Bread is a popular food and a key element of diets in many countries. However, it is often high in carbohydrates, so people with diabetes may wonder if they can still eat it.

The good news is that bread can form part of a healthy diabetes eating plan. It is one of many carbohydrate-containing foods a person can choose to include within their carbohydrate budget for each meal or snack.

This article will explore how people with diabetes can include bread in their diet and list some of the healthier choices available.

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There are two main types of diabetes, type 1 and type 2. People manage them with lifestyle changes and medication.

Diabetes development

Type 1 diabetes happens when the body cannot produce insulin, a hormone that “captures” blood sugar, also called glucose, and transfers it into cells. Glucose is the preferred energy source for cells.

Type 2 diabetes is the most common form. According to the Centers for Disease Control and Prevention (CDC), more than 37 million people have diabetes in the United States, and 90–95% have type 2. Diet, genetics, and lifestyle factors contribute to its development.

The CDC also states that 1 in 3 adults in the U.S. has prediabetes. This is approximately 96 million people, and 80% of these individuals are unaware they have it.

Prediabetes means a person has high blood sugar levels, but not as high as those with diabetes. Prediabetes can potentially develop into diabetes. However, managing blood sugar can help prevent or delay this.

Blood sugar management

With prediabetes or diabetes, a person can improve their health and lower the risk of complications by taking steps to manage the condition. Nutrition plays a crucial role.

Carbohydrates are one of the three major nutrients essential to human health. However, the body converts carbohydrates into glucose, which it absorbs into the bloodstream, raising blood sugar. For this reason, being aware of carbohydrate intake is part of managing blood sugar levels with diabetes or prediabetes.

The American Diabetes Association’s Diabetes Plate Method is a tool to help plan diabetes-friendly meals. According to this method, the makeup of a person’s plate should consist of the following:

  • one-half nonstarchy vegetables such as carrots, leafy greens, broccoli, and peppers
  • one-quarter lean proteins such as lean meats, fish, or tofu
  • one-quarter carbohydrates

Carbohydrate foods suitable for a diabetes eating plan include:

  • starchy vegetables, such as peas, potatoes, and squash
  • beans and legumes, such as chickpeas, black beans, and kidney beans
  • fruits
  • dairy products, such as yogurt and milk, or nondairy milk substitutes
  • whole grain products such as bread, brown rice, and oats

Everyone’s body responds differently to food, including carbohydrates. A person can consult a doctor or registered dietitian to develop a personalized diabetes eating plan to help manage blood sugar according to their individual needs.

Managing portions

Bread is one of many grain products a person can choose to eat within the carbohydrates category.

However, managing portions is important to ensure they only make up one-quarter of the whole plate when following the Diabetes Plate Method.

Eating more bread than the recommended amount may make it harder to meet overall goals for carbohydrate intake and manage blood sugar levels.

Checking sugar content

When producers use yeast to make bread rise, the bread usually needs some sugar to “feed” the yeast.

Some commercial bread types contain more sugar than is necessary to make it rise. A person can check the nutrition label to see the number of carbs and added sugars in a slice of bread.

Most commercial white bread contains only 1–3 grams of added sugar per slice. Higher sugar levels may mean it contains unnecessary added sugars.

Serving bread

People can further reduce the carb content of a meal containing bread by choosing spreads carefully, for example, serving it with unsweetened peanut butter or avocado instead of jellies or chocolate spread.

Types of bread that may be healthier options for people managing diabetes include:

100% whole grain

Most commercially-available bread options contain refined white flour. This provides little to no fiber. Even “wheat bread” may contain refined wheat, not whole grain wheat flour.

Fiber is a type of carbohydrate the body cannot digest. It keeps the bowels regular and helps promote a feeling of fullness.

Fiber can also help control blood sugar. According to a 2020 review of existing research, high fibre diets lead to improvements in measures of blood sugar management and inflammation, as well as a reduction in premature mortality.

Whole grain bread naturally contains fiber. However, 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.

A person can read the ingredients list to check for 100% whole grain or whole wheat flour as the first ingredient in commercial bread. This will contain more nutrients.

Fiber-enriched

Bread can be a good source of fiber if it contains 3 or more grams per slice. Some breads are available that have extra soluble fiber added.

However, fiber-enriched whole grain breads are still relatively high in carbohydrates, so it is important to eat them in moderation.

Low carbohydrate tortillas

Tortillas can provide a tasty, versatile, and sometimes healthier choice for sandwiches. Manufacturers are increasingly providing a wider range of low carbohydrate tortillas.

Many of these 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 bread, wrapping their favorite sandwich ingredients in the tortilla. They can also use them for mini pizzas, homemade burritos, and tacos.

Bread recipes

Many recipes for making grain-free bread are available online.

However, these breads tend to be more expensive to make and often yield a smaller amount compared with traditional bread recipes. Depending on the ingredients, the carbohydrate, sugar, and fiber contents may not provide any benefits over traditional whole grain bread.

If a person chooses to bake their own bread, they might consider a 100% whole wheat, low sugar recipe.

However, knowing the exact carbohydrate content of homemade bread can be challenging, so it may not be suitable for all eating plans.

Checking ingredient lists and nutrition labels on bread packaging can help people with diabetes choose a suitable product.

To recap, to help manage blood sugar, it is most important to choose bread that is:

  • 100% whole grain, such as 100% whole wheat
  • a good source of dietary fiber, containing at least 3 grams per slice
  • low in added sugars, with only 1–3 grams per slice

Some specialty ingredients may provide additional fiber, protein, and healthy fats. These include:

However, bread containing these ingredients can be expensive. Portion-for-portion, they are unlikely to offer extra benefits for managing blood sugar. A budget-friendly 100% whole wheat bread is an equally good choice for a diabetes eating plan.

People with diabetes can choose to include bread and bread products in their diet. However, in a diabetes eating plan, people will need to manage bread portions so as not to exceed their total carbohydrate budget.

Whole grain, high fiber breads with minimal added sugar may be the best options.

Continuing an exercise program, using doctor-prescribed medications, and following a diabetes eating plan are the most effective ways for people with diabetes to manage their blood sugar while continuing to eat the foods they enjoy.