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
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.”
Bladder cancer. In studies of FARXIGA in people with diabetes, bladder cancer occurred in a few more people who were taking FARXIGA than in people who were taking other diabetes medications. There were too few cases of bladder cancer to know if bladder cancer was related to FARXIGA. Tell your healthcare provider right away if you have blood or a red color in your urine or pain while you urinate
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.
In this country, we tend to over- do it on those. Most people do not enjoy measuring their foods or counting carbs. My favorite way to estimate portion sizes is to use the “Create Your Plate” method created by the America Diabetes Association. Simply use a disposable plate divided into three sections (one half-plate section and two quarter plate sections). The large, half plate section should be used for non-starchy vegetables, things like carrots, broccoli, or cauliflower. Place your lean meat or protein in one quarter-plate section, and your carbohydrate in the other quarter-plate section. You can practice designing your meal using this method on their website: http://www.diabetes.org/food-and-fitness/food/planning-meals/create-your-plate/
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.

In the picture to the right you can see the lunch that I was unbelievably served at the 11th International Congress on Obesity in Stockholm 2010. This is a major international conference for obesity doctors and scientists. The food contains almost exclusively energy from sugar and starches, things that are broken down to simple sugars in the stomach.


If you are at risk for diabetes or insulin resistance, be sure to get an annual testing for fasting blood glucose and hemoglobin A1c. If you see these rising over time, this is a sign that your body is having more trouble processing sugar. Your healthcare provider can provide further recommendations for medication and lifestyle changes that can reduce your risk of progressing to type 2 diabetes.
It’s like packing your clothes into a suitcase. At first, the clothes go without any trouble. After a certain point, though, it is just impossible to jam in those last 2 T-shirts. You can’t close the suitcase. The luggage is now ‘resistant’ to the clothes. It’s waaayyy harder to put those last 2 T-shirts than the first 2. It’s the same overflow phenomenon. The cell is filled to bursting with glucose, so trying to force more in is difficult and requires much higher doses of insulin.

Interventional studies showed that high carbohydrate and high monounsaturated fat diets improve insulin sensitivity, whereas glucose disposal dietary measures comprise the first line intervention for control of dyslipidemia in diabetic patients.78 Several dietary interventional studies recommended nutrition therapy and lifestyle changes as the initial treatment for dyslipidemia.79,80 Metabolic control can be considered as the cornerstone in diabetes management and its complications. Acquiring HbA1c target minimizes the risk for developing microvascular complications and may also protect CVD, particularly in newly diagnosed patients.81 Carbohydrate intake has a direct effect on postprandial glucose levels in people with diabetes and is the principal macronutrient of worry in glycemic management.82 In addition, an individual’s food choices and energy balance have an effect on body weight, blood pressure, and lipid levels directly. Through the mutual efforts, health-care professionals can help their patients in achieving health goals by individualizing their nutrition interventions and continuing the support for changes.83-85 A study suggested that intake of virgin olive oil diet in the Mediterranean area has a beneficial effect on the reduction of progression of T2DM retinopathy.86 Dietary habits are essential elements of individual cardiovascular and metabolic risk.87 Numerous health benefits have been observed to the Mediterranean diet over the last decades, which contains abundant intake of fruit and vegetables. The beneficial effects of using fish and olive oil have been reported to be associated with improved glucose metabolism and decreased risk of T2DM, obesity and CVD.88
This pattern of eating is very nutrient-dense, meaning you get many vitamins, minerals, and other healthful nutrients for every calorie consumed. A very large recent study demonstrated that two versions of the Mediterranean diet improved diabetes control including better blood sugar and more weight loss. The two versions of the Mediterranean diet that were studied emphasized either more nuts or more olive oil. Since both were beneficial, a common-sense approach to adopting the Mediterranean diet would include both of these. For example, sprinkle chopped almonds on green beans or drizzle zucchini with olive oil, oregano, and hemp seeds.
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.
Interventional studies showed that high carbohydrate and high monounsaturated fat diets improve insulin sensitivity, whereas glucose disposal dietary measures comprise the first line intervention for control of dyslipidemia in diabetic patients.78 Several dietary interventional studies recommended nutrition therapy and lifestyle changes as the initial treatment for dyslipidemia.79,80 Metabolic control can be considered as the cornerstone in diabetes management and its complications. Acquiring HbA1c target minimizes the risk for developing microvascular complications and may also protect CVD, particularly in newly diagnosed patients.81 Carbohydrate intake has a direct effect on postprandial glucose levels in people with diabetes and is the principal macronutrient of worry in glycemic management.82 In addition, an individual’s food choices and energy balance have an effect on body weight, blood pressure, and lipid levels directly. Through the mutual efforts, health-care professionals can help their patients in achieving health goals by individualizing their nutrition interventions and continuing the support for changes.83-85 A study suggested that intake of virgin olive oil diet in the Mediterranean area has a beneficial effect on the reduction of progression of T2DM retinopathy.86 Dietary habits are essential elements of individual cardiovascular and metabolic risk.87 Numerous health benefits have been observed to the Mediterranean diet over the last decades, which contains abundant intake of fruit and vegetables. The beneficial effects of using fish and olive oil have been reported to be associated with improved glucose metabolism and decreased risk of T2DM, obesity and CVD.88
Perhaps you have learned that you have a high chance of developing type 2 diabetes, the most common type of diabetes. You might be overweight or have a parent, brother, or sister with type 2 diabetes. Maybe you had gestational diabetes, which is diabetes that develops during pregnancy. These are just a few examples of factors that can raise your chances of developing type 2 diabetes.
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.

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.

