The same benefits are seen when looking specifically at people with impaired prediabetes (glucose tolerance/impaired fasting glucose). When diet and exercise are used as tools in this population over a six year study and compared to a control group, glucose tolerance improves by about 76% compared to deterioration in 67% of the control group. The exercise group also had a lesser rate of progression to type 2 diabetes.
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.
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!
One serving in a category is called a "choice." A food choice has about the same amount of carbohydrates, protein, fat and calories — and the same effect on your blood glucose — as a serving of every other food in that same category. So, for example, you could choose to eat half of a large ear of corn or 1/3 cup of cooked pasta for one starch choice.
Fortunately, because environmental factors are modifiable, disease manifestation from these factors is largely preventable. Diet is one of the major factors now linked to a wide range of diseases including diabetes. The amount and type of food consumed is a fundamental determinant of human health. Diet constitutes a crucial aspect of the overall management of diabetes, which may involve diet alone, diet with oral hypoglycemic drugs, or diet with insulin.[11,12,13,14,15] Diet is individualized depending on age, weight, gender, health condition, and occupation etc. The dietary guidelines as used in this review are sets of advisory statements that give quick dietary advice for the management of the diabetic population in order to promote overall nutritional well-being, glycogenic control, and prevent or ameliorate diabetes-related complications.
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.
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.
In addition, many sugar-containing foods also contain a lot of fat. Foods such as cookies, pastries, ice cream and cakes should be avoided largely because of the fat content and because they don't contribute much nutritional value. If you do want a "sweet," make a low-fat choice, such as low-fat frozen yogurt, gingersnaps, fig bars, or graham crackers and substitute it for other carbohydrates on your meal plan.
If you have type 2 diabetes and the blood sugar is controlled during treatment (diet, exercise and medications), it means that the treatment plan is working. You are getting the good blood sugar because of the treatment – NOT because diabetes predisposition has gone away. You will need to continue your treatment; otherwise your blood sugar will go back up.
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.
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.
Although support groups aren't for everyone, they can be good sources of information. Group members often know about the latest treatments and tend to share their own experiences or helpful information, such as where to find carbohydrate counts for your favorite takeout restaurant. If you're interested, your doctor may be able to recommend a group in your area.
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
Note: Type 1 diabetes must be treated with insulin; if you have type 2 diabetes, you may not need to take insulin. This involves injecting insulin under the skin for it to work. Insulin cannot be taken as a pill because the digestive juices in the stomach would destroy the insulin before it could work. Scientists are looking for new ways to give insulin. But today, shots are the only method. There are, however, new methods to give the shots. Insulin pumps are now being widely used and many people are having great results.
Check your risk of diabetes. Take the Life! risk assessment test and learn more about your risk of developing type 2 diabetes. A 12+ score indicates that you are at high risk and may be eligible for the Life! program - a free Victorian lifestyle modification program that helps you reduce your risk of type 2 diabetes and cardiovascular disease, or call 13 RISK (13 7475).
And finally, behavioral changes that set up environments for success are extremely helpful. These may include daily food/beverage/activity/glucose logging, and food-proofing environments. Logging can now be completed easily with electronic applications and website support, such as www.choosemyplate.gov . Food-proofing takes more doing and family/significant other assistance. Environments to review may include home, shopping, work, driving, and social. Review foods in each environment that sabotage efforts to manage blood glucose, and develop strategies to cope. For instance, when driving, bring a planned carb-controlled snack (e.g. small apple, 3 graham cracker squares, sparkling calorie-free water), in case travels extend past expected times; and check driving patterns, since some automatic routes may go past a favorite fast food place that magically pulls the car in!
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.