Summary: In a crossover trial in type 2 diabetes, almond milk offered no postprandial glycaemic, lipid, or gut-hormone advantage over carbohydrate-matched 2% cow milk; cow milk produced higher insulin and glucagon responses but no glycaemic disadvantage.
PICO Summary
| Element | Detail |
|---|---|
| Population | 22 adults with type 2 diabetes and overweight/obesity (mean age 66); three-way open-label crossover. |
| Intervention | Oatmeal with almond milk. |
| Comparison | Oatmeal with carbohydrate-matched or calorie-matched 2% cow milk. |
| Outcome | No difference in the primary endpoint (glucose iAUC over 240 min) or in insulin, glucagon overall, free fatty acids, triglycerides, leptin, or gut hormones. Carbohydrate-matched cow milk gave higher insulin and glucagon iAUC than almond milk (FDR 0.002 and 0.02). |
Expert Commentary
This is a useful, myth-puncturing little study, and I read it positively for what it is, a careful acute postprandial comparison that challenges the widespread assumption that almond milk is automatically better for blood sugar. When carbohydrate was matched, no glycaemic advantage emerged, a clean reminder that fewer carbohydrates on the label does not equal a better metabolic response once protein and the food matrix are accounted for. The higher insulin and glucagon response to dairy is mechanistically interesting and did not translate into worse glucose. My caveats are the obvious ones: twenty-two people, a single four-hour test, and carbohydrate-matching that does not reflect the fact that a real glass of almond milk genuinely contains fewer carbohydrates than cow milk, so the practical picture is more nuanced than the controlled one. Can I use this with my patients? Yes, comfortably, as reassurance. I can tell a patient with type 2 diabetes that choosing between cow milk and almond milk should rest on overall nutrition, protein, calcium, calories, and preference rather than fear of a dairy glucose spike. I would frame it as one food in isolation, not a verdict on whole dietary patterns.
References
Dhaver S, Al-Badri M, Mitri J, et al. Effect of almond milk versus cow milk on postprandial glycemia, lipidemia, and gastrointestinal hormones in patients with overweight or obesity and type 2 diabetes: a randomized controlled clinical trial. Nutrients. 2025;17(13):2092. doi:10.3390/nu17132092