Foods to eat to lower HbA1c are a key focus for anyone managing type 2 diabetes or non-diabetic hyperglycaemia (prediabetes) in the UK. HbA1c reflects your average blood glucose over two to three months, and sustained dietary changes can produce clinically meaningful reductions in this marker. From wholegrains and legumes to oily fish and non-starchy vegetables, the right food choices — combined with appropriate portion sizes and meal patterns — can support better glycaemic control. This article outlines evidence-based dietary strategies aligned with NICE, NHS, and Diabetes UK guidance to help you make informed decisions about your diet.

How Diet Affects HbA1c Levels

Diet directly influences post-meal blood glucose because carbohydrates are broken down into glucose during digestion; the type, quantity, and quality of carbohydrates consumed affects HbA1c over time. Sustained dietary changes, not individual foods, produce clinically meaningful reductions.

HbA1c — or glycated haemoglobin — is a blood marker that reflects your average blood glucose levels over the preceding two to three months. When glucose in the bloodstream binds to haemoglobin in red blood cells, it forms HbA1c. The higher your blood sugar levels over that period, the higher your HbA1c reading will be.

In the UK, an HbA1c of 48 mmol/mol (6.5%) or above is used to diagnose type 2 diabetes. A reading of 42–47 mmol/mol (6.0–6.4%) indicates non-diabetic hyperglycaemia (NDH) — sometimes referred to as prediabetes — which means blood glucose is higher than normal but not yet in the diabetic range. For people with NDH or type 2 diabetes, reducing HbA1c is a key clinical goal, as elevated levels are associated with an increased risk of complications including cardiovascular disease, kidney damage, and neuropathy.

NICE guideline NG28 sets typical HbA1c targets for adults with type 2 diabetes at 48 mmol/mol (6.5%) for those managed by diet or a single medication without hypoglycaemia risk, or 53 mmol/mol (7.0%) for those on therapies that carry a risk of hypoglycaemia (such as sulphonylureas or insulin). These targets are individualised and should be agreed with your diabetes care team. HbA1c is usually re-checked approximately three months after any significant dietary or medication change to assess response.

Diet plays a central role in managing blood glucose because the foods you eat directly influence how much glucose enters the bloodstream after a meal. Carbohydrates, in particular, are broken down into glucose during digestion. The type, quantity, and quality of carbohydrates consumed — as well as the overall dietary pattern — can significantly affect post-meal glucose levels and, over time, HbA1c.

It is important to understand that no single food will dramatically lower HbA1c on its own. Rather, it is the overall dietary pattern sustained over weeks and months that produces meaningful change. Factors such as portion sizes, meal timing, fibre intake, and the glycaemic index (GI) of foods all contribute. Combining dietary changes with regular physical activity and, where prescribed, medication, offers the most effective approach to reducing HbA1c in a clinically meaningful way.

Foods That Can Help Lower HbA1c

Non-starchy vegetables, wholegrains, legumes, oily fish, nuts, and berries are evidence-informed choices that support better blood glucose control and may contribute to lower HbA1c readings. Refined carbohydrates, sugary drinks, and ultra-processed foods should be limited.

Certain foods have been shown in clinical research to support better blood glucose control and, consequently, may contribute to lower HbA1c readings over time. Incorporating these into your regular diet is a practical and evidence-informed strategy. It is worth noting that both the total amount of carbohydrate consumed (glycaemic load) and the type of carbohydrate matter — not GI alone.

Non-starchy vegetables such as broccoli, spinach, kale, courgette, and peppers are low in carbohydrates and rich in fibre, vitamins, and antioxidants. They have a minimal impact on blood glucose and should form a substantial part of every meal.

Wholegrains and high-fibre carbohydrates — including oats, barley, wholegrain bread, brown rice, and lentils — are digested more slowly than refined carbohydrates, resulting in a more gradual rise in blood glucose. Oats, in particular, contain beta-glucan, a soluble fibre associated with improved glycaemic control.

Legumes and pulses such as chickpeas, kidney beans, and lentils have a low glycaemic index and provide both protein and fibre, helping to slow glucose absorption.

Oily fish (salmon, mackerel, sardines) and lean proteins (chicken, turkey, tofu, eggs) do not directly raise blood glucose and can help with satiety, reducing the likelihood of overeating carbohydrate-rich foods.

