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.

The oral glucose tolerance test (OGTT), or glucose tolerance test is a blood test used (not routinely however) to diagnose diabetes, and gestational diabetes. Information in regard to reliability of the oral glucose tolerance test is important, as some conditions (common cold), or food (caffeine), or lifestyle habits (smoking) may alter the results of the oral glucose tolerance test.


Heart-healthy fish. Eat heart-healthy fish at least twice a week. Fish can be a good alternative to high-fat meats. For example, cod, tuna and halibut have less total fat, saturated fat and cholesterol than do meat and poultry. Fish such as salmon, mackerel, tuna, sardines and bluefish are rich in omega-3 fatty acids, which promote heart health by lowering blood fats called triglycerides.
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.
Triglycerides are a common form of fat that we digest. Triglycerides are the main ingredient in animal fats and vegetable oils. Elevated levels of triglycerides are a risk factor for heart disease, heart attack, stroke, fatty liver disease, and pancreatitis. Elevated levels of triglycerides are also associated with diseases like diabetes, kidney disease, and medications (for example, diuretics, birth control pills, and beta blockers). Dietary changes, and medication if necessary can help lower triglyceride blood levels.
Food sources of carbohydrates should always be eaten WITH a source of protein and or unsaturated (“healthy”) fat. Fat and protein digest more slowly which helps prevent blood sugar spikes. Examples of balanced snacks that combine carbohydrate foods with protein/fat include, apple with peanut butter; berries with plain Greek yogurt; whole wheat toast with almond butter; baked potato with cottage cheese.
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.
Obesity: Obesity is probably the most impressive risk factor and in most situations the most controllable. This is in part due to the fact that obesity increases the body's resistance to insulin. Studies have shown that reversal of obesity through weight reduction improves insulin sensitivity and regulation of blood sugar. However, the distribution of fat is important. The classic "pear" shaped person (smaller waist than hips) has a lower risk of developing diabetes than the "apple" shaped person (larger around the waist). The exact reason for this difference is unknown, but it is thought to have something to do with the metabolic activity of the fat tissue in different areas of the body.
Diabetes is a disease that affects how the body uses glucose, the main type of sugar in the blood. Glucose, which comes from the foods we eat, is the major source of energy needed to fuel the body. To use glucose, the body needs the hormone insulin. But in people with diabetes, the body either can't make insulin or the insulin doesn't work in the body like it should.
Food can be powerful in preventing and reversing diabetes. However, dietary approaches have changed as we have learned more about the disease. The traditional approach to diabetes focuses on limiting refined sugars and foods that release sugars during digestion-starches, breads, fruits, etc. With carbohydrates reduced, the diet may contain an unhealthful amount of fat and protein. Therefore, diabetes experts have taken care to limit fats- especially saturated fats that can raise cholesterol levels, and to limit protein for people with impaired kidney function. The new approach focuses more attention on fat. Fat is a problem for people with diabetes. The more fat there is in the diet, the harder time insulin has in getting glucose into the cells. Conversely, minimizing fat intake and reducing body fat help insulin do its job much better. Newer treatment programs drastically reduce meats, high-fat dairy products, and oils.[46,47,48,49,50] At the same time, they increase grains, legumes, fruits, and vegetables. The study found that patients on oral medications and patients on insulin were able to get off of their medications after some days on a near-vegetarian diet and exercise program. During 2 and 3-year follow-ups, most people with diabetes treated with this regimen have retained their gains. The dietary changes are simple, but profound, and they work.[51,52,53]
Today’s widespread availability of oral diabetes medications has decreased the number of adult diabetics taking long-term insulin. However, as we learned in Chapter 5, those diabetes medications carry serious side effects with them. Furthermore, why would you want your condition to deteriorate, requiring progressively more potent medications with increasingly serious side effects? It sounds like it is definitely time for a better solution. The good news? Hintonia to the rescue!
That proved more difficult than she had imagined. She hadn't seen a diabetes educator. The only dietitian covered by her insurer was too far away. And her doctor's sole advice was for Jitahadi to watch what she ate. "I was scared in the beginning," says Jitahadi. "It was through friends and starting to read [about diabetes] that I knew I could do this. I could get through this."

