According to the CDC, more than 37 million Americans—about 1 in 10—have diabetes. And about 1 in 5 people with diabetes don’t even know they have it.

If you are one of them, then you know that managing your disease can be a daily challenge.

You may worry about what to eat, how much to exercise, and whether your blood sugar is under control. But there is good news: by following a healthy diet based on the Mediterranean model, you can help keep your blood sugar in check and manage your diabetes without suffering through boring meals.

The Italian diet is a Mediterranean-style eating plan that emphasizes fruits, vegetables, whole grains, beans, nuts, and olive oil. It also includes a modest amount of lean protein sources such as fish and chicken, while it limits red meat, salt, and refined carbs such as white bread and enriched pasta.

For purposes of our discussion here about Italian food for diabetics, we are referring only to Type 2 Diabetes, also called non-insulin-dependent diabetes mellitus (NIDDM). This was once also referred to as “adult-onset diabetes,” however that is no longer very accurate, since in the last few generations, even some children have been showing signs of Type 2 diabetes.

The Italian Diet for Diabetics is a great way to eat healthy and enjoy delicious food at the same time. This guide provides an easy-to-follow plan designed for people with diabetes. By following the tips in this article, you may be able to better control your blood sugar levels and improve your overall health. *

1. Italians Eat More Whole Grains, Vegetables, and Fruit

Italians typically eat a diet that is high in whole grains, vegetables, and fruit. Common carbohydrates include whole grains in homemade breads and pastas, while vegetables cooked in olive oil are also popular.

italian vegetables

The precise types of vegetables and fruit in the Italian diet vary by region, as Italians tend to eat more locally grown produce. Here is a list of some of the common vegetables grown in different regions of Italy:

  • Northern Italy: Radicchio, fennel, artichokes, peas, beans, lettuce, cauliflower, cabbage, spinach
  • Central Italy: Eggplants, peppers, tomatoes, zucchini, beans, peas, pumpkins, beets, carrots
  • Southern Italy: Tomatoes, eggplants, peppers, olives, capers, fennel, artichokes, figs, grapes, almonds
  • Islands: Citrus fruits, olives, figs, grapes, capers, almonds, tomatoes, peppers

It’s worth noting that Italy has a rich and diverse agricultural landscape, with a wide variety of local produce and traditional dishes in each region. These are just some of the common vegetables grown in each area, and the actual list can vary depending on the specific location, climate, and cultural influences.

2. Italians Eat Less Meat and Fish

The Italian diet contains much less meat than the typical U.S. diet. In fact, they eat less than half the amount as Americans, rarely more than once a day, and a typical serving is only about five ounces, or about the size of a deck of cards. In fact, meat is often used only in small amounts as a flavoring, such as in pasta sauces, rather than the star of the meal.

Fish is eaten more in the coastal areas of Italy, as Italians insist on their food, and especially seafood, to be very fresh. Even so, fish only appears at the table once or twice a week. Economics might play a factor, as seafood can be a bit expensive, especially the further away from the coast that you live.

When you do choose to eat meat or fish, make sure that they are healthy alternatives like grass-fed beef, free-range chicken, or wild-caught salmon.

3. The Italian Diet for Diabetics Limits Sugars and (Bad) Carbs

Contrary to the stereotypes, traditional Italians tend to limit their intake of carbohydrates from bread, pasta, and rice. Instead, they often opt for a healthier alternative of fresh vegetables and salads. (Not to mention that when they do eat pasta or rice, the portions are much smaller than people in the U.S. eat.)

Italians prefer to make their own sauces at home with olive oil, fresh herbs, and garlic. This way, they can control the amount of sodium and fat in the sauce.

Italians also limit their intake of cured meats, such as prosciutto and salami, which can be high in sodium and saturated fat.

Italians often enjoy a glass of wine with their meals, but they try to limit their intake of alcohol, as too much can lead to spiked glucose and weight gain.

If they are eating out at an Italian restaurant, they try to select dishes that are low fat, low sodium, and with a carbohydrate content that fits into their meal plan. They also try to eat at a slower pace, which can help to prevent overeating.

