Dishing up the truth: diabetes myths debunked
Overview: diabetes in care
Outdated diabetes myths still shape care in many care homes, but a more balanced, person-centred approach is delivering better outcomes for residents and teams alike.
Supporting residents with diabetes in care homes is one of the most complex challenges facing care and catering teams today.
With around 25% of care home residents living with diabetes, and over 1 in 3 at risk of malnutrition, managing diabetes isn’t just about controlling blood sugar but balancing clinical needs with nutrition, dignity, and quality of life.
However, despite evolving guidance, many care homes are still influenced by outdated approaches to diabetes care, often leading to unnecessary dietary restrictions that can negatively impact their residents’ intake and wellbeing.
As Tess Warnes, Registered Dietitian and Head of Nutrition & Sustainability at allmanhall, explains:
“Diabetes has always been one of the longest-standing areas of nutrition misinformation. Even now, it’s something on which we constantly have to re-educate.”
How can care homes take a more effective, person-centred approach?
This blog will cover:
- The science of diabetes and the differences between type 1 and type 2 diabetes
- The truth behind common diabetes myths
- Practical guidance for menu planning and catering for residents with diabetes
- Special considerations for residents to ensure choice, dignity, and quality of life
What is diabetes and why does it matter in care homes?
At its core, diabetes is a condition that affects how the body manages blood glucose (sugar). As Tess explains:
“Diabetes is essentially about how the body produces or responds to insulin. When that system isn’t working properly, blood glucose levels can become too high and over time, that’s where complications can develop.”
There are two main types seen in care settings:
- Type 1 diabetes, where the body does not produce the hormone insulin at all and insulin treatment is essential. Less than 10% of those with diabetes have type 1.
- Type 2 diabetes, the most common form, where the body either doesn’t produce enough insulin, or the insulin it produces doesn’t work effectively. There’s no cure, but some people with type 2 diabetes can put their diabetes into remission.
Diabetes treatment focuses on managing blood sugar levels through healthy eating, exercise, and personalised medication plans prescribed by the NHS, including insulin, metformin, and GLP-1 agonists.
While type 1 diabetes requires life-long insulin therapy, type 2 diabetes is managed with lifestyle changes, medication, and sometimes insulin or weight-loss medication.
While the causes and treatments differ, both require careful management, particularly in older adults.
The risk of complications in older adults
When blood glucose levels remain too high over time, this can lead to a range of serious complications. These include:
- Cardiovascular disease, including heart attacks and strokes
- Kidney disease
- Eye conditions, such as retinopathy
- Nerve damage (diabetic neuropathy), often affecting the feet
- Reduced mobility, pain, and increased risk of falls
Tess highlights the importance of understanding this risk in context:
“Long-term high blood glucose levels can damage blood vessels and nerves, which is why good management is important, but it has to be appropriate for the individual.”
However, diabetes management in care homes isn’t just about preventing long-term complications.
Older adults are also more vulnerable to short-term risks, such as blood glucose levels going too high or too low, particularly if meals, medication, and overall intake are not well balanced.
Rethinking the "Diabetic Diet"
One of the most persistent challenges in care catering is the continued reliance on outdated dietary rules. The idea that residents with diabetes require a strict or specialist “diabetic diet” remains widespread, but it is not supported by current evidence.
Tess highlights how deeply embedded these beliefs and diabetes myths can be:
“I’ve worked with so many people who were told to cut out certain foods entirely, like bananas, and you can see how strongly that advice sticks, even when it’s not evidence-based.”
In practice, overly restrictive approaches can do more harm than good. Removing desserts, limiting snacks, or avoiding certain foods entirely can reduce overall intake, particularly concerning in a population where malnutrition is already prevalent.
In care settings, malnutrition should always take priority over diabetes management.
Challenging long-held diabetes myths
Much of the confusion around diabetes stems from long-standing misconceptions.
Common beliefs, such as the need to eliminate sugar, avoid carbohydrates, or rely on “diabetic” products, continue to influence practice, despite clear evidence to the contrary. As Tess puts it:
“There’s no need for special ‘diabetic’ foods. What residents really need is regular, tasty food, just prepared in a thoughtful and balanced way.”
