Thiazolidinediones. Like metformin, these medications — including rosiglitazone (Avandia) and pioglitazone (Actos) — make the body's tissues more sensitive to insulin. These drugs have been linked to weight gain and other more-serious side effects, such as an increased risk of heart failure and anemia. Because of these risks, these medications generally aren't first-choice treatments.

According to American Diabetes Association (ADA) recommendations, it may be appropriate for people with type 2 diabetes whose A1Cs are close to target to manage diabetes with lifestyle changes alone for three to six months—provided their doctor deems them "highly motivated." If that doesn't work, metformin is typically the first in a long list of type 2 blood glucose–lowering medications to add to the diet and exercise 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.
Rather than following a specific diabetes prevention diet, the greatest impact in prevention has occurred with weight reduction. Consequently, there is no single recommended diabetes prevention diet. The American Diabetes Association recommends goals of modest weight loss (5%-10% of body weight) and moderate exercise as primary interventions for preventing type 2 diabetes.
Our advice to anyone trying to live healthier lifestyles is simple, including diabetics trying to manage their disease. Our mantra: Eat real food. What does that mean? Eat whole foods that grow from the ground, are picked from a bush or tree, or came from an animal. Whole vegetables, fruit (both preferably organic), and responsibly raised and fed animals are all a part of a healthy, nutrient-rich diet. If one can stick to this simple rule and minimize or avoid processed and packaged foods and food-like items, you’ll find you look, feel, and perform better than ever.
Research has found, too, that the Pritikin Program can actually reverse the Metabolic Syndrome. In 50% of adult Americans studied, the Pritikin Program reversed the clinical diagnosis of Metabolic Syndrome, and in just three weeks. In research following children with the Metabolic Syndrome, 100% no longer had the syndrome within two weeks of starting the Pritikin Program.
Diabetes mellitus (DM) was first recognized as a disease around 3000 years ago by the ancient Egyptians and Indians, illustrating some clinical features very similar to what we now know as diabetes.1 DM is a combination of two words, “diabetes” Greek word derivative, means siphon - to pass through and the Latin word “mellitus” means honeyed or sweet. In 1776, excess sugar in blood and urine was first confirmed in Great Britain.2,3 With the passage of time, a widespread knowledge of diabetes along with detailed etiology and pathogenesis has been achieved. DM is defined as “a metabolic disorder characterized by hyperglycemia resulting from either the deficiency in insulin secretion or the action of insulin.” The poorly controlled DM can lead to damage various organs, especially the eyes, kidney, nerves, and cardiovascular system.4 DM can be of three major types, based on etiology and clinical features. These are DM type 1 (T1DM), DM type 2 (T2DM), and gestational DM (GDM). In T1DM, there is absolute insulin deficiency due to the destruction of β cells in the pancreas by a cellular mediated autoimmune process. In T2DM, there is insulin resistance and relative insulin deficiency. GDM is any degree of glucose intolerance that is recognized during pregnancy. DM can arise from other diseases or due to drugs such as genetic syndromes, surgery, malnutrition, infections, and corticosteroids intake.5-7
Your care team may recommend that you use a continuous glucose monitor (CGM). A CGM is a wearable device that can measure blood sugar every few minutes around the clock. It's measured by a thread-like sensor inserted under the skin and secured in place. The more frequent CGM blood sugar readings can help you and the care team do an even better job of troubleshooting and adjusting your insulin doses and diabetes management plan to improve blood sugar control.
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.

