Milk is a staple of many diets, but its carbohydrate count can impact blood sugar, which might be a concern for people with diabetes.

Carbohydrates take the form of lactose in milk. Lactose is a natural sugar that provides energy to the body. An 8-ounce (oz) serving of milk contains 12 grams (g) of carbohydrates.

The American Diabetes Association (ADA) recommends individualizing carbohydrate content at meals to obtain healthy blood sugar levels. Checking your blood sugar before and after meals can help you identify to which foods and in what quantities the body and blood sugar respond.

Start with 1 or 2 servings at a meal, or 15 to 30 g of carbohydrates. Many factors can change the recommended amount of milk, however. One cup of cow milk provides 12 grams of carbohydrates, which is equivalent to one serving.

While cow's milk adds calcium to the diet, its impact on blood sugar should cause a person with diabetes to consider alternatives.

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The types of milk recommended for diabetes will vary depending on their carbohydrate requirements.

The "best" milk for a person with diabetes depends on the flavors they prefer, the rest of their daily diet, and their overall daily carbohydrate intake.

For example, if a person aims to reduce their carbohydrate intake as much as possible, almond and flax milk contains nearly zero carbohydrates.

All cow's milk does contain carbohydrates, and it is important for people with diabetes to factor this into their carbohydrate counts. However, skim milk can be a lower- fat, lower-calorie option for people who are not lactose intolerant and prefer cow's milk.

Lower-fat foods and beverages like skimmed milk might result in a higher blood sugar level due to faster absorption. Glucose monitoring might therefore be helpful to determine if and what kind of cow milk is best.

Milk and type 2 diabetes risk

Several scientific studies have attempted to find a link between drinking milk and a reduced risk for type 2 diabetes.

A 2011 study in the Journal of Nutrition examined 82,000 women who had already finished menopause and, at the start of the study, had not received a diagnosis of diabetes. Over the course of 8 years, the researchers measured the participants' intake of dairy products, including milk and yogurt.

They concluded the following:

"A diet high in low-fat dairy products is associated with lower diabetes risk in postmenopausal women, particularly those who are obese."

Another study from 2011, published in the American Journal of Clinical Nutrition, tracked the relationship between dairy consumption during adolescence and their risk for type 2 diabetes as an adult.

The researchers concluded that consuming more dairy products during adolescence were associated with a reduced risk of type 2 diabetes.

The researchers also found that the adolescents with the higher dairy intake and lower prevalence of diabetes later in adulthood also had a lower intake of sugar-sweetened beverages and trans-fats, a lower glycemic load, and consumed less red and processed meats.

Whether or not the resulting lower diabetes risk was due to the dairy itself or the many other lifestyle factors, including consistent dairy intake into adulthood, necessitates more research.

A 2014 study, conducted by researchers in Sweden, found that a higher intake of high-fat dairy products, including butter, yogurt, milk, cream, and cheese, was associated with a lower risk of diabetes.

The researchers examined the effects of different saturated fats and concluded that a diet rich in the types of saturated fat found in dairy had a protective effect against type 2 diabetes.

They also found a link between an increased risk of developing the condition and a diet rich in saturated fats from meat.

Selecting a type of milk might involve different considerations for people who already have type 2 diabetes. They might focus more on controlling carbohydrate intake than fat intake.

However, these studies raise the point that not all fats are harmful to health, including those found in milk.

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Almond milk is one of the many alternatives to cow's milk.

Grocery stores often offer many types of milk, including cow's milk with varying percentages of fat, soy, flax, rice milk, and almond milk.

Below is nutritional information for some common milk options. All serving sizes are for 1 cup, or 8 ounces, of milk:

Whole milk

  • Calories: 149
  • Fat: 8 g
  • Carbohydrate: 12 g
  • Fiber: 0g
  • Protein: 8 g
  • Calcium: 276 mg

Skim milk

  • Calories: 91
  • Fat: 0.61 g
  • Carbohydrate: 12 g
  • Fiber: 0 g
  • Protein: 9 g
  • Calcium: 316 mg

Almond milk (unsweetened)

  • Calories: 39
  • Fat: 2.88 g
  • Carbohydrate: 1.52 g
  • Fiber: 0.5-1 g (depends on brand)
  • Protein: 1.55 g
  • Calcium: 516 mg

Soy milk (unsweetened)

  • Calories: 79
  • Fat: 4.01 g
  • Carbohydrate: 4.01 g
  • Fiber: 1 g
  • Protein: 7 g
  • Calcium: 300 mg

Flax milk (unsweetened, no protein added)

  • Calories: 24
  • Fat: 2.50 g
  • Carbohydrate: 1.02 g
  • Fiber: 0 g (depends on brand)
  • Protein: 0 g
  • Calcium: 300 mg

Rice milk (unsweetened)

  • Calories: 113
  • Fat: 2.33 g
  • Carbohydrate: 22 g
  • Fiber: 0.7 g
  • Protein: 0.67 g
  • Calcium: 283 mg

While these are only a few of the many milk options for people with diabetes, the nutritional contents demonstrate the stark differences between varying types of milk.

It is important to note that the profiles above are for unsweetened varieties. If these types of milk contain added sugars, they also contain more carbohydrates.

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Milk is a vital source of calcium.

Milk can be an important source of calcium, vitamin D, and protein while contributing to the daily fluid intake.

The ADA recommends choosing low-calorie, low-carbohydrate drinks, including:

  • coffee
  • low-calorie drink mixes
  • unsweetened tea
  • water
  • sparkling water

In contrast to the Swedish study above, the ADA suggests choosing a 1 percent or fat-free milk whenever possible and emphasize the importance of remembering to incorporate dairy carbohydrates into the daily count.

Research is ongoing into the saturated fat content of dairy products, and dairy fats might not need to be as restricted as previously believed.

If a person is avoiding lactose, other milk options are available, including products made from rice, almond, soy, flax, coconut, hemp, and cashew.

A diet can be varied and nutritious without the inclusion of milk. People who wish to exclude milk from the diet will need to find alternative sources of calcium.

Most dairy products, including yogurt, cheese, and ice cream, contain carbohydrates. Read nutrition labels carefully for serving sizes and carbohydrate counts.

Regardless of the choice of milk, moderation and blood sugar monitoring are key.

It is always important to check food labels for information about serving sizes and the number of carbohydrates.

A variety of foods contain carbohydrates, including:

  • bread
  • pasta
  • starchy vegetables, such as potatoes, peas, and corn
  • beans
  • milk
  • yogurt
  • fruits
  • sweets
  • fruit juices

It is easy to forget to incorporate the carbohydrates from milk into the carbohydrate count, but this can lead to blood sugar levels that are higher than expected. It might help to measure by thinking in terms of "carbohydrate servings."

One example of a typical dairy carbohydrate serving includes 1 cup of cow's milk and 6 oz of yogurt. There are about as many carbohydrates in this serving as there are in a small piece of fruit or a slice of bread.

Q:

Can I drink milk if I have diabetes?

A:

Drinking milk with diabetes is not a black-and-white issue. The choice is a personal one and based on many factors, including:

  • activity level
  • overall calorie intake
  • distribution of fat intake between saturated and unsaturated fats
  • intake of other beverages
  • the results of blood glucose monitoring results

Overall, I tend to recommend yogurt and full-fat cheese over milk as dairy staples, due to their well-studied fermentation and lower glycemic-load benefits.

However, if a glass of milk helps you avoid a soda, juice, or other sweetened beverage, go for it!

Natalie Butler, RD, LD Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.