Diabetes is a chronic disease that progresses over time, and the causes, symptoms, and management of diabetes are unique to each person affected by it. As a result, sometimes well-intentioned people share information that may be appropriate for them, but not for others. This can make managing your diabetes complicated and confusing.
Below are answers to some common questions about diabetes, following the most current science-based advice.
Does Being Overweight Mean That I Will Definitely Develop Type 2 Diabetes?
No, being overweight does not mean you will automatically develop type 2 diabetes, but it is one factor that can increase your risk. Body weight gets a lot of attention because it is a modifiable risk factor, meaning that your risk will decrease with healthy lifestyle changes.
Research has found that even small amounts of weight loss, between 3% and 7%, can reduce your risk of developing diabetes (American Diabetes Association [ADA] Professional Practice Committee, 2025). As an example, for a person weighing 250 lb, 7% of their body weight is 18 lb. If this person loses 18 lb, they can significantly reduce their risk of developing type 2 diabetes, and their goal weight would be about 232 lb.
There are many people who are overweight who never develop diabetes. Likewise, there are many people who are normal weight or only moderately overweight who develop diabetes, while others in the normal or underweight body mass index (BMI) range will develop diabetes. This highlights the importance of understanding that diabetes can affect people across the weight spectrum.
Individuals with a BMI in the underweight or normal range are still at risk, particularly if other contributing factors are present. Additional risk factors for diabetes include:
- Family history: If a parent or sibling has diabetes, your risk of developing diabetes is higher (American Heart Association, 2024).
- Age: Your risk is higher if you are more than 45 years old.
- Race or ethnic background: People who are Black American, Hispanic or Latino, Native American, Asian American, or Pacific Islander are at higher risk of developing diabetes.
- Physical activity: Being sedentary can raise your risk. Aim for at least 150 min per week of moderate physical activity such as brisk walking, cycling, or dancing (ADA, n.d.-a).
- History of gestational diabetes: If you had diabetes during pregnancy, you are more likely to develop type 2 diabetes later.
- Other health conditions: Conditions such as high blood pressure or nonalcoholic fatty liver disease can also increase your risk (American Heart Association, 2024).
Does Eating Sugar Cause Diabetes?
No, eating sugar by itself does not directly cause diabetes. However, research shows that people who regularly drink large amounts of sugar-sweetened beverages such as soda, sweet tea, or energy drinks have a higher chance of developing diabetes. This may be because sugar-sweetened drinks are high in calories and can lead to weight gain.
It is possible that the link to diabetes is related to being overweight or obese and not to drinking sugar-sweetened beverages alone. Limiting these drinks is a smart step toward preventing obesity and diabetes (Cleveland Clinic, 2024; Centers for Disease Control and Prevention, 2024).
Does Having Diabetes Increase My Risk of a Heart Attack?
Yes, having diabetes increases your risk of serious health problems, including heart disease. People with diabetes are twice as likely to have a heart attack or die from heart disease compared to those without diabetes. This is because elevated blood sugar can damage the walls of the blood vessels and arteries over time.
Other diabetes complications include kidney disease, nerve damage, and vision problems. Like heart disease, the cause of these complications is blood glucose that remains elevated over time. Managing your blood glucose levels reduces your chance of developing all diabetes-related complications, including heart disease (ADA, n.d.-d).
Do People With Diabetes Need to Eat Special Foods?
No, people with diabetes don’t need to eat special or separate foods. A healthy eating plan for someone with diabetes is very similar to what’s recommended for everyone. If you are managing multiple medical conditions, ask your healthcare provider for a referral to a registered dietitian nutritionist (RDN), a nutrition professional who can guide you in making a plan that meets your individual nutritional needs.
The goal is to eat a variety of nutritious foods that help manage blood glucose, support heart health, and maintain a healthy weight. According to the ADA (n.d.-c), some tips for healthy eating with diabetes include:
- Make nonstarchy vegetables—like spinach, broccoli, and peppers—the foundation of your plate. About half of your plate should be filled with nonstarchy vegetables.
- Eat whole grains—such as whole-grain breads, brown rice, oats, or quinoa—instead of refined grains.
- Add lean proteins such as fish, chicken, beans, or tofu.
- Choose healthy fats, like those found in nuts, seeds, and olive oil.
- Use low-fat milk and other dairy products.
- Limit foods with added sugars and those that have been highly processed.
- Choose water or other zero-calorie beverages to accompany your meals.
Can People With Diabetes Eat Starchy Foods, Like Potatoes and Rice?
Yes, people with diabetes can include starchy foods like potatoes, rice, and bread in their meals. These foods contain carbohydrates, which raise blood glucose, so being aware of portion size is important. Choosing whole grains in moderate portion sizes and pairing them with protein or healthy fats can help keep blood sugar levels more stable.
