Milk and Diabetes
Key Takeaways
Milk and milk alternatives are good sources of calcium and can be used as part of a healthy diet.
Options with a balanced amount of carbohydrate and protein are best for blood glucose control.
Diabetes-specific nutritional formula such as Glucerna can be used as a snack or meal replacement.
Milk, yogurt, and other dairy products provide protein and calcium to the diet. The Health Promotion Board recommends choosing low-fat or non-fat dairy products over full-fat dairy options to reduce saturated fat intake, which has been linked to raised blood cholesterol levels.
At the same time, there has been growing interest in plant-based dairy alternatives (e.g. soy milk, oat milk, nut milks like almond/cashew milk). They are not only good options for those with lactose intolerance or milk allergy, but also tend to be low in saturated fat and cholesterol.
With so many options available, how do we tell which options are healthier for us, and how do they affect our blood glucose control?
Having milk and dairy in your diet
Research has found that consuming dairy, especially yogurt and low-fat dairy products, was associated with a decreased risk of type 2 diabetes. Lactose is the main carbohydrate source in dairy products. Due to its chemical structure, lactose is broken down more slowly compared to its other sugar counterparts (e.g. sucrose) and therefore causes a slower rise in blood glucose levels after consumption. The protein and fat found in dairy products also stimulates insulin secretion, which further helps with blood glucose absorption and blood glucose control.
Milk and yogurt also contains a good balance of carbohydrate and protein which helps with blood glucose control. For example, in a 100g portion, whole milk contains 4.8g of carbohydrate and 3.15g of protein while oat milk contains a much higher proportion of carbohydrate, containing 5.1g of carbohydrate and only 0.8g of protein. As a result, the cow’s milk would cause a lower blood glucose spike due to the better balance of carbohydrate and protein. This is the reason some sweetened yogurts have a relatively low glycaemic index (a measure of how quickly a food causes blood glucose levels to rise) and do not cause blood glucose spikes in some people.
Milk Alternatives for Diabetes
Plant-based milk alternatives are developed with the aim of being similar to cow’s milk in terms of appearance, taste, and texture. They are water extracts of plants and tend to be lower in fat and calories compared to cow’s milk. However they also often lack nutrients and need to be fortified with one or more nutrients (e.g. calcium) to make them nutritionally similar to cow’s milk.
Generally, dairy products are higher in protein (including essential amino acids) calories, fat, calcium, and potassium than plant-based milk alternatives and tend to be cheaper. Most plant-based dairy alternatives also contain antinutrient compounds that reduce the absorption of vitamins and minerals from the drink. Furthermore, these nutrients are not fully dissolved in the drink and settle at the bottom, so very little of the vitamins and minerals may be consumed if it is not shaken before consumption.
The main carbohydrates present in plant-based milk alternatives are glucose, sucrose, and maltose. These sugars are known to be broken down more quickly in the body compared to lactose, potentially causing a larger blood glucose spike, especially if it contains a significant amount of carbohydrate and is low in protein.
The table below outlines the nutritional content of milk and milk alternatives. When choosing a milk option, choosing unsweetened versions and options with a balanced carbohydrate and protein amount would be your best bet for optimizing blood glucose control.
Furthermore, plant-based milk alternatives are naturally low in calcium so when choosing them, check if they have been fortified with calcium.
| Food (values per 100g) | Calories (kcal) | Carbohydrate (g) | Sugar (g) | Protein (g) | Fat (g) | Calcium (mg) |
|---|---|---|---|---|---|---|
| Cow’s milk | 61 | 4.8 | 5.05 (lactose) | 3.15 | 3.25 | 113 |
| Low fat milk | 50 | 4.8 | 5.06 (mostly lactose) | 3.3 | 1.98 | 120 |
| Fat-free milk | 34 | 4.96 | 5.09 (lactose) | 3.37 | 0.08 | 122 |
| Yoghurt, plain | 61 | 4.66 | 4.66 | 3.47 | 3.25 | 121 |
| Sweetened condensed milk | 321 | 54.4 | 54.4 | 7.91 | 8.7 | 284 |
| Evaporated milk | 134 | 10 | 10 | 6.81 | 7.56 | 261 |
| Soy milk, unsweetened | 38 | 1.29 | 0.56 (sucrose) | 3.55 | 2.12 | 101 |
| Almond milk, unsweetened | 15 | 1.31 | 0.81 (sucrose) | 0.4 | 0.96 | 184 |
| Oat milk, unsweetened | 48 | 5.1 | 2.32 (glucose + maltose) | 0.8 | 2.75 | 148 |
| Pea milk, unsweetened | 29 | 0 | 0 | 3.33 | 1.88 | 188 |
| Glucerna | 88 | 11.9 | 2.64 | 4.4 | 3.08 | 110 |
Source: USDA FoodData Central
What about Glucerna?
Glucerna is a nutritional drink formulated for people with diabetes to provide balanced nutrition while keeping blood glucose levels more stable compared to high glycemic index carbohydrates (e.g. juice, sweetened beverages, oats, white rice/bread). It is nutritionally complete meaning that it is possible to meet all your nutritional requirements just by consuming Glucerna alone.
One study found that drinking Glucerna resulted in more stable post-meal blood glucose levels compared to eating oatmeal. The effect was attributed to the balance of protein, carbohydrate and fat found in Glucerna, whereas carbohydrate makes up a high percentage of oatmeal.
Glucerna comes in different flavors making it an attractive option for people who do not enjoy the taste of plain, unsweetened milk or milk alternatives. It is a convenient meal or snack replacement option.
It is worth noting that Glucerna contains more than double the amount of carbohydrate compared to protein so monitoring your response to Glucerna is advisable, as it is when trying any new nutritional supplement or milk alternative.
Have more questions? Check out NOVI Magnum, our diabetes management program can help get your blood sugar under control, with the help of your very own healthcare team.
You will get glucose levels reading in real-time to see the immediate impact of what you eat so you and your care team will understand your body better. In addition, your doctor and your dietitian will create a holistic treatment plan covering medication, nutrition and fitness that best suits your unique health goals.