It's not clear why, but whole grains may reduce your risk of diabetes and help maintain blood sugar levels. Try to make at least half your grains whole grains. Many foods made from whole grains come ready to eat, including various breads, pasta products and cereals. Look for the word "whole" on the package and among the first few items in the ingredient list.
Although most vegetable oils are in some ways healthier than animal fats, you will still want to keep them to a minimum. All fats and oils are highly concentrated in calories. A gram of any fat or oil contains 9 calories, compared with only 4 calories for a gram of carbohydrate. Avoid foods fried in oil, oily toppings, and olives, avocados, and peanut butter. Aim for no more than 2-3 grams of fat per serving of food, e.g., white or wheat bread, most cold cereals, watermelon, pineapple, baking potatoes, sugar.
The best way to avoid these foods is to shop around the edges of the grocery store and minimize the number of processed, packaged foods in the middle. Sticking with "real" food in its whole, minimally processed form is the best way to eat well for diabetes. People with type 2 diabetes who eat a healthy diet pattern like the ones discussed here reduce the risk of complications that stem from high blood sugar, like cardiovascular disease and obesity.
We tend to hear much emphasis on calories, carbohydrate counting and the glycemic index when asking about type 2 diabetes management through diet. The most often forgotten nutrient for health is the most important: water. Many of our clients with type 2 diabetes are on the run and may remember to eat, yet do not take adequate time for drinking calorie-free, caffeine-free beverages to rehydrate. Since our bodies are comprised of nearly 70% water, it makes good sense to take in fluids daily to balance out our needs. Sometimes the recommended “8, 8 ounces of water per day” is not enough. A quick assessment of the color of urine coming out, depending on vitamin supplements and medications, can help determine what the right amount of liquid is daily. The lighter the color, the better!
Gestational diabetes is a condition that is first recognized during pregnancy and is characterized by high blood sugar. Approximately 4% of all pregnancies are diagnosed with gestational diabetes. Low blood sugar is prevented by hormones produced by the placenta during a woman's pregnancy. The actions of insulin are stopped by these hormones. Gestational diabetes is the result of the pancreas' inability to produce enough insulin to overcome the effect of the increase hormones during pregnancy.
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.
Research has shown that there are some ways of preventing type 2 diabetes, or at least delaying its onset. Lifestyle changes such as becoming more active (or staying active, if you already engage in regular physical activity) and making sure your weight stays in a healthy range are two ways to help ward off type 2 diabetes, but talk to your doctor about what else you can do to prevent or manage the disease.
The evidence is growing stronger that eating red meat (beef, pork, lamb) and processed red meat (bacon, hot dogs, deli meats) increases the risk of diabetes, even among people who consume only small amounts. The latest support comes from a “meta analysis,” or statistical summary, that combined findings from the long-running Nurses’ Health Study I and II and the Health Professionals Follow-Up Study with those of six other long-term studies. The researchers looked at data from roughly 440,000 people, about 28,000 of whom developed diabetes during the course of the study. (43) They found that eating just one daily 3-ounce serving of red meat—say, a steak that’s about the size of a deck of cards—increased the risk of type 2 diabetes by 20 percent. Eating even smaller amounts of processed red meat each day—just two slices of bacon, one hot dog, or the like—increased diabetes risk by 51 percent.
The only reason to continue to give this bad advice is the lingering fear of natural fat. If you’re going to avoid fat you need to eat more carbohydrates in order to get satiated. But in recent years the old theory about fat being dangerous has been proven incorrect and is today on its way out. Low-fat products are simply unnecessary. So this reason doesn’t hold up either.
If you are like me, going to the gym is not your favorite pass time. Physical activity with diabetes is so beneficial. Being active, however, does not mean having to work out. There are tons of ways to sneak in exercise in your everyday activities. For example, when grocery shopping, park at the end of the lot so you have to walk a longer distance to and from the store. If you enjoy watching tv, stand up and walk in place during the commercials. Take the stairs instead of the elevator as often as you can. If you enjoy dancing, instead of at- home work out videos, put on your favorite tunes and dance away! There are so many different ways to be active without “working out”!
Download this Shopping List for Diabetics, created by the doctors and dietitians at the Pritikin Longevity Center in Miami. Since 1975, the renowned Pritikin Center has been helping people with diabetes launch new lifestyles that maximize health and minimize the need for pills and insulin. It's all about keeping blood sugar and A1C at normal levels, naturally.

