I have a stoma, now I have diabetes – what can I eat?

Being diagnosed with diabetes after stoma surgery can feel overwhelming. Many people already spend time learning which foods work best for their stoma, so adding diabetes into the mix can raise new questions:

Can I still eat the foods that help manage my output?
Do I need to avoid carbohydrates?
What if the advice for diabetes conflicts with stoma advice?

The good news is that it is possible to manage both conditions and still enjoy a balanced diet. The key is understanding how to support your blood sugar levels while keeping your stoma functioning well.

Why managing both can feel confusing

Dietary advice for diabetes and stoma care can sometimes appear to contradict each other.

For example, people with diabetes are often encouraged to choose wholegrains, fibre-rich foods and plenty of fruit and vegetables to help stabilise blood glucose levels. However, some people with a stoma – particularly those with an ileostomy – may be advised to limit certain fibrous foods, especially soon after surgery or if they experience loose output or blockages.

Some traditional stoma advice for thickening output may also include sugary foods such as marshmallows or jelly sweets. While these may help some people, they are not ideal if you have diabetes because they can raise blood sugar levels quickly.

Start with balanced meals

Rather than focusing on foods to avoid, aim to build balanced meals that support both blood sugar control and stoma management.

A helpful approach is to divide your plate into thirds:

Carbohydrates – potatoes, rice, pasta, bread, wraps or other starchy foods
Protein – chicken, fish, eggs, tofu, beans or other alternatives
Vegetables – choosing options that you tolerate well with your stoma

Carbohydrates are still important. They provide energy and can also help thicken stoma output. The goal is finding the right amount and type for your body rather than cutting them out completely.

Which carbohydrates are best?

If you have diabetes, higher fibre carbohydrates are often recommended because they release glucose more slowly.

These can include:

Wholemeal bread
Wholegrain pasta
Brown rice or basmati rice
Oats and porridge
Sweet potatoes
Couscous or bulgur wheat

However, every stoma is different. Some people may find certain high-fibre foods increase output, cause discomfort or are harder to digest.

Try introducing foods gradually and monitor how your body responds. Chewing thoroughly and starting with smaller portions can help. If wholegrain foods do not suit you, softer alternatives such as “best of both” bread, peeled fruit or cooked vegetables may be easier to tolerate.

What if I have an ileostomy and loose output?

People with ileostomies may sometimes need foods that help thicken output.

Diabetes-friendly options include:

✔ White bread or toast
✔ Crackers
✔ Bagels
✔ White pasta or rice
✔ Bananas
✔ Potatoes

These options may help manage output without relying on sugary foods.

If you regularly experience watery output, speak to your stoma nurse or dietitian before making major dietary changes. Medication such as loperamide may also be part of your management plan.

Can I still eat fruit?

Yes. Fruit contains important nutrients and fibre, but it also contains natural sugars.

Many people with diabetes are advised to choose fruits lower in natural sugars, such as berries. However, for some ostomates, seeds and skins may affect output or digestion.

You may find it easier to:

Peel fruit where needed
Cook fruit to soften it
Choose softer options
Introduce new fruits gradually
Chew well

Aim for balance rather than avoidance.

Fibre and stomas – a myth worth busting

A common myth is that having a stoma means avoiding fibre forever.

In reality, fibre is still important for health and can support blood sugar management. After surgery, many people follow a lower fibre approach while the bowel heals, then gradually reintroduce foods over time.

The key is finding your tolerance level.

You may tolerate:

Cooked vegetables better than raw
Peeled fruit better than skins-on fruit
Broccoli florets better than stalks
Oats better than very fibrous foods such as celery or pineapple

Practical tips for living with both a stoma and diabetes

Eat regularly – skipping meals can affect blood sugar control.

Take your time eating – slower eating may help digestion and reduce rapid rises in blood glucose.

Keep a food diary – tracking meals alongside stoma output and blood sugar levels can help identify patterns.

Introduce foods gradually – especially higher fibre foods.

Seek specialist support – if advice feels conflicting, ask to speak with both a diabetes team and stoma nurse or dietitian. Many people feel confused when trying to manage both conditions alone.

You don’t have to choose between managing your stoma and managing diabetes

A diabetes diagnosis doesn’t mean starting over with food. It means adapting what already works for you.

With gradual changes, balanced meals and support from healthcare professionals, it is possible to manage blood sugar levels while continuing to eat in a way that supports your stoma and quality of life.

Need personalised advice? Speak to your stoma nurse, diabetes nurse or registered dietitian if you are struggling to balance both conditions.