Food Safety for People with Diabetes

Food safety is important for people living with diabetes. Diabetes can affect various organs and systems of the body, causing them not to function properly, and making a person more susceptible to infection and food illness.

  • Immune system – With diabetes, the immune system may not readily recognize harmful bacteria or other pathogens. These affects leave diabetes patients more prone to infectious disease, such as foodborne illness. A diabetic patient’s immune system may not immediately recognize harmful foodborne pathogens increasing a person’s risk for infection.
  • Stomach and Intestinal Tract – Diabetes may damage the cells that create stomach acid and the nerves that help your stomach and intestinal tract move the food throughout the intestinal tract. Because of this damage, your stomach may hold on to the food and beverages you consume for a longer period of time, allowing harmful bacteria and other pathogens to grow.
  • Kidneys – Diabetes may damage kidneys, which work to cleanse the body and may not be functioning properly and may hold on to harmful bacteria, toxins, and other pathogens.

As a consequence, having diabetes may leave one more susceptible to developing infections and are more likely to have a lengthier illness, undergo hospitalization, or even die.

To avoid contracting a foodborne illness, people with diabetes must be vigilant when handling, preparing, and consuming foods.

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Make Wise Food Choices

Some foods are more risky for people with diabetes than others.  In general, the foods that are most likely to contain harmful bacteria or viruses fall in two categories:

  • Uncooked fresh fruits and vegetables
  • Some animal products, such as unpasteurized (raw) milk; soft cheeses made with raw milk; and raw or undercooked eggs, raw meat, raw poultry, raw fish, raw shellfish and their juices; luncheon meats and deli-type salads (without added preservatives) prepared on site in a deli-type establishment.

The risk these foods may also depend on the origin or source of the food and how the food is processed, stored, and prepared.  Follow these guidelines (see chart below) for safe selection and preparation of your favorite foods.

Common Foods:  Select the Lower Risk Options

Type of Food Higher Risk Lower Risk
Meat and Poultry
  • Raw or undercooked meat or poultry
Meat or poultry cooked to a safe minimum internal temperature:

  • Beef, Pork, Veal, Lamb, Steaks, Roasts & Chops – 145 ºF with 3-minute rest time
  • Ground – Beef, Pork, Veal, Lamb – 160 ºF
  • Turkey, Chicken & Duck – Whole, Pieces, & Ground
    165 ºF
Tip:  Use a food thermometer to check the internal temperature.
  • Any raw or undercooked fish, or shellfish, or food containing raw or undercooked seafood  e.g., sashimi, found in some sushi or ceviche. Refrigerated smoked fish
  • Partially cooked seafood, such as shrimp and crab
  • Previously cooked seafood heated to 165 °F
  • Canned fish and seafood
  • Seafood cooked to 145 °F
  • Unpasteurized (raw) milk
  • Pasteurized milk
Eggs Foods that contain raw/undercooked eggs, such as:

  • Homemade Caesar salad dressings*
  • Homemade raw cookie dough*
  • Homemade eggnog*
At home:

  • Use pasteurized eggs/egg products when preparing recipes that call for raw or undercooked eggs
  • Egg Dishes – 160 ºF

When eating out:

  • Ask if pasteurized eggs were used
*Tip: Most pre-made foods from grocery stores, such as Caesar dressing, pre-made cookie dough, or packaged eggnog are made with pasteurized eggs.
  • Raw sprouts (alfalfa, bean, or any other sprout)
  • Cooked sprouts
  • Unwashed fresh vegetables, including lettuce/salads
  • Washed fresh vegetables, including salads
  • Cooked vegetables
  • Soft cheeses made from unpasteurized (raw) milk, such as: -Feta

-Queso fresco

  • Hard cheeses
  • Processed cheeses
  • Cream cheese
  • Mozzarella
  • Soft cheeses that are clearly labeled “made from pasteurized milk”
Hot Dogs and Deli Meats
  • Hot dogs, deli and luncheon meats that have not been reheated
  • Hot dogs, luncheon meats, and deli meats reheated to steaming hot or 165 ºF
Tip:  You need to reheat hot dogs, deli meats and luncheon meats before eating them because the bacteria, Listeria monocytogenes grows at refrigerated temperatures (40 ºF or below). This bacteria may cause severe illness, hospitalization, or even death. Reheating these foods until they are steaming hot destroys these dangerous bacteria and makes these foods safe for you to eat.
  • Unpasteurized, refrigerated pâtés or meat spreads
  • Canned or shelf-stable pâtés or meat spreads

Four Food Safety Steps

Learn about safety tips for those at increased risk of foodborne illness. Those living with diabetes should always follow the four food safety steps:

1. Clean:  Wash hands and surfaces often

Bacteria can spread throughout the kitchen and get onto cutting boards, utensils, counter tops, and food.