Nuts and seeds — including almonds, walnuts, chia seeds, and flaxseeds — provide healthy fats and fibre with a low glycaemic impact. A practical portion is a small handful (approximately 30 g) per serving.

Berries such as blueberries, strawberries, and raspberries tend to have a lower sugar content per portion than some other fruits and contain polyphenols that may modestly support insulin sensitivity, though the evidence for this specific effect remains limited. A standard portion of fruit is approximately 80 g (one small piece or a small handful of berries). Whole fruit is preferable to fruit juice or dried fruit, both of which can raise blood glucose more rapidly and should be limited.

Conversely, it is advisable to limit refined carbohydrates, sugary drinks, ultra-processed foods, and foods with a high glycaemic index, as these can cause rapid blood glucose spikes. People with chronic kidney disease or other health conditions may require tailored dietary advice from a registered dietitian, as some general recommendations may not be appropriate for them.

Building a Balanced Plate: Practical Meal Guidance

The Diabetes UK Plate Method recommends filling half your plate with non-starchy vegetables, a quarter with lean protein, and a quarter with high-fibre carbohydrates to limit refined carbohydrate portions whilst maintaining nutritional balance. Water should be the primary drink of choice.

Translating nutritional knowledge into everyday meals can feel challenging, but a few practical frameworks make it considerably more manageable. One widely recommended approach is the Diabetes UK Plate Method, which encourages filling:

• Half your plate with non-starchy vegetables (salad, greens, tomatoes, peppers)

• A quarter of your plate with lean protein (fish, chicken, eggs, pulses, tofu)

• A quarter of your plate with complex, high-fibre carbohydrates (wholegrain rice, sweet potato, lentils, wholemeal bread)

This structure naturally limits refined carbohydrate portions whilst ensuring nutritional balance and satiety. It is broadly consistent with the NHS Eatwell Guide, which provides authoritative UK guidance on healthy eating proportions for the general population.

Meal timing and consistency also matter. Eating at regular intervals helps prevent large fluctuations in blood glucose throughout the day. Skipping meals — particularly breakfast — can lead to compensatory overeating later, which may cause significant glucose spikes. Where snacking is necessary, choosing options such as a small handful of unsalted nuts, plain yoghurt, or vegetable sticks with hummus is preferable to biscuits or crisps.

Cooking methods can also influence glycaemic impact. Boiling or steaming rather than frying is generally preferable. Allowing cooked starchy foods such as pasta or potatoes to cool before eating increases their resistant starch content, which may modestly reduce their glycaemic effect in some people, though this effect is variable and should not be relied upon as a primary strategy.

Hydration is often overlooked but remains important — water should be the primary drink of choice. Sugary drinks, fruit juices, and sweetened teas or coffees can contribute significantly to daily glucose load and should be minimised or avoided.

Regarding alcohol, UK low-risk guidance recommends drinking no more than 14 units per week, spread across three or more days, with several drink-free days each week. For people at risk of hypoglycaemia (for example, those taking sulphonylureas or insulin), alcohol should always be consumed with food and blood glucose should be monitored, as alcohol can mask or worsen hypoglycaemia symptoms and cause unpredictable changes in blood glucose levels.

NHS and NICE Dietary Recommendations for Type 2 Diabetes

NICE guideline NG28 endorses an individualised approach including increased dietary fibre, reduced free sugars, and consideration of Mediterranean-style or low-carbohydrate diets under supervision. People on SGLT2 inhibitors must seek clinical advice before making significant dietary changes due to DKA risk.

In the United Kingdom, dietary guidance for people with type 2 diabetes is informed by NICE guideline NG28 (Type 2 diabetes in adults: management) and supported by resources from NHS England and Diabetes UK. These guidelines emphasise an individualised approach to dietary management, recognising that no single diet suits everyone.

NICE recommends that people with type 2 diabetes receive structured self-management education about diet and lifestyle. In England, established programmes include DESMOND (Diabetes Education and Self-Management for Ongoing and Newly Diagnosed) and X-PERT, both of which provide evidence-based dietary guidance tailored to individual needs and are available through NHS diabetes care teams.

It is important to note that the NHS Diabetes Prevention Programme (NDPP) is designed for people with non-diabetic hyperglycaemia (NDH) — those at high risk of developing type 2 diabetes — rather than for people who already have an established diagnosis of type 2 diabetes.

