What can I eat at McDonald's with diabetes? A guide to making smarter choices

October 3, 2025 •

4 min read

According to the CDC, nearly 37% of Americans consume fast food on a given day. For individuals managing their blood sugar, this can present a challenge. Understanding what can I eat at McDonald's with diabetes? is key to making better, more informed dietary choices.

Quick Summary

Learn how to navigate the McDonald's menu with diabetes by prioritizing lean proteins, managing carbohydrates, and customizing your order. Discover specific menu items and smart swaps to help control blood sugar levels, even when dining at a fast-food restaurant.

Key Points

Prioritize protein: Choose lean protein sources like beef patties, chicken nuggets, or fish fillets to help stabilize blood sugar levels.
Skip the bun: Ordering a burger without the bun dramatically reduces the carbohydrate count, preventing a rapid spike in blood glucose.
Swap fries for fruit: Replace high-carb French fries with apple slices or a side salad to add fiber and vitamins to your meal.
Opt for unsweetened drinks: Choose water, unsweetened iced tea, or diet soda over sugary drinks like regular soda or shakes to avoid empty calories and sugar.
Customize your order: Request sauces on the side, opt for smaller portion sizes, and choose grilled options over fried to control fat, sodium, and carb intake.

Navigating a fast-food menu with diabetes requires a strategy focused on minimizing high-carb, high-fat items and prioritizing lean protein, vegetables, and controlled portions. While McDonald's may not be a top choice for a diabetes-friendly diet, with careful planning and smart substitutions, a manageable meal is possible. The key is to be an educated consumer: check nutritional information online, understand your body's response to different foods, and know which menu items and modifications will work best for you.

Making smart swaps for blood sugar control

Fast food items often contain high levels of simple carbohydrates, saturated fats, and sodium, which can cause significant blood sugar spikes. The most effective strategy is to avoid items laden with refined carbs and added sugar, such as large buns, fries, and sweetened beverages. Your focus should be on building a balanced meal with protein and non-starchy vegetables.

Prioritizing protein for sustained energy

Protein is crucial for managing blood sugar because it slows down the digestion of carbohydrates, leading to a more gradual rise in glucose levels. Lean protein options at McDonald's include grilled items, plain burger patties, and chicken nuggets.

Customized burgers: Order a regular Hamburger or McDouble without the bun. Ask for it in a container with extra lettuce and other veggies like onion and pickles. This dramatically reduces the carbohydrate load. A Big Mac can also be ordered without the bun.
Chicken McNuggets: A 4- or 6-piece order can be a decent source of protein with relatively low carbs, especially when paired with a non-sugary dipping sauce like Spicy Buffalo.
Filet-O-Fish: While this comes on a bun, removing the bun and tartar sauce can significantly lower the carbohydrate and fat content. The fish patty itself is a protein source.

Side dishes and beverages: The right choices matter

The sides and drinks you choose can make or break a diabetes-friendly fast-food meal. Fries and sugary sodas are the biggest offenders, so it’s best to swap them for healthier alternatives.

Swap out fries: Instead of French fries, choose apple slices. This adds fiber and vitamins without the processed carbs and fats. If available, a side salad with a light vinaigrette is another excellent choice.
Choose your drink wisely: Opt for water, unsweetened iced tea, or diet soda. Sugary beverages can cause immediate blood sugar spikes and offer no nutritional value. Avoid juices, milkshakes, and specialty coffee drinks with added syrup.

Comparison table: Better choices vs. default items

This table illustrates how simple swaps can make a big difference in a meal's nutritional profile, especially regarding carbohydrates and fat. Note that specific nutritional values can vary by location and time, so always check the official McDonald's nutrition information.


Item Category	Smarter Choice	Nutritional Consideration	Default Item	Nutritional Consideration
Main Dish	Bunless McDouble	Lower carbs (approx. 5g), higher protein from two beef patties.	Big Mac	Higher carbs (46g), significant fat, and sodium.
Main Dish	6-piece McNuggets	Moderate protein (17g) and carbs (17g), especially without a sugary sauce.	McChicken	Higher carbs (49g) and includes mayo.
Side	Apple Slices	Naturally low in carbs (4g) and fat, good source of fiber.	Medium Fries	Very high carbs (55g) and fat.
Drink	Unsweetened Iced Tea	Zero calories and carbs.	Large Coca-Cola	High in added sugar and simple carbs.
Breakfast	Sausage Burrito	Moderate carbs (25g) and high protein (13g) compared to other breakfast items.	Sausage McGriddle	High carbs from the sweetened griddle cakes.

Tips for customizing your McDonald's order

Even with a limited menu, personalizing your meal is the best way to maintain blood sugar control. Use these practical tips on your next visit to the golden arches:

Go bunless: Ask for any burger or sandwich in a lettuce wrap or a bowl. This is the single most impactful change you can make.
Request sauces on the side: Condiments like ketchup and creamy dressings are often high in sugar and sodium. Ask for mustard or use minimal amounts of a healthier option.
Think small: Opt for a regular or kids' size burger instead of a larger, multi-patty option.
Pair protein and fiber: Combine a protein-rich entree with a high-fiber side like apple slices to slow down digestion and stabilize blood sugar.
Skip the cheese: While cheese adds protein, it also adds calories and saturated fat. Removing it is a simple way to reduce these, especially if you have other sources of protein.
Avoid fried and breaded items: Fried foods are high in unhealthy fats that are not good for heart health, a common concern for people with diabetes.

Conclusion

While frequent consumption of fast food is not recommended for managing diabetes, an occasional trip to McDonald's doesn't have to ruin your diet. By focusing on smart substitutions like bunless burgers, grilled chicken, and healthier sides, you can enjoy a meal without sending your blood sugar on a roller coaster. Customizing your order is key, and simple requests can turn a standard, high-carb meal into a more balanced and diabetes-friendly one. The goal is to make informed choices that fit within your overall nutritional goals, ensuring you stay on track with your health.

For more detailed nutritional information and tips on managing your diet, consider consulting resources like the CDC's guidance on healthy eating while dining out. Eating Out | Diabetes - CDC

Frequently Asked Questions

Yes, a person with diabetes can eat a burger from McDonald's, but it's best to modify it. Ordering a smaller burger, like a regular Hamburger or McDouble, and removing the bun is the most effective strategy for reducing carbohydrates.

A small order of Chicken McNuggets (4 or 6 piece) is a relatively lower-carb, higher-protein option compared to many other items on the menu. To keep it diabetes-friendly, opt for unsweetened dipping sauces, like Spicy Buffalo, instead of sugary ones.

The best side dish is apple slices, as they are a low-carb, high-fiber alternative to French fries. A side salad, if available, is another excellent option when ordered with a light vinaigrette dressing on the side.

Stick to calorie-free, unsweetened beverages. Water, unsweetened iced tea, or diet sodas are the best choices. Avoid regular sodas, juices, and sweetened specialty coffee drinks, which contain high levels of sugar.

To reduce carbs, remove the bun from burgers, skip fries in favor of apple slices or a side salad, and choose water or diet soda. You can also ask for sauces on the side to control intake.

The Sausage Burrito is a moderate-carb, higher-protein breakfast choice compared to high-carb items like McGriddles. It provides a more balanced start to your day, but moderation is still advised.

It is best to avoid French fries due to their high carb and fat content, which can cause blood sugar spikes. If you must have them, opt for a small or kid-size portion and pair them with a lean protein source to help slow digestion.