products - for many reasons. For example, they may contain harmful ingredients or no active ingredients at all. They may also be improperly marketed as non-prescription (over-the-counter) drugs or dietary supplements when they have hidden prescription drugs in the product. 

These products carry an additional risk if they cause people to delay or discontinue effective treatments for diabetes. 

More than 38 million people in the U.S. have diabetes, and almost 1-in-4 adults don't know they have it, according to the Centres for Disease Control and Prevention. Additionally, approximately 96 million adults have pre-diabetes, meaning they have higher than normal blood sugar levels and can reduce their risks of developing diabetes through lifestyle changes, including diet and exercise.

People with diabetes are at a greater risk for developing serious health complications, including:

• Death
• Heart disease
• Chronic kidney disease, 
• Nerve damage, 
• Foot health, 
• Oral health, 
• Hearing loss, 
• Vision loss, 
• Mental health

A far-reaching problem

Products that promise an easy fix might be tempting, but you are gambling with your health if you choose an unapproved, unregulated, or fraudulent product. 

Diabetes is a chronic disease but is generally manageable. You can lower your risk for developing complications by following treatments prescribed by health care professionals, carefully monitoring blood sugar levels, and sticking to an appropriate diet and exercise program.

Unfortunately, "snake-oil peddlers" still prey on people with chronic or incurable diseases, such as diabetes. 

Bogus products for diabetes are particularly troubling because there are effective options available to help manage this serious disease rather than risk exposing patients to unapproved or dangerous products.

One way to tell if a diabetes product is unsafe or ineffective is if it is marketed as a non-prescription product or dietary supplement. 

FDA-approved diabetes drugs are only available by prescription. Additionally, there are no dietary supplements that treat or cure diabetes. In fact, the FDA requires dietary supplement products to be labelled with a disclaimer saying the product is not intended to "diagnose, treat, cure or prevent any disease." You can read more about how to identify fraudulent products at 6 Tip-offs to Rip-offs: Don't Fall for Health Fraud Scams.

To protect the public health, the FDA investigates consumer complaints and monitors the marketplace for fraudulent products, including those promising to treat diabetes and its complications.

Unapproved diabetes drugs

The FDA issues warning letters to various companies marketing products for diabetes in violation of federal law. These products are often marketed as:

• Dietary supplements
• Alternative medicines 
• Over-the-counter or non-prescription drugs
• Homeopathic products

In September 2021, the FDA and the Federal Trade Commission issued warning letters to 10 companies for illegally selling dietary supplements claiming to cure, treat, mitigate, or prevent diabetes.

FDA laboratories find some "all-natural" diabetes products contain hidden active ingredients found in approved prescription drugs used to treat diabetes. You may ask, what the harm is if the products contain these undeclared active ingredients? Don't be fooled, these are illegal products and can be dangerous. 

If consumers, and their health care professionals, are unaware of the actual active ingredients in the products they are taking, these products may interact in dangerous ways with other medications. One possible complication: patients may end up taking a larger combined dose of the diabetic drugs than they intended. This may cause a significant and unsafe drop in blood sugar levels, a condition known as hypoglycaemia.

Fraudulent pharmacies

The FDA also monitors the internet for illegal marketing of prescription drugs or potentially unsafe products by fraudulent online pharmacies. 

Buying medicines from unsafe online pharmacies may put consumers at risk. These websites often sell unapproved, counterfeit, or otherwise unsafe medicines outside of safeguards followed by licensed pharmacies. The products sold, while being passed off as authentic or effective, may contain the wrong ingredients, contain too little, too much, or no active ingredient at all, or contain other harmful ingredients.

Additionally, consumers cannot be certain the manufacturing or handling of these drugs follows U.S. laws or meets other necessary safeguards, such as storing the medicine at the right temperature, which is extremely important for diabetes medicine, such as insulin, to ensure it doesn't lose or have decreased effectiveness.

Visit BeSafeRx for more information about the potential dangers of buying drugs from unsafe websites, tips for purchasing medicines online safely and how to report unlawful sales. 

The FDA maintains a list of Internet Pharmacy Warning Letters issued to companies for:

• Selling illegally marketed products
• Selling counterfeit drugs
• Offering prescription drugs without a prescription
• Offering prescription drugs without adequate directions for safe use
• Offering prescription drugs without FDA-required consumer warnings about the serious health risks associated with the prescription drug

Identifying legitimate online pharmacies

To help ensure you select a safe, licensed online pharmacy, look for one that requires you to have a valid prescription to purchase prescription drugs, provides a physical business address in the U.S., is licensed by a state pharmacy board, and provides a state-licensed pharmacist to answer your questions. You can find your state's pharmacy board using the FDA's Locate a State-Licensed Online Pharmacy webpage.

Talk to your health care professional if you have any questions about your diabetes treatment or if a specific online pharmacy is safe to use. 