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.

Dr. Erica Oberg, ND, MPH, received a BA in anthropology from the University of Colorado, her doctorate of naturopathic medicine (ND) from Bastyr University, and a masters of public health (MPH) in health services research from the University of Washington. She completed her residency at the Bastyr Center for Natural Health in ambulatory primary care and fellowship training at the Health Promotion Research Center at the University of Washington.
Medications in this drug class may reduce the risk of heart attack and stroke in people with a high risk of those conditions. Side effects may include vaginal yeast infections, urinary tract infections, low blood pressure, and a higher risk of diabetic ketoacidosis. Canagliflozin, but not the other drugs in the class, has been associated with increased risk of lower limb amputation.

Other than gestational (which occurs in pregnant women and usually disappears after giving birth), there are two types of diabetes: Type 1 and Type 2. Type 1 diabetes accounts for only 5 percent of all instances in the United States, according to the Centers for Disease Control and Prevention. Type 2 diabetes is the most common, clocking in as the seventh leading cause of death in the United States. Type 2 diabetes is also the only one that’s considered preventable. It generally develops later in life, sometimes as a consequence of lifestyle or other health factors.


There is much you can do with lifestyle alone to prevent diabetes. In a landmark study, the NIH-sponsored Diabetes Prevention Program, scientists tracked 3,234 pre-diabetic men and women for three years. A third of them adopted lifestyle changes. Another third took a drug – metformin (Glucophage®). The remaining third, the control group, took a placebo. Those on the lifestyle-change plan reduced the progression to full-blown Type 2 diabetes by 58% compared to the control group. The reduction was even greater – 71% – among adults aged 60 and older. Treatment with the drug metformin reduced the progression of Type 2 diabetes by just 31%.
Information from several clinical trials strongly supports the idea that type 2 diabetes is preventable. The Diabetes Prevention Program examined the effect of weight loss and increased exercise on the development of type 2 diabetes among men and women with high blood sugar readings that hadn’t yet crossed the line to diabetes. In the group assigned to weight loss and exercise, there were 58 percent fewer cases of diabetes after almost three years than in the group assigned to usual care. (10) Even after the program to promote lifestyle changes ended, the benefits persisted: The risk of diabetes was reduced, albeit to a lesser degree, over 10 years. (11) Similar results were seen in a Finnish study of weight loss, exercise, and dietary change, and in a Chinese study of exercise and dietary change. (12–15)

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.
The theory behind a ketogenic diet for prediabetes is that when your body is in ketosis, you can be sure that you do not have excess carbohydrates in your diet. Since carbohydrates in your diet are broken down into glucose that goes into your bloodstream, being in ketosis assures that you are not inundating your bloodstream with excessive amounts of glucose due to the foods you eat.
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]
Long bouts of hot, sweaty exercise aren’t necessary to reap this benefit. Findings from the Nurses’ Health Study and Health Professionals Follow-up Study suggest that walking briskly for a half hour every day reduces the risk of developing type 2 diabetes by 30 percent. (18, 19) More recently, The Black Women’s Health Study reported similar diabetes-prevention benefits for brisk walking of more than 5 hours per week. (20) This amount of exercise has a variety of other benefits as well. And even greater cardiovascular and other advantages can be attained by more, and more intense, exercise.
Following a healthy eating plan. It is important to reduce the amount of calories you eat and drink each day, so you can lose weight and keep it off. To do that, your diet should include smaller portions and less fat and sugar. You should also eat a variety of foods from each food group, including plenty of whole grains, fruits, and vegetables. It's also a good idea to limit red meat, and avoid processed meats.