Key dietary principles endorsed by NICE and the NHS include:

• Reducing intake of free sugars and avoiding sugar-sweetened beverages

• Increasing dietary fibre through wholegrains, vegetables, pulses, and fruit

• Adopting a Mediterranean-style dietary pattern, which has robust evidence for improving glycaemic control and cardiovascular outcomes

• Considering low-carbohydrate diets as an option for some individuals, under appropriate supervision, as evidence supports their short-to-medium-term effectiveness in reducing HbA1c

Important safety note regarding low-carbohydrate and very low-calorie diets: People taking SGLT2 inhibitors (such as dapagliflozin, empagliflozin, or canagliflozin) should be aware that very low-carbohydrate or ketogenic diets, and rapid calorie restriction, may increase the risk of diabetic ketoacidosis (DKA) — a serious condition that can occur even when blood glucose appears near-normal. The MHRA has issued specific safety guidance on this risk. Anyone taking SGLT2 inhibitors must discuss any significant dietary change with their diabetes care team before making it.

The NHS also highlights the importance of achieving and maintaining a healthy body weight, as even modest weight loss of 5–10% of body weight can produce clinically significant reductions in HbA1c. The NHS Type 2 Diabetes Path to Remission Programme offers a structured, medically supervised very low-calorie diet approach for eligible adults with type 2 diabetes (typically those diagnosed within the past six years with a BMI of 27 kg/m² or above, or 25 kg/m² or above for people of South Asian or other high-risk ethnic backgrounds). Eligibility is assessed by the diabetes care team.

Any significant dietary change should be discussed with a GP or diabetes care team, as medication doses may need adjustment to avoid hypoglycaemia.

When to Seek Further Support From Your GP or Dietitian

Contact your GP or diabetes care team if HbA1c remains elevated after three to six months of dietary changes, if you experience hypoglycaemia symptoms, or before starting a very low-calorie or low-carbohydrate diet. Call 999 immediately for severe hypoglycaemia or suspected diabetic ketoacidosis.

Whilst dietary changes can make a meaningful difference to HbA1c levels, it is important to recognise when professional support is needed. Self-managing diabetes through diet alone is not always sufficient, and attempting to do so without guidance can occasionally carry risks — particularly for those on glucose-lowering medications such as sulphonylureas or insulin, where dietary changes may increase the risk of hypoglycaemia (low blood sugar).

You should contact your GP or diabetes care team if:

• Your HbA1c remains elevated despite sustained dietary changes over three to six months

• You experience symptoms of hypoglycaemia (shakiness, sweating, confusion, palpitations), particularly after changing your diet

• You are considering a significant dietary change such as a very low-calorie or low-carbohydrate diet

• You have other health conditions (such as chronic kidney disease or cardiovascular disease) that may require a modified dietary approach

• You are losing weight unintentionally or experiencing persistent fatigue, increased thirst, or frequent urination

• You are pregnant or planning a pregnancy — dietary guidance and HbA1c targets differ during pregnancy, and early specialist input is important

Urgent situations — seek immediate help:

• If someone experiences severe hypoglycaemia (loss of consciousness, seizure, or inability to swallow), call 999 immediately

• If you develop symptoms of very high blood glucose with vomiting, drowsiness, or difficulty breathing (which may indicate diabetic ketoacidosis), seek urgent medical attention — call 999 or go to your nearest A&E

• For other urgent concerns about blood glucose or acute illness, contact NHS 111 or your GP urgently

A registered dietitian with experience in diabetes management can provide personalised, evidence-based dietary advice that accounts for your medical history, medications, food preferences, and lifestyle. Referrals can be made through your GP or diabetes specialist nurse. In many areas, NHS dietetic services are available directly through your diabetes care team.

If you believe you have experienced a side effect from a diabetes medicine, you can report this to the MHRA Yellow Card Scheme at yellowcard.mhra.gov.uk.

Experiencing these side effects? Our pharmacists can help you navigate them →

It is also worth noting that emotional and psychological factors — including stress, anxiety, and disordered eating — can significantly affect dietary habits and blood glucose control. If you find it difficult to maintain dietary changes due to emotional eating or low mood, speaking to your GP about access to psychological support or a health coach through the NHS is a positive and appropriate step. Managing HbA1c is a long-term endeavour, and having the right support in place makes sustained progress far more achievable.

Frequently Asked Questions