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.
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:
In this country, we tend to over- do it on those. Most people do not enjoy measuring their foods or counting carbs. My favorite way to estimate portion sizes is to use the “Create Your Plate” method created by the America Diabetes Association. Simply use a disposable plate divided into three sections (one half-plate section and two quarter plate sections). The large, half plate section should be used for non-starchy vegetables, things like carrots, broccoli, or cauliflower. Place your lean meat or protein in one quarter-plate section, and your carbohydrate in the other quarter-plate section. You can practice designing your meal using this method on their website: http://www.diabetes.org/food-and-fitness/food/planning-meals/create-your-plate/
Mexican researchers were finally able to isolate the unique way that it works: The plant is an inhibitor of alpha-glucosidase, an enzyme that releases sugar from foods, particularly carbohydrates. We all know that carbohydrates, especially simple carbs like sugar and foods made with white flour, are the bugaboo of people with Type 2 diabetes, so this news alone is a huge boon for people with the disease.
If you like, I can help show you Medicare coverage options that may fit your health goals. To learn more, click the links below to set up a phone appointment or have me send you some personalized plan options by email. If you’d prefer to browse on your own, you can do that too: just click the Compare Plans button on this page to view coverage options in your zip code.

Diabetes is a serious disease requiring professional medical attention. The information and recipes on this site, although as accurate and timely as feasibly possible, should not be considered as medical advice, nor as a substitute for the same. All recipes and menus are provided with the implied understanding that directions for exchange sizes will be strictly adhered to, and that blood glucose levels can be affected by not following individualized dietary guidelines as directed by your physician and/or healthcare team.


[1] Diabetes Prevention Program Research Group. Long-term effects of lifestyle intervention or metformin on diabetes development and microvascular complications over 15-year follow-up: the Diabetes Prevention Program Outcomes Study. The Lancet Diabetes & Endocrinology. 2015;3(11):866‒875. You can find more information about this study at the Diabetes Prevention Program Outcomes Study website.
Choose lean sources of protein. Lean sources of protein include: eggs, egg whites, chicken breast, turkey breast, lean beef, pork tenderloin, fish (e.g., cod, tilapia, orange roughy), beans, or tofu. Adding protein to your daily intake helps to control spikes in blood sugar and helps with fullness to prevent unnecessary snacking on poor choices later.
Type-2 diabetes is a major, non-communicable disease with increasing prevalence at a global level. Type-2 diabetes results when the body does not make enough insulin or the body cannot use the insulin it produces. Type-2 diabetes is the leading cause of premature deaths. Improperly managed, it can lead to a number of health issues, including heart diseases, stroke, kidney disease, blindness, nerve damage, leg and foot amputations, and death. Type-2 diabetes or adult-onset diabetes is most common type of diabetes, usually begins when a person is in his or her mid-50s, but diabetes is not inevitable. Minor changes in your lifestyle can greatly reduce your chances of getting this disease. Therefore, in order to prevent this condition, action should be taken regarding the modifiable factors that influence its development-lifestyle and dietary habits. However, with proper testing, treatment and lifestyle changes, healthy eating as a strategy, promote walking, exercise, and other physical activities have beneficial effects on human health and prevention or treatment of diabetes, promoting adherence to this pattern is of considerable public health importance.
Designed to support positive behaviour change, the program helps eligible participants plan and action small lifestyle changes that have long term health benefits. The program involves six sessions overs six months and is delivered by qualified health professionals. Participants have the choice of group sessions or phone coaching options. Group sessions in local areas work well for people who enjoy social interaction and learning from others’ experiences while phone coaching appeals to those whose work or life situation make it difficult for them to commit to set days and times.
One of the biggest tips I discuss with my clients who are trying to manage their Diabetes is to focus on adding more fiber to their diet. We first start by adding fruits and veggies to the meals that they are already consuming. I find adding to the diet is usually an easier approach for most. Another tip is to focus on adding more whole foods, like apples with the skin versus juices or baked sweet potatoes versus the instant varieties. Along with more fruits and veggies, clients can also add fiber in the forms of nuts and seeds to meals or snacks to help with satiety and blood sugar control. One of the key points I stress to any client is to focus the balance and take it one step at a time. I don’t expect anyone to do a complete 360 on their food intake since it takes time to build new (and healthy) habits that will last long-term.
The medications only hide the blood sugar by cramming it into the engorged body. The diabetes looks better, since you can only see the blood sugars. Doctors can congratulate themselves on a illusion of a job well done, even as the patient gets continually sicker. Patients require ever increasing doses of medications and yet still suffer with heart attacks, congestive heart failure, strokes, kidney failure, amputations and blindness. “Oh well” the doctor tells himself, “It’s a chronic, progressive disease”.
Some easy-to-follow examples I often provide are adding chopped mixed vegetables to scrambled eggs and including fresh fruit on the side; preparing a green smoothie with low-fat milk, low-fat yogurt, chopped fresh kale, and frozen fruit; preparing vegetarian jambalaya with brown rice; or choosing a hearty salad with mixed greens, nuts, beans, and light salad dressing from a salad bar. Food can be medicine and it can also be enjoyable!
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%.

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.
Type 2 diabetes can lead to a number of complications such as kidney, nerve, and eye damage, as well as cardiovascular disease. It also means cells are not receiving the glucose they need for healthy functioning. A calculation called a HOMA Score (Homeostatic Model Assessment) can tell doctors the relative proportion of these factors for an individual with type 2 diabetes. Good glycemic control (that is, keeping sugar/carbohydrate intake low so blood sugar isn't high) can prevent long-term complications of type 2 diabetes. A diet for people with type 2 diabetes also is referred to as a diabetic diet for type 2 diabetes and medical nutrition therapy (MNT) for people with diabetes.
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