Diabetic diet with Pakistani food: what goes on the plate.

How common is diabetes in Pakistan?

More common than anywhere else in the world. According to the IDF Diabetes Atlas 2025, about 34.5 million Pakistani adults aged 20 to 79 had diabetes in 2024. The age-standardised rate, 31.4%, is the highest in the world.

Pakistan also has the fourth-highest number of adults with diabetes, and 26.9% of them, about 9.3 million people, are undiagnosed. The IDF projects 70.2 million adults with diabetes by 2050.

So if someone at home says 'mujhe sugar hai' (I've got sugar), they're far from alone. What you eat every day affects your blood sugar, and a diabetic diet can come from the same pot of salan the rest of the family eats. Nobody needs a separate kitchen.

What blood sugar levels mean prediabetes or diabetes?

Doctors usually check HbA1c, which reflects your average blood sugar over the past few months, or a fasting glucose test. These are the American Diabetes Association ranges.

Many Pakistani lab reports use mg/dL, while UK reports use mmol/L, so the table shows both. A diagnosis usually needs two abnormal results, and WHO and NICE use slightly different prediabetes ranges.

A single reading taken after a heavy biryani dinner doesn't tell the whole story, so let your doctor interpret your results.

What should a diabetic eat at each meal?

Use the plate method. The US CDC suggests starting with a 9-inch plate: fill half with non-starchy vegetables, one quarter with lean protein and one quarter with carbohydrate foods. It fits Pakistani meals once you know where each food goes.

• Half the plate: sabzi such as bhindi, karela, lauki, tinda, palak or gobhi, plus a kachumber salad of cucumber, tomato and onion.
• One quarter: chicken, fish, eggs, daal, chana or dahi (plain yoghurt). Daal and chana also contain carbohydrate, so keep the bowl modest.
• One quarter: roti, rice or naan. Aloo, matar, arvi and shakarkandi (sweet potato) are starchy, so they belong here, not in the sabzi half.

Check your plate with an inch tape. If it's wider than 9 inches, each quarter is bigger too. And when a salan is swimming in oil, take more of the pieces and less of the gravy.

Many people with diabetes are also watching their cholesterol or blood pressure. Our heart-healthy Pakistani diet covers oil, ghee and salt.

How many rotis can a diabetic eat?

It depends on your size, activity and medication, so there's no single number for everyone. These figures, based on USDA FoodData Central, show what a portion holds.

Calories aren't the whole story with diabetes, but the size of your carb portion matters. Restaurant naans and tandoori rotis are usually bigger than the ones made at home. Weigh your dough ball once to learn your usual size; our guide to roti and weight loss shows how.

A few habits make portions easier. Have roti or rice at a meal rather than both. Keep the ghee off the top of your roti. Choose chakki atta (stone-ground whole wheat flour) over maida (refined white flour). Some families mix besan or jau (barley) flour into the atta, and besan adds protein.

Can diabetics have mangoes, chai and mithai?

Yes, with some planning. Nothing has to be banned for life, but sweet things need a set place in your day rather than turning up at every meal.

Fruit, including mangoes: Whole fruit is fine, one portion at a time. In mango season, have a few slices with or after a meal rather than two whole mangoes as an afternoon snack. Juice and mango milkshake lose the fibre and are easy to overdo.

Chai: Four cups a day with two spoons of sugar each adds up to eight spoons of sugar before you've eaten anything sweet. Cut down half a spoon at a time so your taste can adjust.

Mithai at weddings: Pick one small serving of the dessert you love most, have it after the meal rather than on an empty stomach, and take a short walk afterwards if you can. Gur, shakkar, honey and brown sugar are still sugar, so count them the same way.

If you check your sugar at home, test after a meal to see how a particular food affects you, and share the readings with your doctor.

Can you stop prediabetes turning into diabetes?

The risk can be lowered, though nothing is certain. The Diabetes Prevention Program, published in the New England Journal of Medicine in 2002, included 3,234 adults with raised blood sugar. A lifestyle programme aiming for at least 7% weight loss and at least 150 minutes a week of activity like brisk walking cut the risk of developing type 2 diabetes by 58% compared with placebo. Metformin cut it by 31%.

Seven per cent sounds like a lot, but for someone weighing 80 kg it's about 5.6 kg. And 150 minutes is 30 minutes of brisk walking on five days a week: laps of the park after Maghrib, or a treadmill when it's too hot outside.

Start early. Diabetes UK says people of Pakistani, Indian and Bangladeshi background are at higher risk from a younger age: risk rises from age 25, compared with 40 for white Europeans. NICE in the UK also uses lower BMI cut-offs for people of South Asian background, with overweight starting at 23 rather than 25. Our article on the insulin resistance diet covers the stage that often comes before prediabetes.

Is it safe to change your diet if you take diabetes medicine?

Yes, but plan it with your doctor rather than on your own. If you take insulin or tablets such as gliclazide, suddenly cutting carbohydrates can make your blood sugar drop too low. A low can leave you shaky, sweaty and confused, and it needs treating straight away.

So tell your doctor before you start a new diet, and agree what to do if your readings fall. Never stop or reduce your medication by yourself, even if your sugar levels improve. Home remedies such as karela juice or methi dana water are not a replacement for prescribed treatment.

The same goes for Ramadan. If you plan to fast, see your doctor beforehand, because your doses or timings may need to change.

What does a diabetic diet chart look like with Pakistani food?

Here's one example day built on the plate method. It's an illustration, not a prescription: your doctor or dietitian will set portions around your medication, readings and routine.

Spreading food across the day, rather than eating one huge dinner, means less carbohydrate arrives at any one time.

If you'd like help turning this into a plan around your family's cooking, see our blood sugar and heart health service and 28-day plans, or book a consultation.