Diabetes and Milk: A Guide to Understanding Milk Choices

A diabetes nutrition expert spells out the pros and cons of 8 different types of "milk". From cow's milk and soy milk to almond milk, hemp milk and more. Non-dairy milk options may not be as healthy as you think.


varieties of milk in the grocery storeMilk remains a controversial topic. The "Got Milk?" slogan should possibly be updated to say, "Got Plant Milk?" (Photo:Unsplash, NeONBRAND)

So Many Options

With more than 15 different varieties of milk and milk substitutes it can be a little confusing to understand which milk to chose when you live with diabetes. Milk remains a controversial topic. Remember the infamous 1993 ad campaign, "Got Milk?" Well, today's slogan could be updated to say, "Got Plant Milk?"

The milk industry has been in decline with the rise in plant-based milk alternatives. From almond, hemp, goat, cashew milk, there are many options  to choose from. There are also many reasons why people with diabetes look for other milk options: lowering carb intake, to reduce fat/calories, for ethical reasons, dairy intolerances, or in order to follow a vegetarian/vegan lifestyle.

But not all milks are created equal, explains Academy of Nutrition spokesperson and Diabetes Educator Vandana Sheth. “While non-dairy beverages do offer a substitute for cow’s milk, they are not able to completely mimic the nutritional profile, so it is important to choose the correct one based upon your unique needs.”

The dairy industry recently requested the FDA ban plant-based milk producers from using the word “milk,” but the debate has not been resolved.

Below is your guide to understanding the differences in milk and how they stack up to one another in terms of nutrition and recent research related to diabetes.

#1. Cow’s Milk

Are there any benefits in drinking milk? According to some research, YES. However, the choice is entirely personal, and you can still obtain essential nutrients in choosing milk alternatives. There have been many research studies showing the benefits of drinking milk particularly in preventing type 2 diabetes and obesity.  What we know currently is that total dairy intake—whether cheese, yogurt, low fat or regular milk—is associated with lower incidence of diabetes. (See article, "What Is the Best Milk for People with Diabetes?")

“Cow’s milk is high in protein, provides a good mix of key nutrients such as calcium, magnesium, potassium, riboflavin, folate, vitamin B12 and is fortified with vitamin D," Sheth explains. 


  • Great nutrient mix. High in protein, vitamin D, calcium, phosphorus,
  • Available in whole, 2% or low fat. The same nutrient composition—only difference is fat
  • 12g of carbs (all from natural sugars; lactose)—no additional sugar.


  • Does contain carbohydrates (12g per 8oz) which need to be included in the meal plan
  • Can cause unpleasant GI effects if lactose intolerant, but lactose-free options are available 
  • Higher fat versions contain saturated fat—mixed studies in cardiovascular health
  • Some ethical concerns about how dairy cows are raised

#2. Almond Milk
Made from almonds and filtered water. Almond milk sales have skyrocketed in the past decade. Unlike almonds which are a nutrient powerhouse, almond milk lacks many of the essential nutrients found in almonds—specifically nuts, fat, magnesium, phosphorus. But, many alternatives now come fortified with calcium and vitamin D. It has a sweet taste and provides lower calories than cow’s milk.


  • Very low in calories and minimal carbs—8oz have 30 calories and 1-2 g of carbs
  • Good source of calcium and vitamin D, if fortified
  • No saturated fat
  • Vegan and lactose-free


  • Other flavors contain added sugar (12-19 grams), so you need to read labels carefully
  • Limited in nutrition (fat/protein), except for calcium and some vitamin D—if fortified.
  • Not a source of protein
  • Not appropriate for babies—children under 12 months

glass of milk with lawn in backgroundIn terms of nutrition, soy is the closest to cow's milk. (Photo: Pixabay)

#3. Soy Milk

Made by soaking and grinding soybeans, soy milk is the closest alternative to cow’s milk in terms of nutrition, points out the diabetes educator. Sheth is a vegetarian and likes to alternate between soy and almond milk, depending on what nutrients and mood she is in. 


