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.

At Stanford Medical Center in California, while working as a clinical dietitian, I teamed up with a clinical research dietitian who specialized in diabetes.Our goal was to help women reach a weight recommended for their actual height. What resulted was a book Help! My Underwear is Shrinking: One woman’s story of how to eat right, lose weight, and win the battle against diabetes.The book tells the story of one woman as she struggles with her daily routine and responsibilities while trying to follow the plan and lose weight. The character provides humorous insight and methods she used for achieving her goal.


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
There’s been some controversy over whether artificially sweetened beverages are beneficial for weight control and, by extension, diabetes prevention. (35) Some studies have found that people who regularly drink diet beverages have a higher risk of diabetes than people who rarely drink such beverages, (36, 37) but there could be another explanation for those findings: People often start drinking diet beverages because they have a weight problem or have a family history of diabetes; studies that don’t adequately account for these other factors may make it wrongly appear as though the diet soda led to the increased diabetes risk. A recent long-term analysis on data from 40,000 men in the Health Professionals Follow-Up Study finds that drinking one 12-ounce serving of diet soda a day does not appear to increase diabetes risk. (38) So in moderation, diet beverages can be a good sugary-drink alternative.
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).

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.


Find safe ways to exercise at home. If you have trouble leaving the house because of your health or lack of transportation, you can still find safe ways to stay active from home. Find workout videos online, or make even ordinary household chores a little more fun by turning on some music. If it’s safe for you to do so, you might try doing strengthening exercises from home.

Eat healthy foods. Plan meals that limit (not eliminate) foods that contain carbohydrates, which raise your blood sugar. Carbohydrates include starches, fruits, milk, yogurt, starchy vegetables (corn, peas, potatoes) and sweets. “Substitute more non-starchy vegetables into your meals to stay satisfied for fewer carbohydrates and calories,” Compston says.
Low-carbohydrate diets have gotten a lot of attention recently as strategies for reversing prediabetes. The carbohydrates in your diet that provide calories include sugars and starches. Starches are in grains and flour, beans, and starchy vegetables. Added sugars include sugars in sweets, sweetened foods such as flavored oatmeal and ketchup, and sugar-sweetened beverages such as soda. There are also natural sugars, which are found in nutritious foods such as dairy products and fruit.
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.
Diabetic’s dietary practices are mainly influenced by cultural backgrounds. Concerning each of the dimensions of dietary practices, there were significant positive relationships between knowledge regarding diabetic diet and dietary practices. Knowledge was a salient factor related to dietary behaviors control.46 Moreover, patients’ knowledge on a recommended diet indicates their understanding of dietary guidelines which influenced their food selection and eating patterns.47 The association between dietary knowledge and dietary practices among T2DM patients in the previous studies were inconsistent. Another study revealed that there was no relationship between dietary knowledge and compliance of dietary practices.58 On the other hand, the same study found that a high dietary knowledge score was associated with following dietary recommendations and knowledgeable patients performed self-management activities in a better way. Dietary knowledge significantly influences dietary practices. In Indonesia, a study was conducted to measure dietary practices among diabetic patients, which elaborated that the Indonesian people, preferred to consume high-fat foods which lead to an increased risk of CVD.59 The trend of skipping breakfast has dramatically increased over the past 10 years in children, adolescents, and adults.60,61 There is increasing evidence that skipping breakfast is related with overweight and other health issues.62 In addition, frequent eating or snacking may also increase the body weight and risk of metabolic diseases.63,64 Rimm65 demarcated western and prudent dietary patterns. The prudent dietary pattern was characterized by increased consumption of fish, poultry, various vegetables and fruits whereas; the western dietary pattern was characterized by an increased consumption of processed and red meat, chips, dairy products, refined grains, and sweets and desserts. These patterns were previously associated with T2DM risk. The glycemic index is an indicator of the postprandial blood glucose response to food per gram of carbohydrate compared with a reference food such as white bread or glucose. Hence, the glycemic load represents both the quality and quantity of the carbohydrates consumed.66-69 Another study conducted in Lebanon demonstrated direct correlation of the refined grains and desserts and fast food patterns with T2DM, however, in the same study an inverse correlation was observed between the traditional food pattern and T2DM among Lebanese adults.70
Although kids and teens might be able to prevent or delay the onset of type 2 diabetes by managing their weight and increasing physical activity, other risk factors for type 2 diabetes can't be changed. Kids with one or more family members with type 2 diabetes have an increased risk for the disease, and some ethnic and racial groups are more likely to developing it.
The problems behind the numbers are even more alarming. Diabetes is the leading cause of blindness and kidney failure among adults. It causes mild to severe nerve damage that, coupled with diabetes-related circulation problems, often leads to the loss of a leg or foot. Diabetes significantly increases the risk of heart disease. And it’s the seventh leading cause of death in the U.S., directly causing almost 70,000 deaths each year and contributing to thousands more. (4)

Getting to—and staying at—a healthy weight: Being overweight (BMI greater than 25 kg/m2) increases your risk of developing type 2 diabetes, so if you’re overweight, you should take steps to lose weight. By losing 5% to 10% of your body weight, you can reduce your risk. You can do this by eating smaller portions and being more physically active, which, conveniently enough, are two other ways to prevent type 2 diabetes.


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.
Over a period of years, you went from pre-diabetes, to diabetes, to taking one medication, then two then three and then finally large doses of insulin. Here’s the thing. If you are taking more and more medications to keep your blood sugars at the same level, your diabetes is getting worse! Even if your blood sugars get better, your diabetes is getting worse. This is unfortunately what happens to virtually every patient. The body is already overflowing with sugar.
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.
When adjusted for family history, the benefits of exercise can be evaluated based on previous studies. Of note, for every 500 kcal burned weekly through exercise, there is a 6% decrease in relative risk for the development of diabetes. This data is from a study done in men who were followed over a period of 10 years. The study also notes a greater benefit in men who were heavier at baseline. There have been similar reports on the effects of exercise in women.
​The best way to maintain healthy blood sugar levels is to eliminate high carbohydrate foods, eat only low glycemic foods, monitor your levels daily and work with a qualified healthcare practitioner. Losing weight and maintaining the weight loss are important and will prevent many other risk factors caused by obesity. I have a very so specific plan that addresses blood sugar issues and promotes a healthy lifestyle. When you live with diabetes, it does not have to be a life sentence, it can be reversed and it can be monitored wisely. I offer a FREE 15 minute consultation to anyone who is interested in learning more
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.

One of the key factors in Joslin’s treatment of diabetes is tight blood glucose control, so be certain that your treatment helps get your blood glucose readings as close to normal as safely possible. Patients should discuss with their doctors what their target blood glucose range is. It is also important to determine what your goal is for A1C readings (a test that determines how well your diabetes is controlled over the past 2-3 months). By maintaining blood glucose in the desired range, you’ll likely avoid many of the complications some people with diabetes face.

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.


The more intense the exercise, the better. According to the British diabetes association diabetes.co.uk, high-intensity interval training (HIIT) may be better for weight loss and glucose control than continuous aerobic activity like jogging. HIIT involves alternating between short bursts of increased intensity exercise and rest — for instance, running and then walking on and off throughout the workout.
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.
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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.

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.”

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