There are several meal/dietary patterns that include these principles and support blood glucose management. These include the Mediterranean diet, the DASH diet, and a modified version of MyPlate, called the Diabetes Plate.
The ADA (n.d.-c) recommends following these Diabetes Plate steps:
- Start with a 9-in. plate.
- Visually divide the plate into four quarters.
- Fill half of your plate (two quarters) with nonstarchy vegetables, like spinach, broccoli, peppers, and greens.
- Fill one quarter of your plate with starchy vegetables, like potatoes or corn, or with other carbohydrates, like fruits, whole grains, or dairy.
- Complete the plate by filling the last quarter with a lean source of protein.
- Finish the meal with a zero-calorie beverage or water.
Do People With Diabetes Need to Avoid Carbohydrates?
No, because carbohydrates are an important part of a healthy diet for everyone—maybe even more so for people with diabetes. Some people with diabetes take medications like insulin or metformin. These medications are specifically designed to decrease the amount of glucose in your blood. If someone is taking a medication that decreases blood glucose but does not eat foods with carbohydrates, their blood glucose could drop dangerously low.
The key when including carbohydrates in your meal plan is choosing nutritious, fiber-rich options to support healthy blood glucose levels (ADA, n.d.-b), such as:
- nonstarchy vegetables, like tomatoes, peppers, broccoli, cauliflower, mushrooms, and spinach
- fruits
- whole grains
- legumes, such as beans, peas, and lentils
Working with an RDN or a certified diabetes care and education specialist (CDCES) can help you figure out the right amount of carbohydrates for you.
Can People With Diabetes Eat Sweets or Desserts?
Yes, with proper planning, people with diabetes can include sweets or desserts in their meal plans. People with diabetes may need to eat these foods less often or in smaller portion sizes to manage their blood glucose levels.
One strategy for including these foods in your meal plan is to substitute a small portion of a sweet item for another carbohydrate in your meal. One example is swapping a small dessert for a slice of bread instead of eating both the dessert and bread. A registered dietitian can help you fit your favorite treats into a healthy meal plan while maintaining healthy blood glucose levels (Centers for Disease Control and Prevention, 2024).
Does Needing Insulin Mean I Failed to Manage My Diabetes?
No, needing insulin does not mean that you failed to manage your diabetes. Type 2 diabetes is a progressive disease that can change and worsen over time. When people with type 2 diabetes are first diagnosed, they can often manage their diabetes by taking oral medications, planning their meals, and engaging in physical activity. Over time, people with type 2 diabetes gradually lose the ability to make insulin, and it must be administered through injections or insulin pumps.
Insulin is a tool that helps a person with diabetes get their blood glucose to a healthy level. Keeping your blood glucose at a healthy level prevents complications associated with diabetes (ADA, 2007).
References
American Diabetes Association. (n.d.-a). Fitness: Weekly exercise targets. Retrieved July 2, 2025, from https://diabetes.org/health-wellness/fitness/weekly-exercise-targets
American Diabetes Association. (n.d.-b). Food & nutrition: Conquer your carb confusion. Retrieved July 2, 2025, from https://diabetes.org/food-nutrition/understanding-carbs/conquer-your-carbs
American Diabetes Association. (n.d.-c). Food & nutrition: Tips for eating well. Retrieved June 26, 2025, from https://diabetes.org/food-nutrition/eating-healthy
American Diabetes Association. (n.d.-d). Health & wellness: Diabetes can affect your heart. Retrieved July 2, 2025, from https://diabetes.org/health-wellness/diabetes-and-your-heart/diabetes-affect-your-heart
American Diabetes Association. (2007). Insulin myths and facts. Clinical Diabetes, 25(1), 39–40. https://doi.org/10.2337/diaclin.25.1.39
American Diabetes Association Professional Practice Committee. (2025). Obesity and weight management for the prevention and treatment of type 2 diabetes: Standards of care in diabetes–2025. Diabetes Care, 48(Supplement 1), S167–S180. https://doi.org/10.2337/dc25-S008
American Heart Association. (2024). Diabetes risk factors. Retrieved June 26, 2025, from https://www.heart.org/en/health-topics/diabetes/understand-your-risk-for-diabetes
Centers for Disease Control and Prevention. (2024, May 15). Can people with diabetes have dessert? Retrieved June 26, 2025, from https://www.cdc.gov/diabetes/healthy-eating/people-with-diabetes-dessert.html
Cleveland Clinic. (2024, January 11). Can too much sugar cause diabetes? Retrieved July 2, 2025, from https://health.clevelandclinic.org/can-you-get-diabetes-from-eating-too-much-sugar
