This content originally appeared on Everyday Health. Republished with permission.

By Madeline R. Vann, MPH, LPC

Medically Reviewed by Lynn Grieger, RDN, CDCES

When it comes to successfully managing type 2 diabetes, what you drink is just as important as what you eat. In fact, you may be surprised by how much a single drink can affect your blood sugar.

Drinks with carbohydrates (read: sugar) will affect your blood sugar more readily than zero-carb, zero-sugar drinks like water. “Anything that’s liquid that has carbohydrates will digest faster than something you would have to chew,” says Lori Zanini, RD, CDCES, a registered dietitian who’s based in Los Angeles. The result: a quick spike in blood sugar.

If you have type 2 diabetes, this means taking sugary drinks — such as regular soda, sweet tea, and even juice — off the table and replacing them with low-sugar and sugar-free options, including water.

If you enjoy swigging bottled drinks, you may be at a loss for how to stay hydrated. Fortunately, there’s a variety of refreshing, flavorful beverages you can enjoy, says Katherine Basbaum, RD, a registered dietitian at the University of Virginia Health System in Charlottesville.

RELATED: What Makes for a Good Type 2 Diabetes Diet?

Before you take your next sip, here are the top drinking dos and don’ts for people with diabetes.

1. Drink Plain Water, Which Has a Neutral Effect on Blood Sugar

Water is one of the few beverages you can drink without worry throughout the day. “Water is neutral,” Zanini says. This means that water neither raises nor lowers your blood sugar.

Drinking water is also a great way to stay hydrated, and staying hydrated will help you regulate your blood sugar. “Water helps dilute your blood, which lowers your blood sugar levels,” Zanini explains.

In terms of daily fluid intake, the Mayo Clinic says men should aim for approximately 15½ cups, while women should target about 11½ cups. Keep an eye on your hydration by checking that the color of your urine is light yellow, Zanini says.

If you often forget to drink as much water as you should, Basbaum has a suggestion for increasing your intake: Drink one 8 ounce (oz) glass of water for every other beverage you drink that contains sugar substitutes or caffeine. Shake things up with sparkling water or by squeezing lemon or lime juice into your glass.

2. Drink Cow’s Milk, Which Also Provides Protein and Calcium

“Skim or low-fat milk is also a good beverage option, but it must be counted toward your carb total for a particular meal or snack,” Basbaum says.

According to the U.S. Department of Agriculture (USDA), a cup of 1 percent milk (low-fat milk) also provides 310 milligrams (mg) of calcium, which accounts for about 24 percent of the daily value.

Be aware that nondairy milk options, such as almond milk, may have added sweeteners and flavorings. They also often lack the blood-sugar-stabilizing protein of cow’s milk.

RELATED: A Detailed Guide to Soy Milk

3. Don’t Drink Sugar-Sweetened Sodas or Teas

Regular consumption of sugar-sweetened beverages like soda and sweetened bottled tea wreaks havoc on your body in a variety of ways.

For example, a study found that middle-aged adults who drank more than three sugar-sweetened beverages per week had a 46 percent higher risk of developing prediabetes than people who didn’t drink sugary beverages. Similarly, an earlier study revealed that people who consumed just two sugar-sweetened soda or juice beverages per week had an increased risk of developing type 2 diabetes, particularly if they’d gained more than 6 pounds over a five-year period.

“Sugar-sweetened drinks are absorbed into your bloodstream much too quickly, causing a spike in blood glucose levels,” explains Basbaum. Furthermore, these drinks will affect your carb intake. A typical 12-oz can of soda contains about 38.5 g of carbs, according to the USDA.

Get in the habit of carrying a bottle of water with you in case you get caught somewhere with no sugar-free drink options available.

4. Drink Artificially Sweetened Drinks — Maybe

Drinks with artificial sweeteners, such as diet sodas, remain a controversial topic.

On the one hand, drinks with artificial sweeteners can be a calorie-reducing alternative to sweetened drinks. “I do endorse artificially sweetened beverages for the purpose of controlling blood sugar and weight,” Basbaum says.

Because artificially sweetened drinks have zero carbohydrates and low calorie counts, the Mayo Clinic says they may be a good alternative to soda and juice sweetened with traditional sugar. Some research, however, has a different view and suggests even artificially sweetened beverages can increase diabetes risk, including a review published in 2019.

Yet artificial sweeteners can be several hundred to several thousand times more intense than natural sugar, research has shown. Plus, in Zanini’s experience, they cause people to crave sweets more.

Some studies support this notion. A research paper noted that eating artificial sweeteners may cause brain changes that trigger overeating. The article also references research that may link consumption of these sugar alternatives to a higher risk of type 2 diabetes and cardiovascular disease. Ultimately, more studies are needed, the authors concluded.