  • Good source of protein—equal protein as cow's milk
  • Similar nutrient composition like cow’s milk—potassium, b12
  • Vegan & lactose-free


  • Does contain carbohydrates (12g per 8 oz) which need to be included in the meal plan
  • Kids allergic to milk-based protein may not tolerate soy

#4. Goat Milk

Made from goats, so it’s technically still considered dairy. In many parts of the world, goat milk is more popular than cow’s milk. Goat milk's claim to fame came with the rise of the paleo diet which recommended goat milk instead of cow's milk. It has a similar profile to cow’s milk, and it’s rich in essential nutrients like calcium, riboflavin, and phosphorus.


  • High in important nutrients, calcium, protein, phosphorus, riboflavin
  • Lower in lactose, so it’s easier to digest. Great for those with lactose intolerance.
  • More calcium compared to cow’s milk


  • More saturated fat
  • Costs more
  • Not as high in B12 compared to cow's milk

#5. Rice Milk

One of the first milk-alternatives in the market. Made from boiled rice, rice syrup, and brown rice starch. This rice beverage is higher in carbs compared to other plant-based milk as it is usually sweetened with cane sugars or corn syrup with a high glycemic index. Eight ounces yields approximately 23g of carbs compared to 12g of carbs in cow’s milk.


  • Low in fat
  • Inexpensive
  • Vegan & lactose-free


  • High in carbs mostly from added sugars—1 cup yields 25g carbs
  • Lacks protein
  • Not a significant source of vitamins
  • May contain higher levels or arsenic
  • Higher in calories (equal to 2% milk); 1 cup is 120 calories

#6. Hemp Milk

Hemp milk has been increasing in popularity in the plant-based world because it provides complete nutritional benefits. Made from whole hemp seeds which naturally makes it nutritionally superior compared to other plant-based milks “Hemp milk may be a good option for vegans since it is a good source of omega 3 fats, however, make sure ensure that it is fortified with calcium, vitamin D, B12," Sheth recommends.


  • Creamy consistency and nutty flavor
  • Rich in omega 3 fats
  • Low in carbs (0-2g per serving)


  • Not available everywhere
  • May contain added sugars if not unsweetened
  • Slightly lower in protein compared to cow’s

#7. Coconut Milk

Not to be confused with the coconut milk you buy in a can, which is very high in both calories, saturated fat, and sugar. Coconut milk is more like a diluted beverage made from coconut cream and filtered water. It might seem like you are getting the same nutrition as a natural coconut, but the nutrition label and ingredients suggest otherwise.


  • High in minerals: magnesium, iron, copper
  • Sweet and creamy taste
  • High in medium-chain triglyceride (MCT) fats, absorb differently and may have a protective effect in reducing cholesterol levels


  • Not a source of protein
  • Not a natural source of vitamin D or calcium, but may be fortified. Look for them in the label
  • High in saturated fat
  • Can be high in added sugars, if flavored

#8. Pea-Based Milk

One of the newest additions to the plant-based milk alternatives, pea milk is made from combining whole peas with water and other ingredients like sunflower oil. It is an excellent source of plant-based protein because it is derived from peas.


  • Great source of potassium, vitamin D, calcium
  • High protein content, equal to cows. (1 cup = 8 grams of protein)
  • Lower in calories, 1 cup unsweetened provides 70 calories
  • Creamier consistency


  • Not a complete protein since it lacks essential minerals found in soy or cow milk
  • Fat comes from vegetable oil, sunflower oil
  • May contain gums and gels added to improve consistency

Let the Label Lead the Way

Whether you have a milk intolerance, follow a vegan lifestyle or just want to cut the carbohydrates from cow’s milk, it’s important to read the label and understand what you are getting in the milk-alternative.

No two milk beverages are alike, but It’s a matter of choice, taste and INDIVIDUAL nutrition needs. Moreover, remember we rarely drink milk alone, we also accompany with something else. So, rather than focusing on just one nutrient, let's focus on the entire meal.


Updated on: June 13, 2019
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