Steve Phelps always had a sweet tooth. He blamed that weakness for his weight, the 360 pounds that were too much for his 5-foot, 7-inch frame. He was shocked, then, when the food journal he'd been keeping—a tool he'd started to use after he was diagnosed with type 2 diabetes—revealed otherwise. "I was under the misconception that my diet was fine [except that] I liked sweets and I ate a lot of sweets," he says. "I discovered quickly that it wasn't just eating cake or pie that was making me fat. It was all the other stuff, too." Fried chicken. Mashed potatoes. Fast food. Phelps ate as much as he wanted without much thought.
Although the genes you inherit may influence the development of type 2 diabetes, they take a back seat to behavioral and lifestyle factors. Data from the Nurses’ Health Study suggest that 90 percent of type 2 diabetes in women can be attributed to five such factors: excess weight, lack of exercise, a less-than-healthy diet, smoking, and abstaining from alcohol. (8)
Traditional lattes, cappuccinos, and flat whites all contain milk, and may have added sweeteners if you get a flavor. Caffeinated drinks that have no carbohydrates include Americanos, espressos, and just black coffee. Whether you prefer coffee beans or instant coffee powder doesn’t make a difference nutritionally, however taste, freshness, and caffeine content may vary.
Ketoacidosis occurred in people with type 1 and type 2 diabetes during treatment with FARXIGA. Ketoacidosis is a serious condition which may require hospitalization and may lead to death. Symptoms may include nausea, tiredness, vomiting, trouble breathing, and abdominal pain. If you get any of these symptoms, stop taking FARXIGA and call your healthcare provider right away. If possible, check for ketones in your urine or blood, even if your blood sugar is less than 250 mg/dL
If you’ve recently been diagnosed with type 2 diabetes, pay special attention.  Research on newly diagnosed type 2 diabetics coming to the Pritikin Longevity Center illustrate how profoundly beneficial early intervention can be.  Scientists from UCLA followed 243 people in the early stages of diabetes (not yet on medications).  Within three weeks of coming to Pritikin, their fasting blood sugar (glucose) plummeted on average from 160 to 124.  Research has also found that the Pritikin Program reduces fasting insulin by 25 to 40%.

Protein provides slow steady energy with relatively little effect on blood sugar. Protein, especially plant-based protein, should always be part of a meal or snack. Protein not only keeps blood sugar stable, but it also helps with sugar cravings and feeling full after eating (satiety). Protein can come from both animal or plant sources; however, animal sources are also often sources of unhealthy saturated fats.