In reality:
- Sugar does not need to be eliminated, but managed sensibly within meals
- Carbohydrates remain an essential energy source, particularly for older adults
- “Diabetic” or “sugar-free” products are unnecessary and can be misleading
- Skipping meals can destabilise blood glucose levels rather than improve them
- Fruit, in appropriate portions, is a valuable source of fibre and nutrients
The focus should instead be on balance, consistency, and overall dietary quality, not restriction.
Why individualised care matters
There is no one-size-fits-all approach to diabetes in care environments.
Residents present with a wide range of needs, from those requiring weight management to those at significant risk of undernutrition. Some may experience swallowing difficulties, reduced appetite, or other medical conditions that further complicate dietary planning.
Guidance from the National Advisory Panel on Care Home Diabetes emphasises the importance of a fully individualised approach, where nutritional care plans reflect both clinical priorities and personal needs. Tess Summarises this clearly:
“Food is part of diabetes management but it’s also about dignity, pleasure, and quality of life. We have to weigh all of that up.”
This may involve:
- Prioritising calorie intake for underweight residents
- Adjusting portion sizes rather than restricting food groups
- Continuing to offer desserts and snacks to support intake
- Encouraging slow-release carbohydrates where appropriate
Above all, it reinforces a key principle: choice must remain central.
Balancing clinical care with quality of life
Food plays a far greater role than simply meeting nutritional requirements. In care settings, it is a key part of the day, providing structure, enjoyment, and social connection.
Overly restrictive dietary practices can unintentionally remove these benefits. When residents avoid snacks or desserts due to perceived “rules”, the impact is not just nutritional – it affects overall wellbeing. Tess shares a common scenario:
“I’ve seen residents stop having snacks altogether because they think they shouldn’t have what’s on offer. That’s where we start to see real issues with intake.”
A more effective approach is one that enables:
- Choice and flexibility
- Enjoyable, familiar meals
- Regular eating patterns
- Confidence among care and catering teams
Because ultimately, good diabetes care is not about perfection – it’s about balance
Practical considerations for care teams
Adopting a more balanced approach does not require complexity. In many cases, it involves small but meaningful changes:
- Provide regular meals and snacks containing slow-release carbohydrates e.g., wholemeal bread, rice, pasta, and skin-on potatoes
- Focus on portion control rather than restriction
- Limit sugary drinks and added sugars in cereals
- Avoid unnecessary “diabetic” products
- Offer 2-3 portions of fruit a day and make up the ‘5 a day’ using vegetables
- Always prioritise the individual’s needs and preferences
“Food is an integral part of the day – don’t take that away from residents.”
A more progressive approach to diabetes care
As understanding of diabetes, and moves towards debunking the diabetes myths, continues to evolve, so too must the approach within care settings.
Moving away from outdated restrictions towards a more person-centred model allows care teams to better support both health outcomes and quality of life. Tess captures this shift perfectly:
“When we move away from restriction and focus on balance and the individual, that’s when we start to see the best outcomes, not just clinically, but in overall wellbeing.”
By combining evidence-based nutrition with practical, flexible catering strategies, it is possible to deliver care that is not only clinically appropriate but genuinely supportive of residents’ wellbeing.
And that is where the greatest impact lies.
How allmanhall can support you
Delivering this kind of balanced, person-centred approach to diabetes care takes the right expertise, insight, and ongoing support.
allmanhall work as an extension of our client partners’ catering teams, bringing together food procurement, foodservice consultancy, and nutrition & dietetics expertise to help confidently manage complex dietary needs, including diabetes.
Our support includes access to a Registered Dietitian, providing tailored guidance, training, and menu development, alongside procurement solutions that give greater choice, control, and cost efficiency without compromising on quality. As Tess Warnes concludes:
“It’s about giving care teams the confidence to do what’s right for their residents – balancing nutrition, health, and quality of life, without unnecessary restriction.”
If you’re reviewing your approach to diabetes care or want to give your teams greater confidence in supporting residents, allmanhall are here to help.
Get in touch to discover how we can support your organisation in delivering practical, effective, and person-centred nutrition solutions.