The superfood vinegar is best consumed as vinaigrette dressing on your salad, but it has beneficial effects no matter how you enjoy it. Vinegar slows gastric emptying, which has several beneficial effects for people with type 2 diabetes. This slows the glucose release into the bloodstream, allowing for a small, steady insulin response instead of a large insulin surge. Vinegar also increases satiety, so if you enjoy salad with vinaigrette as your first course, you are less likely to overeat during the main course.
The American Diabetes Association (ADA) recommends lean proteins low in saturated fat for people with diabetes. If you’re following a vegan or vegetarian diet, getting enough and the right balance of protein may be more challenging, but you can rely on foods like beans, nuts, and tofu to get your fix. Just be sure to keep portion size in mind when snacking on nuts, as they are also high in fat and calories.
In addition to the millions of adults with diabetes, another 57 million adults have “pre-diabetes.” (7) This early warning sign is characterized by high blood sugar levels on a glucose tolerance test or a fasting glucose test. Whether pre-diabetes expands into full-blown type 2 diabetes is largely up to the individual. Making changes in weight, exercise, and diet can not only prevent pre-diabetes from becoming diabetes, but can also return blood glucose levels to the normal range.
Eventually, even though the pancreas is working at its best to produce more and more insulin, the body tissues (for example, muscle and fat cells) do not respond and become insensitive to the insulin. At this point, overt diabetes occurs as the body is no longer able to effectively use its insulin to maintain normal blood sugar levels. Over time, these high levels of sugar result in the complications we see all too often in patients with diabetes.
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
The only reason to continue to give this bad advice is the lingering fear of natural fat. If you’re going to avoid fat you need to eat more carbohydrates in order to get satiated. But in recent years the old theory about fat being dangerous has been proven incorrect and is today on its way out. Low-fat products are simply unnecessary. So this reason doesn’t hold up either.
Exercise can also help people with type 2 diabetes avoid long-term complications, especially heart problems. People with diabetes are susceptible to developing blocked arteries (arteriosclerosis), which can lead to a heart attack. Exercise helps keep your heart healthy and strong. Plus, exercise helps you maintain good cholesterol—and that helps you avoid arteriosclerosis.
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
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
For this method, you will need to learn what foods have carbohydrate in them, what information to look for on a food label, and how to approximate a serving of carbohydrate when a food label is not available. Once you become familiar with these, you will be able to easily track your carbs to make sure you're not consuming too much. You may want to keep a log throughout the day.
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#10. ALCOHOL—Moderate amounts of alcohol are linked with less type 2 diabetes. Don't go overboard—excess can raise your risk. In a review of published studies looking at more than 477,000 people, researchers found a moderate intake of alcohol was most protective against getting type 2 diabetes. That translates to about 1.5  drinks a day. Note: In the United States, one "standard" drink contains roughly 14 grams of pure alcohol, which is found in: 12 ounces of regular beer (typically 5% alcohol); 5 ounces of wine (about 12% alcohol) and 1.5 ounces of distilled spirits, which is about 40% alcohol. However, it's a good idea to get advice on alcohol intake from your doctor, who knows your personal health history. 12   