DM is the fourth among the leading causes of global deaths due to complications. Annually, more than three million people die because of diabetes or its complications. Worldwide, this disease weighs down on health systems and also on patients and their families who have to face too much financial, social and emotional strains. Diabetic patients have an increased risk of developing complications such as stroke, myocardial infarction, and coronary artery disease. However, complications such as retinopathy, nephropathy, and neuropathy can have a distressing impact on patient’s quality of life and a significant increase in financial burden. The prevalence reported from studies conducted worldwide on the complications of T2DM showed varying rates. The prevalence of cataracts was 26-62%, retinopathy 17-50%, blindness 3%, nephropathy 17-28%, cardiovascular complications 10-22.5%, stroke 6-12%, neuropathy 19-42%, and foot problems 5-23%. Mortality from all causes was reported between 14% and 40%.71 In a study, researchers found that 15.8% incidence of DR is in the developing countries. The prevalence of DR reported from Saudi Arabia, Sri Lanka, and Brazil was 30%, 31.3%, and 35.4%, respectively; while in Kashmir it was 27% and in South Africa it was 40%. The prevalence of DR 26.1% was observed among 3000 diabetic patients from Pakistan; it was significantly higher than that what was reported in India (18%) and in Malaysia (14.9%).72-76 Studies conducted on diabetes complications in Saudi Arabia are very few and restricted. A 1992 study from Saudi Arabia showed that in T2DM patients; occurrence rate of cataract was 42.7%, neuropathy in 35.9% patients, retinopathy in 31.5% patients, hypertension in 25% patients, nephropathy in 17.8% patients, ischemic heart disease in 41.3% patients, stroke in 9.4% patients, and foot infections in 10.4% of the patients. However, this study reported complications for both types of diabetes.77
The review of various studies suggests that T2DM patients require reinforcement of DM education including dietary management through stakeholders (health-care providers, health facilities, etc.) to encourage them to understand the disease management better, for more appropriate self-care and better quality of life. The overall purpose of treating T2DM is to help the patients from developing early end-organ complications which can be achieved through proper dietary management. The success of dietary management requires that the health professionals should have an orientation about the cultural beliefs, thoughts, family, and communal networks of the patients. As diabetes is a disease which continues for the lifetime, proper therapy methods with special emphasis on diet should be given by the healthcare providers in a way to control the disease, reduce the symptoms, and prevent the appearance of the complications. The patients should also have good knowledge about the disease and diet, for this purpose, the health-care providers must inform the patients to make changes in their nutritional habits and food preparations. Active and effective dietary education may prevent the onset of diabetes and its complications.
Globally, T2DM is at present one of the most common diseases and its levels are progressively on the rise. It has been evaluated that around 366 million people worldwide or 8.3% in the age group of 20-79 years had T2DM in 2011. This figure is expected to rise to 552 million (9.9%) by 2030.10 This disease is associated with severe complications which affect patient’s health, productivity, and quality of life. More than 50% of people with diabetes die of cardiovascular disease (CVD) (primarily heart disease and stroke) and is a sole cause of end stage renal disease which requires either dialysis or kidney transplantation. It is also a major cause of blindness due to retinal damage in adult age group referred to as diabetic retinopathy (DR). People with T2DM have an increased risk of lower limb amputation that may be 25 times greater than those without the disease. This disease caused around 4.6 million deaths in the age-group of 20-79 years in 2011.11
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Risk factors for type 2 diabetes include obesity, high cholesterol, high blood pressure, and physical inactivity. The risk of developing type 2 diabetes also increases as people grow older. People who are over 40 and overweight are more likely to develop type 2 diabetes, although the incidence of this type of diabetes in adolescents is growing. Diabetes is more common among Native Americans, African Americans, Hispanic Americans and Asian Americans/Pacific Islanders. Also, people who develop diabetes while pregnant (a condition called gestational diabetes) are more likely to develop type 2 diabetes later in life.
But just as with grains, it’s important to roll out your carb-counting skills when noshing on nature’s candy. The ADA notes that a small piece of whole fruit or ½ cup of canned fruit in natural juices or frozen fruit typically contains 15 g of carbs, while fruit juice — a less ideal source of fruit for diabetes — can have that much in 1/3 to ½ cup.
Often, people with type 2 diabetes start using insulin with one long-acting shot at night, such as insulin glargine (Lantus) or insulin detemir (Levemir). Discuss the pros and cons of different drugs with your doctor. Together you can decide which medication is best for you after considering many factors, including costs and other aspects of your health.
Imagine our bodies to be a sugar bowl. A bowl of sugar. When we are young, our sugar bowl is empty. Over decades, we eat too much of the wrong things – sugary cereals, desserts and white bread. The sugar bowl gradually fills up with sugar until completely full. The next time you eat, sugar comes into the body, but the bowl is full, so it spills out into the blood.

Here’s another big plus to our Shopping List for Diabetics. In addition to icons that are diabetes-focused like “sugar free,” this list uses icons like “low cholesterol” and “low sodium” because many people with diabetes are working to control not just diabetes but related conditions like high cholesterol levels and high blood pressure.  This list can help you identify those foods most advantageous in helping you reach your personal health goals.


There are two major forms of diabetes - type 1 and type 2. This article focuses specifically on the prevention of type 2 diabetes since there is no know way to prevent type 1 diabetes. This form of diabetes is virtually a pandemic in the United States. This information reviews the risk factors for developing type 2 diabetes and reviews key points regarding prediction of those at risk for type 2 diabetes. It also is a review of what they can do about it.
A neck lump or nodule is the most common symptom of thyroid cancer. You may feel a lump, notice one side of your neck appears to be different, or your doctor may find it during a routine examination. If the tumor is large, it may cause neck or facial pain, shortness of breath, difficulty swallowing, cough unrelated to a cold, hoarseness or voice change.

Gestational diabetes is a type of diabetes that develops during pregnancy. Most of the time, gestational diabetes goes away after your baby is born. Even if your gestational diabetes goes away, you still have a greater chance of developing type 2 diabetes within 5 to 10 years. Your child may also be more likely to become obese and develop type 2 diabetes later in life. Making healthy choices helps the whole family and may protect your child from becoming obese or developing diabetes.
5. Cut back on refined carbs and sugary drinks. White bread, white rice, white pasta and potatoes cause quick increases in blood sugar, as do sugary soft drinks, fruit punch, and fruit juice. Over time, eating lots of these refined carbohydrates and sugar may increase your risk of type 2 diabetes.  To lower your risk, switch to whole grains and skip the sugar — especially the sugary drinks.

