More than half of the dialysis patients I see are type 2 diabetic – a few are type 1 (maybe 5 in a hundred) – it’s scary because when I see overweight people I think to myself if they don’t die first of heart disease they will be on dialysis. My advice now is to get our children outside playing and exercising – and watching their diets. Often fat kids grow up to be fat adults – AMEN – Peggy Harum RD, LD renal dietitian for more than 40 years
I recommend for my patients to eat a variety of foods when managing Diabetes Type 2 with diet. I particularly encourage patients to include protein from a variety of sources, fiber, and vegetables or fruit with each meal. Including small portions of many food groups with each meal ensures that patients’ bodies are being healthfully fueled and they will often feel more satisfied with their meals preventing overeating and grazing throughout the day.
Stay Hydrated. Drinking water throughout the day is always good to keep your organs and skin healthy. Of course, getting some fluid before, during and after exercise is just as important to avoid becoming dehydrated. However, what you choose matters a lot. For example, skip the soda. New findings come out regularly to warn against the negative health effects of added sugar, including fructose (ie, high fructose corn syrup), honey, and agave.

About 41 million Americans between the ages of 40 and 74 have "pre-diabetes." Prediabetes is a condition that, as the name implies, can be considered an early, potentially reversible, stage in the development of Type II diabetes. Pre-diabetes is sometimes called impaired glucose tolerance or Impaired Fasting Glucose (IGT/IFG). In pre-diabetes, a person's blood sugar(glucose) levels are slightly higher than the normal range, but not high enough for a true diagnosis of diabetes. People with pre-diabetes have a significant risk of developing full-blown diabetes.
There are two main types of diabetes – Type 1 and Type 2. At least 90% of diabetics in America have Type 2 diabetes. Studying the evolution and lifestyle habits of humankind, we can confidently assert that Type 2 diabetes is virtually entirely preventable. Worldwide, many populations are now suffering epidemic rates of Type 2 diabetes because many populations live in a “food toxic” environment and exercise little or not at all.
Diabetic’s dietary practices are mainly influenced by cultural backgrounds. Concerning each of the dimensions of dietary practices, there were significant positive relationships between knowledge regarding diabetic diet and dietary practices. Knowledge was a salient factor related to dietary behaviors control.46 Moreover, patients’ knowledge on a recommended diet indicates their understanding of dietary guidelines which influenced their food selection and eating patterns.47 The association between dietary knowledge and dietary practices among T2DM patients in the previous studies were inconsistent. Another study revealed that there was no relationship between dietary knowledge and compliance of dietary practices.58 On the other hand, the same study found that a high dietary knowledge score was associated with following dietary recommendations and knowledgeable patients performed self-management activities in a better way. Dietary knowledge significantly influences dietary practices. In Indonesia, a study was conducted to measure dietary practices among diabetic patients, which elaborated that the Indonesian people, preferred to consume high-fat foods which lead to an increased risk of CVD.59 The trend of skipping breakfast has dramatically increased over the past 10 years in children, adolescents, and adults.60,61 There is increasing evidence that skipping breakfast is related with overweight and other health issues.62 In addition, frequent eating or snacking may also increase the body weight and risk of metabolic diseases.63,64 Rimm65 demarcated western and prudent dietary patterns. The prudent dietary pattern was characterized by increased consumption of fish, poultry, various vegetables and fruits whereas; the western dietary pattern was characterized by an increased consumption of processed and red meat, chips, dairy products, refined grains, and sweets and desserts. These patterns were previously associated with T2DM risk. The glycemic index is an indicator of the postprandial blood glucose response to food per gram of carbohydrate compared with a reference food such as white bread or glucose. Hence, the glycemic load represents both the quality and quantity of the carbohydrates consumed.66-69 Another study conducted in Lebanon demonstrated direct correlation of the refined grains and desserts and fast food patterns with T2DM, however, in the same study an inverse correlation was observed between the traditional food pattern and T2DM among Lebanese adults.70
When overweight diabetic patients drop some weight by trimming down ‘serving sizes’ and calories, insulin sensitivity improves, thereby optimizing drug therapy. The fundamental principle behind maintenance of body weight is the energy balance. This group should be encouraged to maintain their current weight by: Maintaining current ‘serving sizes,’ eating about the same amount of food each day, eating at about the same times each day, taking their drugs at the same times each day, and exercising at the same times each day. These patients should also endeavor to choose their daily foods from starches, vegetables, fruits, and protein, while limiting the amount of fats.[41,42,43,44,45]
The Life! program is a Victorian lifestyle modification program that helps you reduce your risk of type 2 diabetes and cardiovascular disease. Run by expert health professionals, the program is delivered as a Group Course or a Telephone Health Coaching service. Funded by the Victorian Government and managed by Diabetes Victoria it is the biggest prevention program of its type in Australia.
Food sources of carbohydrates including breads, cereals, crackers, pasta, starchy vegetables (peas, corn, potatoes), fruit and sweets/desserts need to be eaten consistently throughout the day by focusing on small and frequent meals every 3-4 hours. Patients with type 2 diabetes should work with a dietitian who can prescribe a goal number of carbohydrate servings (or grams) at each meal and snack and teach appropriate portion size for each carbohydrate food. Daily carbohydrate needs will vary based on the individual.
National Center for Health Statistics reported that socioeconomic status plays an important role in the development of T2DM; where it was known as a disease of the rich.49 On the contrary, the same reference reported that T2DM was more prevalent in lower income level and in those with less education. The differences may be due to the type of food consumed. Nutritionists advised that nutrition is very important in managing diabetes, not only type but also quantity of food which influences blood sugar. Meals should be consumed at regular times with low fat and high fiber contents including a limited amount of carbohydrates. It was observed that daily consumption of protein, fat and energy intake by Saudi residents were higher than what is recommended by the International Nutritional Organization.50

