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.
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.
Metformin’s effectiveness didn’t change significantly in older adults compared with younger adults (hazard ratio [HR] for developing diabetes at age 60-85 years vs 25-44 years=1.45; 95% CI, 0.98-2.16; P=.06). In contrast, lifestyle modification worked better in older adults than younger adults (HR at age 60-85 years vs 25-44 years=0.47; 95% CI, 0.28- 0.78;P<.01).
People who have hypertension may follow a similar dietary plan to those who have diabetes. However, people with hypertension should also reduce sodium and caffeine intake. Individuals with both diabetes and hypertension should look for foods with low sodium counts, avoid coffee or caffeinated beverages, and avoid foods high in saturated and trans fats.
Other medications such as metformin or the DPP4 drug class are weight neutral. While this won’t make things worse, they won’t make things better either. Since weight loss is the key to reversing type 2 diabetes, medications won’t make things better. Medications make blood sugars better, but not the diabetes. We can pretend the disease is better, but that doesn’t make it true.
Insulin is a hormone made by your pancreas that acts like a key to let blood sugar into cells for use as energy. If you have prediabetes, the cells in your body don’t respond normally to insulin. Your pancreas makes more insulin to try to get cells to respond. Eventually your pancreas can’t keep up, and your blood sugar rises, setting the stage for prediabetes—and type 2 diabetes down the road.

Smoking 16 to 20 cigarettes a day or more can increase a person's risk of developing diabetes to more than three times that of nonsmokers. The exact reason for this isn't well understood. It may be that smoking directly decreases the body's ability to utilize insulin. Moreover, it has been observed that after smoking, blood sugar levels increase. Finally, there is also an association between smoking and body fat distribution, smoking tends to encourage the "apple" shape, which is a risk factor for diabetes.


DM can be controlled through improvement in patient’s dietary knowledge, attitudes, and practices. These factors are considered as an integral part of comprehensive diabetes care.51 Although the prevalence of DM is high in gulf countries, patients are still deficient in understanding the importance of diet in diabetes management.52 Studies have shown that assessing patients’ dietary attitude may have a considerable benefit toward treatment compliance and decrease the occurrence rate of complications as well.52 A study conducted in Egypt reported that the attitude of the patients toward food, compliance to treatment, food control with and without drug use and foot care was inadequate.53 Another study presented that one-third of the diabetic patients were aware about the importance of diet planning, and limiting cholesterol intake to prevent CVD. Various studies have documented increased prevalence of eating disorders and eating disorder symptoms in T2DM patients. Most of these studies have discussed about the binge eating disorder, due to its strong correlation with obesity, a condition that leads to T2DM.53 Furthermore, a study revealed that the weight gain among diabetic patients was associated with the eating disorder due to psychological distress.54 In another study that examined eating disorder-related symptoms in T2DM patients, suggested that the dieting-bingeing sequence can be applied to diabetics, especially obese diabetic patients.55 Unhealthy eating habits and physical inactivity are the leading causes of diabetes. Failure to follow a strict diet plan and workout, along with prescribed medication are leading causes of complications among patients of T2DM.56 Previous studies57 conducted in Saudi Arabia have reported that diabetic patients do not regard the advice given by their physicians regularly regarding diet planning, diet modification and exercise.
There is convincing evidence that diets rich in whole grains protect against diabetes, whereas diets rich in refined carbohydrates lead to increased risk (53). In the Nurses’ Health Studies I and II, for example, researchers looked at the whole grain consumption of more than 160,000 women whose health and dietary habits were followed for up to 18 years. Women who averaged two to three servings of whole grains a day were 30 percent less likely to have developed type 2 diabetes than those who rarely ate whole grains. (21) When the researchers combined these results with those of several other large studies, they found that eating an extra 2 servings of whole grains a day decreased the risk of type 2 diabetes by 21 percent.

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The DPP study showed a similar result. In this study, there was also a group taking metformin (Glucophage) as a preventative measure. At the end of the study, the lifestyle group actually did better at prevention of diabetes than those taking metformin. In fact, the study was stopped early, because the benefit of weight loss (the weight loss group lost about 15 pounds on average and kept it off) was so dramatic.
It’s best to get fiber from food. But if you can’t get enough, then taking fiber supplements can help. Examples include psyllium, methylcellulose, wheat dextrin, and calcium polycarbophil. If you take a fiber supplement, increase the amount you take slowly. This can help prevent gas and cramping. It’s also important to drink enough liquids when you increase your fiber intake.
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