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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.
Fruits constitute a commercially important and nutritionally indispensable food commodity. Being a part of a balanced diet, fruits play a vital role in human nutrition by supplying the necessary growth regulating factors essential for maintaining normal health. They have been especially valuable for their ability to prevent vitamin C and vitamin A deficiencies. Fruits and vegetables are good source of vitamins, minerals, flavonoids (anti-oxidants), saponins, polyphenols, carotenoids (vitamin A-like compounds), isothiocyanates (sulfur-containing compounds), and several types of dietary fibers. The fruits and vegetables not only prevent malnutrition but also help in maintaining optimum health through a host of chemical components that are still being identified, tested, and measured. They prevent various chronic diseases like stroke, hypertension, birth defects, cataracts, diabetes, heart disease, cancers, diverticulosis, obstructive pulmonary disease (asthma and bronchitis), and obesity etc.[53,54,55,56] Diets that are high in insoluble fiber may offer the best protection against this disease. Fruits and vegetables are high in cellulose-a type of insoluble fiber. Diets that are high in fiber may be able to help in the management of diabetes. Soluble fiber delays glucose absorption from the small intestine and thus may help prevent the spike in blood glucose levels that follow a meal or snack. The long-term effect may be insignificant, however, due to the many other factors that affect blood glucose. The effects of the fruit and vegetables on the human health allowed to once again measuring the enormous stakes.[57,58,59,60] More and more emphasis is put on the importance of the diversity of food, and in particular of the fruit and vegetables. This new and effective approach to diabetes is remarkably simple. Here are 4 simple steps to managing your blood sugar (and weight, blood pressure, and cholesterol) with diet.[61,62,63,64,65,66,67,68,69,70]
There’s more troubling news. The pre-cursors of Type 2 diabetes – pre-diabetes and the Metabolic Syndrome – increase our risk of heart disease almost as much as Type 2 diabetes does. These pre-cursors are so widespread in 21st century America that scientists now estimate that the majority of the current U.S. population over the age of 65 has them. And they put people at dangerously high risk of developing full-blown Type 2 diabetes and cardiovascular disease, and dying prematurely.
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.
A common recommendation for preventing diabetes is “eat healthy and lose weight.” But that advice is extremely broad. What does that even mean? One person’s interpretation of how to eat healthy could be entirely different from the next. And some tactics people might try in order to lose weight can be counterproductive and increase the risk of diabetes instead.
Hemoglobin A1c or HbA1c is a protein on the surface of red blood cells. The HbA1c test is used to monitor blood sugar levels in people with type 1 and type 2 diabetes over time. Normal HbA1c levels are 6% or less. HbA1c levels can be affected by insulin use, fasting, glucose intake (oral or IV), or a combination of these and other factors. High hemoglobin A1c levels in the blood increases the risk of microvascular complications, for example, diabetic neuropathy, eye, and kidney disease.
Download this Shopping List for Diabetics, created by the doctors and dietitians at the Pritikin Longevity Center in Miami. Since 1975, the renowned Pritikin Center has been helping people with diabetes launch new lifestyles that maximize health and minimize the need for pills and insulin. It's all about keeping blood sugar and A1C at normal levels, naturally.
You may be able to manage your type 2 diabetes with healthy eating and being active, or your doctor may prescribe insulin, other injectable medications, or oral diabetes medicines to help control your blood sugar and avoid complications. You’ll still need to eat healthy and be active if you take insulin or other medicines. It’s also important to keep your blood pressure and cholesterol under control and get necessary screening tests.
Chong points to previous research in Circulation that describes the underlying mechanisms of sleep apnea. In people with sleep apnea, activation of the sympathetic nervous system — including increased heart rate, increased blood pressure, and constriction of blood vessels — all led to a higher risk of heart attack and stroke, which can be compounded in people who have type 2 diabetes (and thus already have a higher risk of heart disease).
Although we cannot change your genetic risk for developing type 2 diabetes, we do know that even modest exercise and weight loss can delay or prevent the development of type 2 diabetes. A landmark research study in the United States, the Diabetes Prevention Program (DPP) was completed in 2002 and showed that when people modified their risk factors for type 2 diabetes, they reduced their chance of developing the condition. Similar results have been shown in Finland.
Phelps also made significant changes to his exercise routine, which went from 1/3-mile walks around his neighborhood (it took him 40 minutes and three rest stops the first time) to walking a half marathon a little under a year later. As he lost weight and became fitter, Phelps got addicted to triathlons. At 64, he's now set his sights on Ironman races, which he hopes to compete in next year.
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.