How to report

If you believe you have found a website that may be illegally selling human drugs, dietary supplements, or other medical products, we encourage you to submit the information through the Reporting Unlawful Sales of Medical Products on the Internet available on the FDA website.

Health care professionals and consumers should report any problems or reactions—often referred to as potential adverse reactions—to FDA's MedWatch program at www.fda.gov/Medwatch/report.htm. Or, you can call 800-FDA-1088 (800-332-1088), send a fax to 800-FDA-0178, or mail FDA form 3500 (available on the MedWatch "Download Forms" page) to the address on the pre-addressed form.

https://www.news-medical.net/news/20250221/The-dangers-of-fraudulent-diabetes-products-and-how-to-avoid-them.aspx

Which Milks Are Best for Diabetes?

From everydayhealth.com

Cow’s milk, almond milk, soy milk, oat milk — the amount of choices can feel overwhelming. And if you’re living with diabetes, it’s important to know that the various types of milk you might pour into a glass, bowl of cereal, or cup of coffee can have different effects on your blood sugar levels. 

That’s because different types of milk have varying amounts of carbohydrates and sugar, and there are other nutritional considerations too, such as fat, protein, and calcium content. Choosing the right type of milk is also partly a matter of taste — along with working with your healthcare provider to manage your blood sugar levels.

How Milk Impacts Blood Sugar Levels

Cow’s milk and plant-based milks, such as almond, soy, and oat, all have potentially different effects on blood sugar levels, particularly if the milk is sweetened with added sugar. 

“It comes down to the total carbohydrate content, which is what increases blood sugar,” says Courtney Smith, RD, CDCES, a diabetes specialist in Salida, Colorado, and founder of The Keys to Nutrition. Plant-based milks that are higher in carbohydrates, such as rice milk, tend to promote a higher blood sugar response. You can find total carbohydrate content for any type of milk listed on the package’s nutritional information label.

People with diabetes (and those at risk of developing it) are advised to avoid sugar-sweetened beverages as much as possible, for better glycaemic control. But even natural cow’s milk can raise your blood sugar, because it contains lactose, a carbohydrate sometimes referred to as milk sugar.

Protein and fat are also considerations when it comes to blood sugar impact of the milk you’re drinking or the food you’re pairing it with. 

“When milk is paired with other healthy fats and protein, it helps stabilize the blood sugar level and not have such an immediate rise or response,” says Amy Kimberlain, RDN, CDCES, a Miami-based spokesperson for the Academy of Nutrition and Dietetics. 

Cow’s milk and plant-based milks themselves contain different amounts of protein and fat, depending on what varieties you’re purchasing. These are all factors to consider when you’re making choices at the grocery store and at home preparing meals and snacks.

Cow’s Milk

Public health authorities like the U.S. Department of Agriculture recommend consuming dairy as part of a healthy diet, including for people with diabetes. Of course, regular milk doesn’t work for everyone: You may be lactose intolerant, allergic to milk, dislike the flavour of cow’s milk, or be following a vegan diet.

On the plus side for cows, their milk is extremely nutrient-dense. Milk, along with other dairy products like yogurt and cheese, is filled with nutrients like calcium, protein, vitamin A, vitamin D, riboflavin, B12, and zinc. It also has no added sugar, unless it’s flavoured or sweetened like chocolate or condensed milk. One cup of whole milk contains 11 grams of carbohydrates, which may require a dose of insulin for people who use fast-acting insulin before meals.

Cow’s milk offers other potential benefits for people with diabetes. For example, the protein in low-fat dairy, especially whey, is associated with stimulating the release of insulin and lowering hyperglycaemia after eating. And alpha-linolenic acid, an omega-3 fatty acid that’s more plentiful in grass-fed cow’s milk, has been associated with many benefits for people with diabetes.

Whole milk may not be the best choice, especially for people who are watching their weight or heart health. “If consumed in excess, full-fat varieties could contribute to weight gain and increase one’s saturated fat intake, which is something to monitor for people with diabetes, since they have an increased risk for cardiovascular disease,” says Kimberlain. If you choose to drink dairy milk, the American Diabetes Association advises fat-free or 1 percent low-fat milk.

Some evidence has found that consuming low-fat dairy may lower the risk of developing type 2 diabetes. If you avoid dairy altogether, it’s important to find another way to get key vitamins and minerals such as calcium, vitamin A, and magnesium, to avoid conditions like osteoporosis, osteopenia, and even malnutrition.

Non-dairy Milks

Plant-based milks vary widely in nutritional content, so it’s crucial to read the nutrition label on the packaging before putting one in your shopping cart. But some of them can definitely be part of a diabetes-friendly diet.

“Some unsweetened nut milks can be helpful to not increase the carb content of a meal when other carb sources are present,” says Smith. “A good example of this is cereal, which is high in carbs already. So, pairing that with another carb increases the carbohydrate content.”

There are several other perks and pitfalls to know about specific non-dairy milks as well.