If you have found that your fasting blood glucose is rising over time, even if it is normal, and certainly if you "officially" have impaired glucose intolerance (pre-diabetes), strongly consider getting a home glucose meter and testing your own blood to see if you can determine which lifestyle changes help lower and stabilize your blood glucose. The only problem is that many insurance companies will not pay for this preventative step, and the test strips are admittedly expensive. Still, you might be able to afford to monitor yourself at least occasionally or find a diabetic friend who sometimes has extra strips. Tracking your blood glucose response to meals and over time can be a big help in preventing the progression of diabetes.
Jitahadi bought books on diabetes, nutrition, the glycemic index, and diabetes-friendly meals. Instead of slightly modifying her diet, Jitahadi decided to completely overhaul it. "I started realizing that what ['watch what you eat'] really meant was I needed to eat healthier, more balanced meals," she says. She wrote down everything she ate. And instead of dining out, she cooked meals from scratch. Jitahadi swapped white sugar for lower-glycemic sweeteners, traded in white rice for brown, lowered the amount of sodium she consumed, cut a lot of carbs, and made veggies the mainstay of each meal. (Her favorite: grated cauliflower sautéed with veggies and chicken or egg for low-carb fried "rice.")

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.
#1. LEGUMES—Diets rich in legumes—soybeans, black beans, kidney beans, lentils, pinto beans—are good for your blood sugar levels both short-term and long-term. The secret? "Resistant starches," which resist digestion in the small intestine and go straight to the colon, feeding the bacteria in your gut and in the process improve your body's response to insulin.  (These resistant starches are also in green bananas, uncooked oats, and potatoes that have been cooked and cooled. Rejoice, potato salad lovers who can control their portions.)
Choose carbs wisely: The glycemic index (GI) is a value assigned to foods based on how quickly or slowly they spike your blood sugar levels. For someone with diabetes, high GI foods (like refined sugar or other simple carbohydrates like white rice and bread) can cause blood glucose levels to shoot up rapidly. Make sure that your carbs are high-fiber, whole grains – like legumes, brown rice, or quinoa – as these foods are high in nutrients and break down slowly into the bloodstream.
Eat a Source of Protein with Breakfast: As the first meal of the day, breakfast can set the tone for your body’s blood sugar balance and overall mindset on eating well (which, of course is also affected by a steady blood sugar!). Many typical breakfast foods tend to be rich in carbohydrates (fruit, cereal, oatmeal, toast, etc.) which may lead to spikes in blood sugar if eaten in large quantities alone.Add in sources of protein, fiber and/or healthy fats to create a blood-sugar steadying breakfast: pair fruit with yogurt or cottage cheese, oatmeal with a spoonful of peanut or almond butter, or a slice or two of whole grain toast with a couple of eggs or hummus.
As a bonus, stress relief may help you sleep better, which is important because studies show that not getting enough sleep can worsen type 2 diabetes. Sleeping less than six hours a night has also been found to contribute to impaired glucose tolerance, a condition that often precedes type 2 diabetes. In fact, a review published in 2015 in Diabetes Care analyzed 10 studies that involved more than 18,000 participants combined and found the lowest risk of type 2 diabetes in the group of participants that slept seven to eight hours per day. That’s the minimum recommended amount of sleep for most adults, according to the National Sleep Foundation.
Among 85,000 married female nurses, 3,300 developed type 2 diabetes over a 16-year period. Women in the low-risk group were 90 percent less likely to have developed diabetes than the rest of the women. Low-risk meant a healthy weight (body mass index less than 25), a healthy diet, 30 minutes or more of exercise daily, no smoking, and having about three alcoholic drinks per week.
Recently, evidence suggested a link between the intake of soft drinks with obesity and diabetes, resulting from large amounts of high fructose corn syrup used in the manufacturing of soft drinks, which raises blood glucose levels and BMI to the dangerous levels.38 It was also stated by Assy39 that diet soft drinks contain glycated chemicals that markedly augment insulin resistance. Food intake has been strongly linked with obesity, not only related to the volume of food but also in terms of the composition and quality of diet.40 High intake of red meat, sweets and fried foods, contribute to the increased the risk of insulin resistance and T2DM.41 In contrast, an inverse correlation was observed between intake of vegetables and T2DM. Consumption of fruits and vegetables may protect the development of T2DM, as they are rich in nutrients, fiber and antioxidants which are considered as protective barrier against the diseases.42 Recently, in Japanese women, a report revealed that elevated intake of white rice was associated with an increased risk of T2DM.43 This demands an urgent need for changing lifestyle among general population and further increase the awareness of healthy diet patterns in all groups.
×