Whether you decide to drink artificially sweetened beverages (and how much) is a matter of taste and preference and a choice to make with your healthcare team.

5. Drink Tomato Juice Instead of Sugary Fruit Juice

If you enjoy drinking juice — or you’re tired of drinking water all the time — avoid sugary fruit options and instead opt for a small portion of vegetable juice, like tomato juice, Zanini says. And as long as you stick to 100 percent tomato juice with no added salt or sugar, it might provide you with some good overall health benefits.

For instance, drinking 1½ cups of tomato juice a day for a month cut down on some measures of inflammation in obese women, according to research. Tomato juice has about 10 grams (g) of carbs per cup, according to the USDA, so you’ll need to factor that in.

As always, it’s better to eat whole fruits and vegetables than drink them, Zanini says. Eating one whole tomato per day may help reduce blood pressure and, by extension, the cardiovascular risk associated with type 2 diabetes, according to a study.

6. Drink Unsweetened Coffee and Tea — in Small Amounts

Feel free to drink tea and coffee — hot or iced — in moderation. “Try them either unsweetened or prepared with a sugar substitute,” Basbaum says. Your best bet is to stick to unsweetened coffee or tea, but if you have to add something, look for low-calorie sweeteners. Keep in mind that any milk, cream, or creamer you add to your drink must be counted as part of the carbohydrates in your diet. If you enjoy syrup flavors in coffee drinks, look for sugar-free variations.

Rather than adding sugar, tea can be flavored with lemon juice. But if you need some sugar, Zanini recommends going for Stevia instead of artificial sweeteners as a more natural option.

Research suggests that coffee and tea — green tea in particular — may lower type 2 diabetes risk.

RELATED: Why Drinking Tea May Help Prevent and Manage Type 2 Diabetes

7. Don’t Drink Sports Drinks — Unless You’re an Endurance Athlete

Exercise is great for managing type 2 diabetes, but skip sports drinks, which are high in carbohydrates. One 8 oz serving of Powerade, for example, packs about 19 g of carbs, notes the USDA, and that’s not even the whole bottle.

Dietitians only recommend sports drinks for endurance athletes, who may exercise strenuously enough to need salt and nutrient replacement. “Sports drinks are usually not necessary unless someone has been very active for over an hour,” Zanini says.

Water is sufficient to keep you hydrated for moderate exercise. You can also plan on a healthy postworkout snack that provides you with some carbs and protein, such as an apple with a bit of peanut butter or a hard-boiled egg and an orange. These options will give you the protein and carbs you need to kick-start your exercise recovery without spiking your blood sugar.

8. Drink 100 Percent Fruit Juices — Occasionally and in Moderation

You can have the occasional 4 to 6 oz glass of 100 percent fruit juice as a treat, Basbaum says. Remember to count the carbs as part of your overall meal, and plan for the blood sugar spike the juice might cause.

For example, if you like to have breakfast with fresh-squeezed orange juice, which has 24 g carbs per 8 oz, according to the USDA, calculate its nutrient makeup along with your eggs and whole-grain toast for a complete picture of the meal.

9. Drink Alcohol Sparingly and on Special Occasions

While previous research found that moderate alcohol consumption may offer heart-protective effects for people with diabetes, more recent research suggests that no amount of alcohol is safe.

If you choose to imbibe, do so in small quantities, especially because alcohol can cause blood sugar fluctuations, notes the American Diabetes Association (ADA). According to the ADA, moderate drinking is defined as up to one drink for women and two drinks for men per day. One drink equals 1.5 oz of liquor, 12 oz of beer, or 5 oz of wine.

And because the benefits of alcohol are debated, for people with diabetes and the general public, if you don’t already drink alcohol, don’t start, the Centers for Disease Control and Prevention (CDC) advises.

10. Don’t Drink Energy Drinks, Which Contain Sugar and Caffeine

Energy drinks give you a temporary boost of energy that comes from sugar, caffeine, and other additives, but all of that can also cause heart rhythm disturbances, increase heart rate and blood pressure, and disrupt sleep, according to the National Center for Complementary and Integrative Health. Just one 8.4 oz serving of Red Bull energy drink contains more than 26 g of sugar and 75 mg of caffeine, notes the USDA, and even the sugar-free version has 75 mg of caffeine.

Instead of relying on liquid energy to keep you going, fight fatigue in other ways. Some of the best ways to stay healthy and alert are to focus on getting quality sleep (Zanini says seven to nine hours per night is the sweet spot) and regular exercise (150 minutes of moderate-intensity exercise along with two full-body strength sessions per week at a minimum, per the CDC). If you do need a quick energy boost, stick to healthier beverage options like unsweetened coffee and tea.

Additional reporting by Lauren Bedosky.

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