In addition, many sugar-containing foods also contain a lot of fat. Foods such as cookies, pastries, ice cream and cakes should be avoided largely because of the fat content and because they don't contribute much nutritional value. If you do want a "sweet," make a low-fat choice, such as low-fat frozen yogurt, gingersnaps, fig bars, or graham crackers and substitute it for other carbohydrates on your meal plan.
Don’t be surprised if you have to use multiple medications to control the blood sugar. Multiple medications, also known as combination therapy is common in the treatment of diabetes! If one medication is not enough, you medical provider may give you two or three or more different types of pills. Insulin or other injected medications also may be prescribed. Or, depending on your medical condition, you may be treated only with insulin or injected medication therapy.
The main kinds of carbohydrates are starches, sugars, and fiber. Learn which foods have carbohydrates. This will help with meal planning so that you can keep your blood sugar in your target range. Not all carbohydrates can be broken down and absorbed by your body. Foods with more non-digestable carbohydrates, or fiber, are less likely to increase your blood sugar out of your goal range. These include foods such as beans and whole grains.
Consider signing up for a virtual coach.  Trying to make these changes on your own, at your own pace, and in your own time is very hard. So consider joining a support group like Overeaters Anonymous so you don't have to go it alone. Another way to gain insights and get some help as you attempt to make some changes is to find an app that offers personalized tips and ideas. Having a virtual coach is both convenient has been shown effective in improving diabetes care.
Meanwhile, processed or packaged foods should be avoided or limited in your diabetes diet because, in addition to added sugars and processed carbohydrates, these foods are often high in sodium and therefore may increase your blood pressure and, in turn, the risk of heart disease or stroke — two common complications of diabetes. It’s important to keep your blood pressure in check when managing diabetes.
Get regular exercise. Exercise has many health benefits, including helping you to lose weight and lower your blood sugar levels. These both lower your risk of type 2 diabetes. Try to get at least 30 minutes of physical activity 5 days a week. If you have not been active, talk with your health care professional to figure out which types of exercise are best for you. You can start slowly and work up to your goal.
Awareness of prediabetes could be the best thing that ever happened to you. It gives you the chance to find a prediabetic diet that works for your health and for your lifestyle. Once you decide to make those healthy changes, you are more likely to succeed with a support system that works for you, and a health app could be what you need for information and accountability.
How do sugary drinks lead to this increased risk? Weight gain may explain the link: In both the Nurses’ Health Study II and the Black Women’s Health Study, women who increased their consumption of sugary drinks gained more weight than women who cut back on sugary drinks. (26, 28) Several studies show that children and adults who drink soda or other sugar-sweetened beverages are more likely to gain weight than those who don’t, (28, 30) and that switching from these to water or unsweetened beverages can reduce weight. (31) Even so, however, weight gain caused by sugary drinks may not completely explain the increased diabetes risk.  There is mounting evidence that sugary drinks contribute to chronic inflammation, high triglycerides, decreased “good” (HDL) cholesterol, and increased insulin resistance, all of which are risk factors for diabetes. (32)
At each meal and snack pair carbohydrates with a protein and heart healthy fat. For meals make half your plate vegetables (raw, steamed or sautéed in a heart healthy oil like olive oil),a quarter lean protein (think less legs are better – choose fish, chicken, pork and have beef (aka red meat) on occasion), the remaining quarter of your plate should be from grains, preferably whole (i.e. quinoa, couscous, rice or even a baked potato- just go easy on the butter and sour cream). Some snack ideas include pairing fruit or vegetable with a protein, such as a banana or apple with peanut butter, raw vegetables (carrots, bell or sweet pepper strips, snap peas, celery) with hummus or even whole grain crackers with a low-fat cheese or plain yogurt with added fruit.
Along with healthy eating, you can help keep your blood sugar in target range by maintaining a healthy weight. People with type 2 diabetes are often overweight or obese. Losing even 10 pounds (4.5 kilograms) can help you manage your diabetes better. Eating healthy foods and staying active (for example, 60 total minutes of walking or other activity per day) can help you meet and maintain your weight loss goal.
“High glycemic index foods are going to be primarily processed foods,” says Lori Chong, RD, CDE, at The Ohio State University Wexner Medical Center in Columbus. Those processed foods tend to have more white sugar and flour in them, which are higher on the GI, she says. Foods lower on the GI include vegetables, especially non-starchy vegetables, like broccoli, cauliflower, and leafy greens and whole-grain products, such as brown rice (as opposed to white rice), Chong says. She notes that even many fruits are low on the GI, with pineapple and dried fruit being some of the highest (Berries, apples, and pears tend to be fairly low.)
Fresh vegetables are a great option, and usually the tastiest option. Studies show that frozen veggies have just as many vitamins and nutrients because they are often frozen within hours of harvesting. Just check to make sure there aren't added fats or sweeteners in the sauces that are on some frozen veggies. If you don't like vegetables on their own, try preparing them with fresh or dried herbs, olive oil, or a vinaigrette dressing. Aiming to consume a rainbow of colors through your vegetables is a good way to get all of your nutrients.