To ensure that your hands and surfaces are clean, be sure to:

  • Wash hands in warm soapy water for at least 20 seconds before and after handling food and using the bathroom, changing diapers, or handling pets.
  • Wash cutting boards, dishes, utensils, and counter tops with hot soapy water between the preparation of raw meat, poultry, and seafood products and preparation of any other food that will not be cooked. As an added precaution, sanitize cutting boards and counter tops by rinsing them in a solution made of one tablespoon of unscented liquid chlorine bleach per gallon of water, or, as an alternative, you may run the plastic board through the wash cycle in your automatic dishwasher.
  • Use paper towels to clean up kitchen surfaces.  If using cloth towels, you should wash them often in the hot cycle of the washing machine.
  • Wash produce.  Rinse fruits and vegetables, and rub firm-skin fruits and vegetables under running tap water, including those with skins and rinds that are not eaten.
  • With canned goods: remember to clean lids before opening.

2. Separate:  Don’t cross-contaminate

Cross-contamination occurs when bacteria are spread from one food product to another.  This is especially common when handling raw meat, poultry, seafood, and eggs.  The key is to keep these foods – and their juices – away from ready-to-eat foods.

To prevent cross-contamination, remember to:

  • Separate raw meat, poultry, seafood, and eggs from other foods in your grocery shopping cart, grocery bags, and in your refrigerator.
  • Never place cooked food on a plate that previously held raw meat, poultry, seafood, or eggs without first washing the plate with hot soapy water.
  • Don’t reuse marinades used on raw foods unless you bring them to a boil first.
  • Consider using one cutting board only for raw foods and another only for ready-to-eat foods, such as bread, fresh fruits and vegetables, and cooked meat.

3. Cook: Cook to safe temperatures

Foods are safely cooked when they are heated to the USDA-FDA recommended safe minimum internal temperatures:

To ensure that your foods are cooked safely, always:

  • Use a food thermometer to measure the internal temperature of cooked foods.  Check the internal temperature in several places to make sure that the meat, poultry, seafood, or egg product is cooked to safe minimum internal temperatures.
  • Cook ground beef to at least 160 ºF and ground poultry to a safe minimum internal temperature of 165 ºF.  Color of food is not a reliable indicator of safety or doneness.
  • Reheat fully cooked hams packaged at a USDA-inspected plant to 140 ºF. For fully cooked ham that has been repackaged in any other location or for leftover fully cooked ham, heat to 165 ºF.
  • Cook seafood to 145 F.  Cook shrimp, lobster, and crab until they turn red and the flesh is pearly opaque.  Cook clams, mussels, and oysters until the shells open.  If the shells do not open, do not eat the seafood inside.
  • Cook eggs until the yolks and whites are firm.  Use only recipes in which the eggs are cooked or heated to 160 ºF.
  • Cook all raw beef, lamb, pork, and veal steaks, roasts, and chops to 145 ºF with a 3-minute rest time after removal from the heat source.
  • Bring sauces, soups, and gravy to a boil when reheating. Heat other leftovers to 165 ºF.
  • Reheat hot dogs, luncheon meats, bologna, and other deli meats until steaming hot or 165 ºF.
  • When cooking in a microwave oven, cover food, stir, and rotate for even cooking.  If there is no turntable, rotate the dish by hand once or twice during cooking.  Always allow standing time, which completes the cooking, before checking the internal temperature with a food thermometer. Food is done when it reaches the USDA- FDA recommended safe minimum internal temperature.

Is It Done Yet?
Use a food thermometer to be most accurate. You can’t always tell by looking.

USDA-FDA Recommended Safe Minimum Internal Temperatures

  • Beef, Pork, Veal, Lamb, Steaks, Roasts & Chops: 145 ºF with 3-minute rest time
  • Fish: 145 ºF
  • Beef, Pork, Veal, Lamb Ground: 160 ºF
  • Egg Dishes: 160 ºF
  • Turkey, Chicken & Duck Whole, Pieces & Ground: 165 ºF

4. Chill: Refrigerate promptly

Cold temperatures slow the growth of harmful bacteria. Keeping a constant refrigerator temperature of 40 °F or below is one of the most effective ways to reduce risk of foodborne illness. Use an appliance thermometer to be sure the refrigerator temperature is consistently 40 °F or below and the freezer temperature is 0 °F or below.

To chill foods properly:

  • Refrigerate or freeze meat, poultry, eggs, seafood, and other perishables within 2 hours of cooking or purchasing. Refrigerate within 1 hour if the temperature outside is above 90 °F.
  • Never thaw food at room temperature, such as on the counter top. It is safe to thaw food in the refrigerator, in cold water, or in the microwave. If you thaw food in cold water or in the microwave, you should cook it immediately. Divide large amounts of food into shallow containers for quicker cooling in the refrigerator.

USDA: Food Safety for People with Diabetes

A need-to-know guide for those who have been diagnosed with diabetes.

Other Diabetes Resources


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