When many people think about diabetes, food is one of the first things that comes to mind.
We associate diabetes with eating more vegetables, choosing wholegrains, reducing sugar, and following a balanced diet. People are encouraged to make healthy choices and manage their health through what they eat.
And these are all important messages – healthy eating plays an important role in prevention and management of type 2 diabetes. But during Diabetes Week, it may be worth asking a more fundamental question: what happens when healthy eating is not simply a matter of choice?
For millions of people across the UK, the challenge is not only knowing what a healthy diet looks like, but being able to afford it.
Type 2 diabetes affects around four million people in the UK, and continues to rise each year (Diabetes UK). At the same time, food insecurity remains a reality for many individuals and families. While these issues are often seen separately, they are closely connected.
Managing diabetes often relates to what we eat. Regular meals, balanced nutrition and consistent carbohydrate intake – all help manage blood sugar levels and reduce risk of complications. However, when people are forced to manage rising food costs alongside other expenses, following these recommendations can become challenging.
Many people living with diabetes and food insecurity are caught in a difficult position. They may understand the dietary advice they have been given, but the realities of everyday life make it difficult to follow. When budgets are stretched, nutritious foods can become harder to access or prioritise, particularly alongside other pressures such as housing, energy and transport costs. For some, this may mean relying on cheaper options that are more filling or longer-lasting, even when they do not align with dietary recommendations. In these circumstances, food choices become less about health and more about what is practical and affordable.
This is one of the hidden realities of food insecurity. It is not just about hunger, but about trying to make limited resources last and having to put affordability before nutrition. For someone living with diabetes, that can make managing their condition more difficult and can affect their physical and mental health.
Many of the conversations about diabetes tend to focus on individual responsibility. While personal choices certainly do matter, taking this perspective alone can cause the wider social and economic conditions that shape those choices to be overlooked.
If someone cannot afford fresh food, is dietary advice alone enough?
If someone is relying on emergency food support, can we expect them to follow guidance that does not reflect what is available to them?
If someone is worried about paying their rent or heating their home, where does managing a long-term health condition fit within that hierarchy of urgent needs?
These questions remind us that health is not created solely in clinics, hospitals or households, but is shaped by the environments in which people live. It is just as important that people have access to affordable, nutritious food as it is that they have access to healthcare itself.
This is why addressing diabetes requires action on the underlying causes of food insecurity, not just education about healthy eating. It requires communities, healthcare services, policymakers and food organisations to work together to ensure that everyone has access to the food they need.
Research increasingly highlights the importance of compassionate, person-centered support. People are more likely to engage with healthcare when they feel understood rather than judge .When someone is struggling to afford food, practical support often depends on strong links between healthcare services, community organisations and local food initiatives that can help people access the support they need.
At FEAST, we recognise that food is about more than what is on our plates. It is closely connected to dignity, security, culture, community and health. When people have reliable access to nutritious food, they are better able to manage their wellbeing, support their families and participate in their communities.
Our healthy eating on a budget programme empowers people with confidence and skills through access to nutritional knowledge and techniques and skills to stretch food budgets.
“Since completing the programme, I’ve started using frozen vegetables more after learning that they’re just as nutritious, even more than fresh food, and they don’t spoil as quickly, and it saves money” – Taraji, programme participant
This Diabetes Week, let us move beyond focusing on what people should eat and focus instead on whether everyone has a fair opportunity to do so. Because improving health is not only about changing individual behaviours, but also creating the conditions that make healthy choices possible in the first place.
References:
- Creevy, N. and Boocock, R. (2026) ‘Information and Support Needs of Clinicians and Food‐Insecure Adults with Type 2 Diabetes: a Systematic review,’ Journal of Human Nutrition and Dietetics, 39(1), p. e70191. https://doi.org/10.1111/jhn.70191.
- Diabetes UK (no date) Diabetes UK – Know diabetes. Fight diabetes. | Diabetes UK. https://www.diabetes.org.uk/.
- Douglas, F., MacIver, E. and Kennedy, C. (2025) Food Insecurity, diabetes Self-Management and Support for Self-Management in High-Income Countries: A Qualitative Systematic Review and Synthesis (2008 to 2024), Health & Social Care in the Community. journal-article, pp. 1–29. https://doi.org/10.1155/hsc/7249750.
- Healthy eating with diabetes – South Tees Hospitals NHS Foundation Trust (2024). https://www.southtees.nhs.uk/resources/healthy-eating-with-diabetes/.
- Seligman, H.K. et al. (2023) ‘Assessing and monitoring nutrition security to promote healthy dietary intake and outcomes in the United States,’ Annual Review of Nutrition, 43(1), pp. 409–429. https://doi.org/10.1146/annurev-nutr-062222-023359. NHS (2023) Malnutrition – Symptoms https://www.nhs.uk/conditions/malnutrition/symptoms/
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Written by Nadia Gerber