As a renal dietitian my focus can’t be solely on diabetes. Although a very large percentage of our patients with chronic kidney disease are here due to unmanaged blood sugar control, that is just one of our problems. I have to prioritize my counseling in other ways – the most important being control of potassium, then sodium (fluid), protein and phosphorus.
Eating right and exercising more often is good for everyone. But it's especially important for people with type 2 diabetes. When people put on too much body fat, it's because they're eating more calories than they use each day. The body stores that extra energy in fat cells. Over time, gaining pounds of extra fat can lead to obesity and diseases related to obesity, like type 2 diabetes.
The process of type 2 diabetes begins years or even decades before the diagnosis of diabetes, with insulin resistance. Insulin resistance is the beginning of the body not dealing well with sugar, which is the breakdown product of all carbohydrates. Insulin tells certain body cells to open up and store glucose as fat. When the cells stop responding your blood sugar rises, which triggers the release of more insulin in a vicious cycle. Insulin resistance is associated with abdominal obesity, high blood pressure, high triglycerides, and low HDL ("good cholesterol"). When these occur together, it is known as metabolic syndrome or pre-diabetes. It is a risk factor for heart disease and type 2 diabetes.
Although sugar does not cause the blood sugar to rise any higher than other carbohydrates, it should be eaten along with other healthy foods. If you choose to drink a 12-ounce can of a sugar-sweetened soft drink, that would use up about 45 grams of carba, and you wouldn't have gotten any nutrition (protein, vitamins, or minerals). What a waste of calories!
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings through its clearinghouses and education programs to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The glycemic index identifies foods that increase blood sugar rapidly. This handy tool allows you to favor foods that have much less effect on blood sugar. High-glycemic-index foods include sugar itself, white potatoes, most wheat flour products, and most cold cereals, e.g., pumpernickel, rye, multigrain, or sourdough bread, old-fashioned oatmeal, bran cereals, grape-nuts, most fruits, sweet potatoes, pasta, rice, barley, couscous, beans, peas, lentils, most vegetables [Table 1].
People are missing the forest through the trees while trying to be perfect in the way they eat. It has become difficult to accept the tip “eat more fruits and vegetables”. All the food “philosophers” (aka non-science based food guru) have filled our heads with lies about the types, packaging and serving of these foods. Saying things like “they are worthless if they are packaged in such-and-such a way”. STOP with the “all-prefect or nothing” mentality. Just eat fruits and vegetables! Canned, fresh, frozen, cooked, raw, or pulverized; just get them in your belly.
The majority of our dialysis patients lose kidney function completely – in other words they no longer urinate. So imagine what happens when they eat salty foods (not salt) – they get thirsty and drink – Then the dialysis treatment must try (only try) to remove the fluid they accumulate. It is true that high blood sugar also causes thirst – which I must keep in mind. I have many patients who rely on their PCP for advice with their insulin. They take the same amount of insulin regardless of their blood sugar – and the A1C remains elevated – I can’t change how they administer the insulin – but only recommend asking for a referral to an endocrinologist.
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.

Hot liquids fill you up better than most anything else – coffee, teas, non-fat hot chocolate. I have become a big fan of soup. I make it myself by browning onions in non-stick cooking spray (to bring out the flavor), then add whatever vegetables I have around with some broth (vegetable or chicken). When the veggies are soft, cool slightly, then blend in small batches. Season with S&P, or experiment with turmeric or cardamon. Makes a lovely thick, creamy soup without the calories. I use sweet potatoes, carrots, broccoli, cauliflower, whatever.
The process of type 2 diabetes begins years or even decades before the diagnosis of diabetes, with insulin resistance. Insulin resistance is the beginning of the body not dealing well with sugar, which is the breakdown product of all carbohydrates. Insulin tells certain body cells to open up and store glucose as fat. When the cells stop responding your blood sugar rises, which triggers the release of more insulin in a vicious cycle. Insulin resistance is associated with abdominal obesity, high blood pressure, high triglycerides, and low HDL ("good cholesterol"). When these occur together, it is known as metabolic syndrome or pre-diabetes. It is a risk factor for heart disease and type 2 diabetes.
You may feel fine, but that is no guarantee that your blood sugar levels are in the target range. Remember, diabetic complications do not appear right away. And complications may develop even when the blood sugar is only slightly elevated. Regular blood sugar monitoring can help you keep your blood sugars in control and prevent serious damage to your eyes, kidneys and nerves. If your sugar levels are out of line, consult your doctor.
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.
The president of the International Diabetes Foundation was the lead author on another study that strongly recommended the use of this unique herb in treating and preventing Type 2 diabetes. Not only because of improved blood sugar control, but also because of its effectiveness in lowering cholesterol and other elements of metabolic syndrome that can lead to Type 2 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.")