Example: Let’s say you are at an Italian restaurant for dinner. You could start off with a small salad that is dressed with olive oil and balsamic vinegar. For your main course, you could order a fish dish with a side of steamed vegetables. For dessert, you could have a piece of fresh fruit. This meal would satisfy your cravings for Italian food, while still being mindful of your carb and fat intake.

italian vegetable pasta for diabetes

4. Enjoy Pasta, But Choose the Right Kind

When eating pasta on a diabetes diet, it’s important to look for whole grain varieties and pay attention to portion size. Whole grain varieties of pasta are high in fiber, which helps regulate blood sugar levels. Examples of whole grain pasta include wheat pasta, lentil pasta, buckwheat pasta, chickpea pasta, and pea pasta.

Additionally, vegetable noodles can serve as a great alternative to pasta. Vegetable noodles can be created from zucchini, carrot, spaghetti squash, butternut squash, and cucumber.

When it comes to sauces, it’s best to choose tomato-based sauces over rich and creamy dairy-based sauces to avoid an increase in calories and fat. Additionally, check the tomato-based sauces for added sugars. Pesto sauce is another great option.

“Alfredo” sauce (which doesn’t even exist in Italy) contains parmesan cheese, butter, and oil, which add more calories and fat to pasta dishes than marinara-style tomato sauces.

5. Add Flavor with Fresh Herbs

Adding fresh herbs to Italian dishes can help make the Italian diet more suitable for diabetics. The fresh herbs, such as basil and thyme, can add flavor and complexity to dishes without adding extra sugar, fats, and calories.

Basil can be used, for example, to create a delicious pesto sauce and can also be incorporated into a tomato salad. Thyme can also be used to create a flavorful tomato sauce that is much lower in sugar and calories than the traditional creamy sauce.

fresh italian herbs

These herbs can also help create flavorful and healthy dishes, like shrimp with lemon zest, chicken salad with pesto, or basil focaccia wedges. In this way, incorporating fresh herbs into Italian dishes can help make the Italian diet healthier, tastier, and more suitable for diabetics.

Finally, herbs contain micronutrients, which seem to have health benefits of their own. These aren’t completely understood, but anecdotally, Italian grandmothers have been “prescribing” herbs to cure common ailments for centuries.

6. The Italian Diet for Diabetics Is Plant-Based

Dietary guidelines for the Italian diet for diabetics focus on eating foods that are lower in carbohydrates and fats. This means fruits and vegetables should be eaten in abundance, and foods that are high in sugar, such as cakes and cookies, should be avoided.

As previously mentioned, meat and seafood ingredients are less often used as a main course, and more often used to flavor foods, such as pasta dishes. Instead, Italians often eat beans or legumes as a plant-based source of high-quality protein. This puts the Italian Mediterranean Diet vs The Keto Diet in sharp contrast.

Replacing white rice and pasta with whole grain varieties is also important, as is limiting the amount of butter used in recipes. Additionally, Italians generally enjoy smaller portions of food, so it is important to practice portion control when following the Italian diet.

7. Italians Eat in Moderation

When it comes to moderation, Italians have managed to create a balanced diet that is rich in fresh fruits, vegetables, and whole grains. This diet is low in added sugar, fat, and processed food, which can have a positive effect on diabetics. In comparison, people in the U.S. tend to get most of their calories from refined carbohydrates and added sugars, which can lead to an increased risk of diabetes.

One factor is that Italians do not have access to the same number of fast-food chains and processed foods that are readily available in the U.S. Additionally, Italians eat at a slower pace and opt for smaller portion sizes of about 100 grams of pasta compared to 300 or 400 grams in the U.S.

The environment in Italy also contributes to a healthier lifestyle; many streets are closed to cars, making walking more appealing. Additionally, there are lots of water fountains distributed throughout Rome, making it easy to stay hydrated. All these factors make it easier for Italians to maintain a healthy weight and eat in moderation.