Medications and insulin do nothing to slow down the progression of this organ damage, because they do not eliminate the toxic sugar load from our body. We’ve known this inconvenient fact since 2008. No less than 7 multinational, multi-centre, randomized controlled trials of tight blood glucose control with medications (ACCORD, ADVANCE, VADT, ORIGIN, TECOS, ELIXA, SAVOR) failed to demonstrate reductions in heart disease, the major killer of diabetic patients. We pretended that using medications to lower blood sugar makes people healthier. But it’s only been a lie. You can’t use drugs to cure a dietary disease.
I think the best response to a one sentence question that includes the words diet and control is Mindfulness. Get knowledgeable about this topic so that you realize that eating is a continuum. There are so many decisions that go into what and how much we eat, that if we do not elevate intention to the priority level it requires to attain control, we will flounder in reaching our goals. Food choices, eating, and time management are so complex in our lives that clarifying our specific goals related to food and our health is imperative to approach control in a positive way.

Dehydration (the loss of body water and salt), which may cause you to feel dizzy, faint, lightheaded, or weak, especially when you stand up (orthostatic hypotension). You may be at a higher risk of dehydration if you have low blood pressure; take medicines to lower your blood pressure, including water pills (diuretics); are 65 years of age or older; are on a low salt diet, or have kidney problems


While there is still no cure for diabetes, there is good news; the progression from prediabetes to diabetes is not inevitable. The National Institutes of Health clinical trial, the Diabetes Prevention Program, found that for people with prediabetes modest lifestyle changes led to weight loss of 5 to 7 percent in participants and can reduce the risk of type 2 diabetes by 58% in individuals at high risk.
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]

While diabetes is characterized by high blood sugar values, type 2 diabetes is also associated with a condition known as insulin resistance. Even though there is an element of impaired insulin secretion from the beta cells of the pancreas, especially when toxic levels of glucose occur (when blood sugars are constantly very high), the major defect in type 2 diabetes is the body's inability to respond properly to insulin.

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).
Another essential element of Crawford's new lifestyle: her new food philosophy. "If you want something good for yourself, it's worth the time to invest in cooking," she says of her switch from eating out to staying in. "I let go of the processed foods and rely on foods as a whole. Everything we need is in our backyard." Crawford, now 30, tries to eat seasonally, makes fresh produce the center of her meals, and prefers organic food over conventional.
Up your soluble fiber intake: There are two types of fiber – the type that does not dissolve in water (insoluble fiber) and the kind that does (soluble fiber). Insoluble fiber can help manage weight and prevent constipation by moving quickly through the digestive tract and adding bulk to stool. Soluble fiber, on the other hand, absorbs water and turns into a gel-like consistency during digestion. This process slows down digestion and nutrient absorption. Soluble fiber can also lower blood sugar and cholesterol levels: because it isn’t well absorbed, it doesn’t contribute to blood sugar spikes and can help manage type 2 diabetes.
The first step is to eliminate all sugar and refined starches from your diet. Sugar has no nutritional value and can therefore be eliminated. Starches are simply long chains of sugars. Highly refined starches such as flour or white rice are quickly broken down by digestion into glucose. This is quickly absorbed into the blood and raises blood sugar. For example, eating white bread increases blood sugars very quickly.

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.
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.
"Many people with type 2 have had type 2 for a while prior to diagnosis," says Anne Peters, MD, director of the University of Southern California Clinical Diabetes Program and an author of the ADA's position statement on the management of type 2. A person who has had diabetes for five years before being diagnosed may have complications that require good blood glucose control—pronto. It will most likely take medications to achieve a quick improvement. Plus, you can always stop a medication once you've started it if lifestyle changes lead to on-target blood glucose levels—with your health care provider's guidance, of course.
But some pleasant news: When consumed in moderation and made with whole ingredients and without added sugar, fruit smoothies can be a good food for diabetes. Consider stocking your fridge with unsweetened frozen fruit so you can whip up one in a hurry for breakfast. Adding ingredients with protein, such as yogurt or a small amount of nut butter, will also help your body break down the carbohydrates more slowly, leading to less of a spike in blood sugar.
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