Charlene Crawford has spent more than half of her life with diabetes. At 14, she was diagnosed with prediabetes. By 18, she had type 2. She was prescribed medication, which she barely took, and advised to make lifestyle changes, which she didn't do. But when she got pregnant, her priorities shifted. "Having a child makes you see things differently," says Crawford, a mother of two. "I wanted to be there for him and not be so tired and be active when he needed me."
The beneficial effect of the dietary pattern on diabetes mellitus and glucose metabolism in general and traditional food pattern was associated with a significant reduction in the risk of developing type-2 diabetes. The dietary pattern emphasizes a consumption of fat primarily from foods high in unsaturated fatty acids, and encourages daily consumption of fruits, vegetables, low fat dairy products and whole grains, low consumption of fish, poultry, tree nuts, legumes, very less consumption of red meat.[18,19,20] The composition of diet is one of the best known dietary patterns for its beneficial effects on human health that may act beneficially against the development of type-2 diabetes, including reduced oxidative stress and insulin resistance. High consumption of vegetables, fruits, legumes, nuts, fish, cereals and oil leads to a high ratio of monounsaturated fatty acids to saturated fatty acids, a low intake of trans fatty acids, and high ingestion of dietary fiber, antioxidants, polyphenols. The diets are characterized by a low degree of energy density overall; such diet prevent weight gain and exert a protective effect on the development of type-2 diabetes, a condition that is partially mediated through weight maintenance. Greater adherence to the diet in combination with light physical activity was associated with lower odds of having diabetes after adjustment for various factors.[21,22,23,24,25] On the other hand, a paleolithic diet (i.e., a diet consisting of lean meat, fish, shellfish, fruits and vegetables, roots, eggs and nuts, but not grains, dairy products, salt or refined fats, and sugar) was associated with marked improvement of glucose tolerance while control subjects who were advised to follow a diet did not significantly improve their glucose tolerance despite decreases in weight and waist circumference.[26,27,28] People most likely to get diabetes are: People who are overweight, upper-body obesity, have a family history of diabetes, age 40 or older, and women (50% more often than men).
Globally, T2DM is at present one of the most common diseases and its levels are progressively on the rise. It has been evaluated that around 366 million people worldwide or 8.3% in the age group of 20-79 years had T2DM in 2011. This figure is expected to rise to 552 million (9.9%) by 2030.10 This disease is associated with severe complications which affect patient’s health, productivity, and quality of life. More than 50% of people with diabetes die of cardiovascular disease (CVD) (primarily heart disease and stroke) and is a sole cause of end stage renal disease which requires either dialysis or kidney transplantation. It is also a major cause of blindness due to retinal damage in adult age group referred to as diabetic retinopathy (DR). People with T2DM have an increased risk of lower limb amputation that may be 25 times greater than those without the disease. This disease caused around 4.6 million deaths in the age-group of 20-79 years in 2011.11
Aside from managing your diabetes, a diabetes diet offers other benefits, too. Because a diabetes diet recommends generous amounts of fruits, vegetables and fiber, following it is likely to reduce your risk of cardiovascular diseases and certain types of cancer. And consuming low-fat dairy products can reduce your risk of low bone mass in the future.