More recent findings from the Nurses Health Studies I and II and the Health Professionals Follow-Up Study suggest that swapping whole grains for white rice could help lower diabetes risk: Researchers found that women and men who ate the most white rice—five or more servings a week—had a 17 percent higher risk of diabetes than those who ate white rice less than one time a month. People who ate the most brown rice—two or more servings a week—had an 11 percent lower risk of diabetes than those who rarely ate brown rice. Researchers estimate that swapping whole grains in place of even some white rice could lower diabetes risk by 36 percent. (25)
Low-carb diets, the glycemic index diet or other fad diets may help you lose weight at first. But their effectiveness at preventing diabetes isn't known, nor are their long-term effects. And by excluding or strictly limiting a particular food group, you may be giving up essential nutrients. Instead, make variety and portion control part of your healthy-eating plan.
The review of various studies suggests that T2DM patients require reinforcement of DM education including dietary management through stakeholders (health-care providers, health facilities, etc.) to encourage them to understand the disease management better, for more appropriate self-care and better quality of life. The overall purpose of treating T2DM is to help the patients from developing early end-organ complications which can be achieved through proper dietary management. The success of dietary management requires that the health professionals should have an orientation about the cultural beliefs, thoughts, family, and communal networks of the patients. As diabetes is a disease which continues for the lifetime, proper therapy methods with special emphasis on diet should be given by the healthcare providers in a way to control the disease, reduce the symptoms, and prevent the appearance of the complications. The patients should also have good knowledge about the disease and diet, for this purpose, the health-care providers must inform the patients to make changes in their nutritional habits and food preparations. Active and effective dietary education may prevent the onset of diabetes and its complications.
Eat smaller portions of foods and remember that your lunch and dinner plate should be 1/4 protein, 1/4 starch (including potatoes), and 1/2 vegetables. Eat 3 balanced meals per day (no more than 6 hours apart), and don't skip meals; snack with fruit between meals. Choose foods lower in fat and sugar; choose low GI index foods whenever possible; avoid “white” foods (white flour and white sugar).
Some people who have type 2 diabetes can achieve their target blood sugar levels with diet and exercise alone, but many also need diabetes medications or insulin therapy. The decision about which medications are best depends on many factors, including your blood sugar level and any other health problems you have. Your doctor might combine drugs from different classes to help you control your blood sugar in several different ways.
So you go to your doctor. What does he do? Instead of getting rid of the toxic sugar load, he doubles the dose of the medication. If the luggage doesn’t close, the solution is to empty it out, not use more force to . The higher dose of medication helps, for a time. Blood sugars go down as you force your body to gag down even more sugar. But eventually, this dose fails as well. So then your doctor gives you a second medication, then a third one and then eventually insulin injections.
So you go to your doctor. What does he do? Instead of getting rid of the toxic sugar load, he doubles the dose of the medication. If the luggage doesn’t close, the solution is to empty it out, not use more force to . The higher dose of medication helps, for a time. Blood sugars go down as you force your body to gag down even more sugar. But eventually, this dose fails as well. So then your doctor gives you a second medication, then a third one and then eventually insulin injections.
Treat yourself as you would a good friend who is struggling with a lifestyle change. You would be supportive and encouraging – a slip is not the end of it all. Sometimes it’s OK to indulge in a treat, but don’t feel guilty – enjoy it to the fullest – then get back on track. It’s OK to sit and read a book one day – just try to not make it the normal thing to do. I realized this morning when I had breakfast with a friend who is struggling with weight loss and I saw that the biggest difference was our attitude. She was moaning about how hard it was to lose and what she couldn’t eat and how much she had to work out, instead of looking at the fact that she has lost 20 pounds! That said, it’s not always easy to be positive, but all I really need to do is look back 4 months and I know I am making a difference.”

Only looking back could Jitahadi see how self-destructive her old eating habits were. At the time, she had a three-hour daily commute and had just lost one of her daughters. Healthy eating wasn't a top priority. "I realize how much I wasn't taking care of myself, and if I wanted to be here for my other daughter, I needed to turn this around," she says.


Don’t be surprised if you have to use multiple medications to control the blood sugar. Multiple medications, also known as combination therapy is common in the treatment of diabetes! If one medication is not enough, you medical provider may give you two or three or more different types of pills. Insulin or other injected medications also may be prescribed. Or, depending on your medical condition, you may be treated only with insulin or injected medication therapy. 
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