Overall, the Italian diet is a great example of how people can eat healthily and in moderation. By reducing our intake of added sugar and processed food and increasing our intake of fresh fruits and vegetables, we can create a healthier and more balanced diet that can benefit diabetics and non-diabetics alike.

diabetic friendly italian pizza

8. Italians Plan Meals and Don’t Snack

How do Italian diabetics plan meals to accommodate their nutritional needs and still “Eat Like an Italian?’ Here are some suggestions:

  1. Control Portion Sizes: Italians typically serve smaller portions than Americans, with a single portion of fresh pasta being around 100 grams. To practice portion control, use a smaller plate and fill it with a balanced meal of carbohydrates, proteins, and fats.
  2. Consume Less Sugar: Italians consume about half the amount of sugar as Americans, with a recommended daily intake of less than 6 teaspoons. Choose natural sweeteners such as honey, dates, and maple syrup when adding sweetness to your food.
  3. Eat Whole Foods: Italians eat mostly whole foods, such as fresh fruits and vegetables, whole grains, legumes, and lean proteins. Choose whole foods over processed foods and snacks to ensure that you are getting the nutrition you need.
  4. Drink More Water: In Italy, it is common to order water or wine with meals instead of sugary sodas and juices.
  5. No snacking. Breakfast is very light, sometimes only coffee. Lunch is a heartier meal, but still not overdone. Dinner is usually less calorically dense than lunch, and importantly, NO eating between dinner and bedtime!
  6. Walk or Bike When Possible: Many streets in Italy are closed off to cars, making it easy to walk or bike to get around. Choose active modes of transportation over cars or buses when possible.

9. Italians Engage in Physical Activity

Italians have a more leisurely pace of life than Americans, which could contribute to improved quality of life and lower stress levels. It seems that many Italians choose to get around via bikes rather than cars, and that many shops, groceries stores, and cafes are within walking distance.

walking in italy to prevent diabetes

This suggests that Italians engage in some physical activity on a regular basis, either through walking or biking. Additionally, the fact that many streets are closed off to cars could provide further incentive for people to get around by foot or by bike.

Also worth mentioning is the social aspect of Italian life, particularly around mealtime. Italians typically eat in the company of family and friends, seldom alone, and never “on-the-go.” Research has shown that this social aspect of the Italian diet has a great impact on overall well-being.

10. Italians Occasionally Fast

Traditionally, most Italians observed the Roman Catholic religion and its traditions. At certain times of the year, this called for a period of fasting. During Lent, for example, the period leading up to Easter Sunday.

Furthermore, before the 1950s, Italy was a relatively poor country economically. The infrastructure wasn’t great, so food transportation was limited to very short regional areas. Therefore, many Italians grew at least some of their own food, and in any case, food wasn’t as abundant as it is today.

For all of these reasons, Italians have historically enjoyed some of the health benefits of fasting, whether it was intentional or not.

Nowadays we know that fasting produces enormous health benefits, and there are many different protocols that allow modern people to improve their health by implementing fasting regimes that can treat a wide variety of ailments, including Type 2 diabetes.

Italian Diet for Diabetics – FAQs

What Do Italian Diabetics Eat?

Italian food is a great option for diabetics as it offers many delicious yet healthy options including lots of fresh vegetables, whole grains, and high-quality proteins. Indeed, Italian diabetics pretty much eat the same diet as non-diabetics, with only a few exceptions, such as watching their desserts, as well as breakfast time pastries.

What Can a Diabetic Eat at an Italian Restaurant?

Italian cuisine offers a variety of delicious and healthy options for those with diabetes. For starters, opt for a broth-based soup or a fresh garden salad. For a main course, with heathier options like seafood that’s baked or steamed, not fried. Thin-crust, whole wheat pizzas with vegetables are also great options. For sides, order vegetables steamed with a little olive oil.

Eat Like an Italian to Control Type 2 Diabetes

According to an article in The National Library of Medicine, “Each component of the [Italian] Mediterranean diet could be involved in processes related to diabetes homeostasis. Overall, single actions from different nutrients could be enhanced by interactions and synergies that make the Mediterranean diet an invaluable tool in the primary and secondary prevention of diabetes. The importance of this diet within the set of habits of a healthy lifestyle must be emphasized.”

If you have diabetes, the Italian Mediterranean diet may be a good option for you. Always consult your physician, of course, but this style of eating emphasizes fresh, healthy foods and can help you control your blood sugar levels.

So eat like an Italian and start your journey on the road to better health today!

*Content on this site is for informational purposes only and is not intended as medical advice.

Rick Zullo


Former doctor, current science teacher, and life-long food lover, Rick's passion for Mediterranean cuisine was ignited while living as an expat in Rome, Italy. 


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