A large number of cross-sectional as well as prospective and retrospective studies have found significant association between physical inactivity and T2DM.12 A prospective study was carried out among more than thousand nondiabetic individuals from the high-risk population of Pima Indians. During an average follow-up period of 6-year, it was found that the diabetes incidence rate remained higher in less active men and women from all BMI groups.13 The existing evidence suggests a number of possible biological pathways for the protective effect of physical activity on the development of T2DM. First, it has been suggested that physical activity increases sensitivity to insulin. In a comprehensive report published by Health and Human Services, USA, 2015 reported that physical activity enormously improved abnormal glucose tolerance when caused by insulin resistance primarily than when it was caused by deficient amounts of circulating insulin.14 Second, physical activity is likely to be most beneficial in preventing the progression of T2DM during the initial stages, before insulin therapy is required. The protective mechanism of physical activity appears to have a synergistic effect with insulin. During a single prolonged session of physical activity, contracting skeletal muscle enhances glucose uptake into the cells. This effect increases blood flow in the muscle and enhances glucose transport into the muscle cell.15 Third, physical activity has also been found to reduce intra-abdominal fat, which is a known risk factor for insulin resistance. In certain other studies, physical activity has been inversely associated with intra-abdominal fat distribution and can reduce body fat stores.16 Lifestyle and environmental factors are reported to be the main causes of extreme increase in the incidence of T2DM.17
Here’s another big plus to our Shopping List for Diabetics. In addition to icons that are diabetes-focused like “sugar free,” this list uses icons like “low cholesterol” and “low sodium” because many people with diabetes are working to control not just diabetes but related conditions like high cholesterol levels and high blood pressure.  This list can help you identify those foods most advantageous in helping you reach your personal health goals.
The average American eats 2 servings of produce a day and french fries and ketchup count! These colorful earthly delights provide us with so much nutrition that we would be fools not to figure out a way to enjoy them. Start with just increasing by 1 serving a week and before you know it you will have reached the recommended 9-11 servings a day. The quickest way to get a jump on more vegetables is to fill half your lunch a dinner plate with a cooked or raw vegetable. My favorite is pre-cut, washed and shredded raw cabbage salad with carrots, cherry tomatoes, avocado and little dressing.
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Reduce portions and eat healthier: First, build your meals around vegetables rather than meat, and cut back on your starches. Avoiding added sugar and sugar substitutes, as well as processed grains. Instead, substitute with heart-healthy fats, high protein-whole grains (eg, pasta made from chickpea flour, quinoa, sprouted wheat bread), fruit to add sweetness even to salads or as a snack, and lean meats and dairy products. Seek out new, appetizing recipes; there are many cookbooks that offer lower-fat and healthier recipes.

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.
#8. COFFEE—Several studies have found coffee, whether regular or decaf, reduces risk of type 2 diabetes. Some research has found that those drinking 6 or 7 cups a day have about a 35% lower risk of getting diabetes than those drinking less than 2 cups.10 Drink wisely, Weisenberger says. Unfiltered coffee has compounds that raise your bad (LDL) cholesterol, so use a paper filter with methods such as French press. And don't undo the benefits by adding too much sugar, cream or syrup.

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.


How do sugary drinks lead to this increased risk? Weight gain may explain the link: In both the Nurses’ Health Study II and the Black Women’s Health Study, women who increased their consumption of sugary drinks gained more weight than women who cut back on sugary drinks. (26, 28) Several studies show that children and adults who drink soda or other sugar-sweetened beverages are more likely to gain weight than those who don’t, (28, 30) and that switching from these to water or unsweetened beverages can reduce weight. (31) Even so, however, weight gain caused by sugary drinks may not completely explain the increased diabetes risk.  There is mounting evidence that sugary drinks contribute to chronic inflammation, high triglycerides, decreased “good” (HDL) cholesterol, and increased insulin resistance, all of which are risk factors for diabetes. (32)
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