The good news is that most people can eat bread unless a doctor advises otherwise. However, it should be the right kind of bread.
Whole-grain breads with high-fiber ingredients, such as oats and bran, are usually the best option for people with diabetes.
Making bread at home with specific, diabetes-friendly ingredients may also help reduce the impact that bread can have on blood sugar levels.
Nutrition and diabetes
In moderation, wholegrain bread can be healthful for people with diabetes.
There are two main types of diabetes, type 1 and type 2.
According to the Centers for Disease Control and Prevention (CDC), more than 30 million people have diabetes in the United States, and 90 to 95 percent of them have type 2.
Type 1 diabetes happens when the body cannot produce insulin, a hormone that "captures" blood sugar (or glucose) and transfers it into cells. Glucose is the preferred energy source for cells.
Type 2 diabetes is the most common form of diabetes. This is also the easier form to prevent and manage with lifestyle changes and medication. Taking measures to control blood glucose levels in the early stages can help prevent this condition from progressing to diabetes.
Poor diet, genetic factors, and lifestyle habits contribute to the development of type 2 diabetes.
Carbohydrate is one of the three major nutrients essential to human health.
However, carbohydrates also raise blood sugar and can reduce effective diabetes control. This is mainly because carbohydrates break down into blood sugar.
The key to keeping blood sugar in check after a meal is to choose food items that contain quality carbohydrates. Quality carbohydrates are those that rate low or medium on the glycemic index.
Improving the glycemic index of bread
The glycemic index is a measurement of individual foods and their effects on blood sugar. The three basic categories of the glycemic index (GI) are low, medium, and high.
What is the glycemic index?
The American Diabetes Association (ADA) explain that the GI compares the way foods raise blood sugar levels compared with a reference food, usually glucose.
Glucose is a reference point for the GI with a score of 100. White bread would score around 71.
Foods that do not contain carbohydrates, such as meats and fats, do not have a GI score.
Low-glycemic foods score 55 or less and include:
- 100-percent stone-ground whole-wheat or pumpernickel bread
- oatmeal (rolled or steel-cut)
- sweet potato, corn, yam, lima beans, butter beans, peas, lentils, and legumes
- non-starchy vegetables and carrots
- most fruits
Medium-glycemic foods score 56 to 69 and include:
- whole wheat, rye, and pita bread
- quick oats
- brown, wild, or basmati rice
High-glycemic foods score 70 or more and include:
- foods made with refined grains, such as white bread, bagels, pretzels, saltine crackers, and many breakfast cereals
- white rice and rice pasta
- russet potatoes
- melon and pineapple
The more processed or cooked a food is, the more likely it is to have a high GI.
Commercially-produced white bread is high on the GI index, but wholemeal bread can be lower on the GI scale.
The first step in choosing a suitable bread is to opt for bread made with wholemeal or stone-ground flour. The less processed the flour, the lower the GI score will be.
Reduce the sugar content
When bread uses yeast to rise, it usually needs some sugar to "feed" the yeast.
Some commercial breads contain more sugar than is necessary to make the bread rise.
If you make bread at home, whether by hand or in a bread-making machine, you can experiment with smaller amounts of sugar.
Ingredients to add
Make your own bread and add in extra seeds and grains to boost the nutritional content.
If you are making bread at home, you can add ingredients that lower the GI score.
High-fiber, high-protein, and high-fat ingredients may be important additions to reduce the impact the bread has on blood sugar.
These ingredients include things like:
- flaxseed meal
- chia seeds
- wheat bran
One idea is to replace one-fourth of regular flour with an equal proportion of the other, more healthful ingredients.
Avocado on wholemeal bread is a healthful option for people with diabetes.
For example, if a favorite bread recipe calls for 2 cups of flour, you can replace half a cup of flour with half a cup of flaxseed meal.
Swapping out all-white flour for whole-wheat bread or pastry flour is also a good idea.
Serving the bread
You can reduce the GI score further by choosing spreads carefully, for example, using unsweetened peanut butter or avocado instead of jellies and chocolate spread.
Recipes for bread and other foods that are suitable for diabetes are available to purchase online.
Most commercially-available breads contain refined, white flour. This contains no fiber, and it can cause blood sugar to rise.
Even "wheat bread" may be made with refined wheat and not whole grain.
Some brands that identify their bread as "seven grain" or "nine grain" only use those grains on the crust, while most of the bread still consists of refined white flour.
Being aware of the packaging and labeling of breads can help people with diabetes choose a suitable product.
Here are four types of breads that may be healthier options for diabetes control:
Fiber-enriched whole-grain bread
Fiber is a type of carbohydrate that the body cannot digest. It keeps bowels regular and helps to promote a feeling of fullness. Fiber can also help control blood sugar.
This is why fiber is said to lower the GI score of a food.
Adding soluble fiber to breads may help a person manage blood sugar.
However, fiber-enriched whole-grain breads are still relatively high in carbohydrates, so it is important to eat them in moderation.
A person should also consume breads alongside a regime of exercise and other healthful life choices.
Multi-grain sandwich bread
A multi-grain bread is high in carbohydrates but it tends to contain whole, unrefined grains that are high in naturally occurring fiber. This can help lessen the impact of carbohydrates on blood sugar.
When choosing whole-grain bread, people should find one that includes ingredients such as oats, quinoa, buckwheat, whole-grain wheat, brown rice, bran, and barley.
Whole grains have a lower GI score than wheat flour, and many grains contain other nutrients, such as zinc, vitamin E, and protein.
Tortillas can provide a tasty, versatile, and sometimes healthier choice for sandwiches.
Manufacturers are increasingly providing a wider range of low-carbohydrate tortillas to appeal to health-conscious consumers.
Many of these low-carbohydrate tortillas have added fiber to reduce the carbohydrate count. Some tortillas contain low-carbohydrate ingredients, such as whey and soy protein powders.
People can use low-carbohydrate tortillas as they would use bread, wrapping their favorite sandwich ingredients in the tortilla. You can also use tortillas for mini pizzas, homemade burritos, and tacos.
Perhaps the best choice for diabetes-friendly bread is one that contains no flour or grains.
Flourless sprouted-grain breads are available, and they are a good source of fiber. However, they are still rich in carbohydrates.
Specialty health food stores may sell grain-free breads made with ingredients like almond flour, coconut flour, and flaxseed meal. Check the nutrition facts however, since they may also be higher in calories.
Many recipes for making grain-free bread are available on the Internet.
A search term like "grain-free bread recipe" will bring up some low-carbohydrate bread recipes.
These breads tend to be more expensive to make and often yield a smaller amount compared with traditional bread recipes.
Unless a doctor or dietitian specifies, people with diabetes may not need to eliminate bread or bread products from their diet.
Low-carbohydrate, multi-grain, or whole-grain bread may be the best options.
Continuing an exercise program, using doctor-prescribed medications, and consuming mostly low-glycemic foods are the most effective ways for people with diabetes to control their blood sugar while continuing to eat the foods they enjoy.