Among the patients, diabetes awareness and management are still the major challenges faced by stakeholders worldwide. Poor knowledge related to diabetes is reported in many studies from the developing countries.18 Some studies have suggested that the occurrence of diabetes is different in various ethnic groups.19 Knowledge is a requirement to achieve better compliance with medical therapy.20 According to a study conducted by Mohammadi21 patient’s knowledge and self-care management regarding DM was not sufficient. Low awareness of DM affects the outcome of diabetes. Another study conducted in Slovakia by Magurová22 compared two groups of patients (those who received diabetes education and those who did not). The results indicated that receiving diabetes education significantly increased awareness about the disease in patients (p < 0.001). The study further concluded that having diabetes knowledge can notably improve patient’s quality of life and lessen the burden on their family. Dussa23 conducted a cross-sectional study on assessment of diabetes awareness in India. The study concluded that level of diabetes awareness among patients and general population was low. Another study conducted in India by Shah24 reported that 63% of T2DM patients did not know what DM is and the majority were also unaware about its complications.
If you have prediabetes, losing a small amount of weight if you’re overweight and getting regular physical activity can lower your risk for developing type 2 diabetes. A small amount of weight loss means around 5% to 7% of your body weight, just 10 to 14 pounds for a 200-pound person. Regular physical activity means getting at least 150 minutes a week of brisk walking or a similar activity. That’s just 30 minutes a day, five days a week.

High blood sugar (hyperglycemia). Lots of things can cause your blood sugar to rise, including eating too much, being sick or not taking enough glucose-lowering medication. Watch for signs and symptoms of high blood sugar — frequent urination, increased thirst, dry mouth, blurred vision, fatigue and nausea — and check your blood sugar if necessary.

To hit your blood sugar level target, eat a variety of foods but monitor portions for foods with a high carbohydrate content, says Alison Massey, RD, CDE, the director of diabetes education at Mercy Medical Center in Baltimore. “[Foods high in carbohydrates] have the most impact on blood sugar level. This is why some people with diabetes count their carbohydrates at meals and snacks,” she says.

Carry a Rescue Snack: Going too long without eating can lead to dips in blood sugar, sometimes called “lows”, which create unpleasant symptoms, including ravenous hunger. This often leads to poor food choices, since we’re more focused on eating anything in sight, even if it’s not healthy. Rather than getting to this point, keep a healthy snack with you throughout the day in case you get stuck somewhere you didn’t plan at a mealtime. A balanced snack will combine a nutritious carb or veggie + source of protein or healthy fat.The chart below provides portable options you can mix and match to your tastes:
The American Diabetes Association (ADA) advocates for a healthy diet with an emphasis on balancing energy intake with exercise. Historically, they have advocated for the majority of calories coming from complex carbohydrates from whole grains such as whole-grain bread and other whole-grain cereal products and a decreased intake of total fat with most of it coming from unsaturated fat.
You can talk to your diabetes health care team about making any necessary meal or medication adjustments when you exercise. They'll offer specific suggestions to help you get ready for exercise or join a sport and give you written instructions to help you respond to any diabetes problems that may happen during exercise, like hypoglycemia (low blood sugar), or hyperglycemia (high blood sugar).
Foods might sometimes appear to be packaged into individual serving sizes even though they contain two or more servings per package. To determine that, look at "serving size" and "servings per container" at the top of any food label. For example, if a serving size is 1 and there are 2 servings per container, you will need to double all of the nutrient values on the label in order to get a clear picture of the value of the entire container.
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