Oat Milk

Oat milk is a good option for people who want a dairy alternative that doesn’t contain nuts or soy. It’s generally fortified with calcium, vitamin D, vitamin A, and riboflavin, and it also has some protein, but lower amounts than dairy or soy milk.

With 2 grams of fibre per cup, oat milk has more fibre than cow’s milk, but it also has about twice the amount of carbs, and processing oats to make oat milk creates some sugars. These two factors mean it’s probably not the best plant-based milk for people with type 2 diabetes.

Almond Milk

Almond milk is a natural source of vitamin E and is high in omega-3 fatty acids. Commercial almond milk is typically fortified with calcium and vitamins A and D. And because it’s plant-based, it contains neither cholesterol nor saturated fat.

“Unsweetened almond milk is lower in carbohydrates and calories than dairy, making it a suitable option for those watching their blood sugar levels,” says Kimberlain. “It’s important to note that not all almond milk contains protein, so for someone managing blood sugar levels, you’ll want to eat a mix of carbs, lean protein, healthy fats, and fibre to manage better blood sugar levels.”

Soy Milk

Soy milk is derived from soybeans and is often fortified with vitamins and minerals, including vitamin D, calcium, omega-3 fatty acids, and flavonoids. Nutritionally, it’s the most similar to low-fat cow’s milk, compared with other plant milks. 

“Unsweetened soy milk is another plant-based alternative that is beneficial for blood sugar management,” says Kimberlain. “It contains protein and healthy fats, which help slow down the absorption of carbohydrates and prevent a quick spike in blood sugar.”

Soy milk consumption may lower blood pressure, LDL (“bad”) cholesterol, and waist circumference, all of which may be elevated in people with diabetes.

Rice Milk

Rice milk is made with milled rice and water, and it’s a vegan option that’s allergy friendly and easy to digest. But this plant-based option contains added sugars and has twice as many grams of carbohydrates per serving as cow’s milk. It also contains very little protein. Because of that nutrient profile, rice milk isn’t the strongest milk choice for people with diabetes.

Coconut Milk Beverage

Coconut milk beverage is the unsweetened, ready-to-drink dairy alternative found in cartons, not the thick, sweet, canned milk commonly used in soups, curries, and sauces. The beverage version of coconut milk can be low in calories, but it tends to have several grams per serving of saturated fat and no protein.

The good news for people with diabetes is that unsweetened coconut milk is very low in carbohydrates. As with other plant-based milks, select those fortified with calcium and other nutrients.

Decoding the Labels

Plant-based milks can be healthy alternatives to cow’s milk, but they are not uniform from one brand or product to another, and the advice in this article may not apply to every brand you’ll find at the grocery store. It’s critical to read nutrition labels while shopping and know what to look for in both dairy and non-dairy milk options. 

• Fat: Look at both the type of fat (“bad” saturated fats versus “good” unsaturated, monounsaturated, or polyunsaturated fats) and the amount per serving. Managing fat intake and body weight are crucial for effective management of both type 2 diabetes and type 1 diabetes.
• Protein: The gold standards are dairy milk and soy milk, which have around 8 grams of protein per cup. Oat, almond, rice, and coconut milk all have 2 grams or less.
• Calcium: Cow’s milk naturally has about 300 milligrams of calcium per cup. Non-dairy milks are often fortified with about the same amount, but calcium added to foods may not be absorbed as well by the body. You may need to up your calcium by taking supplements if you’re not eating dairy, since even foods like dark-green leafy vegetables do not provide optimal calcium absorption.
• Carbohydrates: People with diabetes should always be aware of their carbohydrate intake, since carbohydrates directly raise blood sugar levels.
• Added sugars: “Whether dairy or plant-based milk, it’s important to avoid flavoured or sweetened varieties, as they often contain added sugars that can elevate blood glucose levels,” says Kimberlain. “Always opt for unsweetened versions.”
• Added nutrients: Because non-dairy milks are generally lacking many of the natural nutrients of dairy milks, choose products fortified with calcium, protein, and other vitamins and minerals, such as potassium, vitamin B12, and iodine.

The Takeaway

• Both cow’s milk and plant-based milks can affect blood sugar levels, particularly if the product contains added sugar and has a higher carbohydrate content.
• Cow’s milk is nutrient-dense in terms of calcium and protein, and dairy can be a part of a healthy diet for people with diabetes. But those who monitor their weight and fat intake should opt for low-fat or non-fat versions to help manage the potential cardiovascular risks.
• Unsweetened plant-based milks like soy milk or almond milk are suitable choices for people with diabetes. Rice milk and oat milk are higher in carbohydrates, which are less beneficial for blood sugar management.
• Always read the nutrition labels carefully to ensure that your chosen milk aligns with your dietary needs and blood sugar management plan.

https://www.everydayhealth.com/diabetes/best-milks-for-diabetes/