"Many people with type 2 have had type 2 for a while prior to diagnosis," says Anne Peters, MD, director of the University of Southern California Clinical Diabetes Program and an author of the ADA's position statement on the management of type 2. A person who has had diabetes for five years before being diagnosed may have complications that require good blood glucose control—pronto. It will most likely take medications to achieve a quick improvement. Plus, you can always stop a medication once you've started it if lifestyle changes lead to on-target blood glucose levels—with your health care provider's guidance, of course.
With the start of the New Year, we tend to reflect on the previous year as well as contemplate the year ahead of us. This is a great time to set your intentions and goals for the new year and ACT upon them! Going into the New Year, I did not have a specific goal in mind. However, on New Year’s Day morning, I saw a post from the North Carolina State Parks Instagram account (@ncstateparks) promoting their NC 100… Continue reading »
Foods might sometimes appear to be packaged into individual serving sizes even though they contain two or more servings per package. To determine that, look at "serving size" and "servings per container" at the top of any food label. For example, if a serving size is 1 and there are 2 servings per container, you will need to double all of the nutrient values on the label in order to get a clear picture of the value of the entire container.
Although the genes you inherit may influence the development of type 2 diabetes, they take a back seat to behavioral and lifestyle factors. Data from the Nurses’ Health Study suggest that 90 percent of type 2 diabetes in women can be attributed to five such factors: excess weight, lack of exercise, a less-than-healthy diet, smoking, and abstaining from alcohol. (8)
Your doctor will be able to check your heart health, which is particularly important if you already have blocked arteries or high blood pressure. You also need to take into consideration any other diabetes-related complications—retinopathy or neuropathy, for example. As you begin an exercise program, your doctor can refer you to an exercise physiologist or diabetes educator to help you figure out the best exercise program that allows you to get in shape for your fitness level.
Contrary to popular belief, not all carbs are off-limits if you’re managing diabetes. In fact, the ADA recommends vitamin-rich whole grains in a healthy diabetes diet. These foods contain fiber, which is beneficial for digestive health. Fiber can also promote feelings of fullness, preventing you from reaching for unhealthy snacks, and it can help slow the rise of blood sugar. Plus, whole grains contain healthy vitamins, minerals, and phytochemicals that are healthy for anyone, regardless of whether they have diabetes or not.
The first step is to eliminate all sugar and refined starches from your diet. Sugar has no nutritional value and can therefore be eliminated. Starches are simply long chains of sugars. Highly refined starches such as flour or white rice are quickly broken down by digestion into glucose. This is quickly absorbed into the blood and raises blood sugar. For example, eating white bread increases blood sugars very quickly.
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.
"Many people with type 2 have had type 2 for a while prior to diagnosis," says Anne Peters, MD, director of the University of Southern California Clinical Diabetes Program and an author of the ADA's position statement on the management of type 2. A person who has had diabetes for five years before being diagnosed may have complications that require good blood glucose control—pronto. It will most likely take medications to achieve a quick improvement. Plus, you can always stop a medication once you've started it if lifestyle changes lead to on-target blood glucose levels—with your health care provider's guidance, of course.
Consider signing up for a virtual coach.  Trying to make these changes on your own, at your own pace, and in your own time is very hard. So consider joining a support group like Overeaters Anonymous so you don't have to go it alone. Another way to gain insights and get some help as you attempt to make some changes is to find an app that offers personalized tips and ideas. Having a virtual coach is both convenient has been shown effective in improving diabetes care.
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].
High blood sugar (hyperglycemia). Lots of things can cause your blood sugar to rise, including eating too much, being sick or not taking enough glucose-lowering medication. Watch for signs and symptoms of high blood sugar — frequent urination, increased thirst, dry mouth, blurred vision, fatigue and nausea — and check your blood sugar if necessary.
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.
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.
The "Nutrition Facts" label on most foods is the best way to get carbohydrate information, but not all foods have labels. Your local bookstore and library have books that list the carbohydrate in restaurant foods, fast foods, convenience foods and fresh foods. You will still need to weigh or measure the foods to know the amount of grams of carbohydrates present.
There is convincing evidence that diets rich in whole grains protect against diabetes, whereas diets rich in refined carbohydrates lead to increased risk (53). In the Nurses’ Health Studies I and II, for example, researchers looked at the whole grain consumption of more than 160,000 women whose health and dietary habits were followed for up to 18 years. Women who averaged two to three servings of whole grains a day were 30 percent less likely to have developed type 2 diabetes than those who rarely ate whole grains. (21) When the researchers combined these results with those of several other large studies, they found that eating an extra 2 servings of whole grains a day decreased the risk of type 2 diabetes by 21 percent.
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.
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%.
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.
A terrific rule to follow is to use a luncheon size plate rather than a dinner plate.  This is an easy way to guide your portion sizes without having to think so much about it. Enjoy a glass of red wine or similar drinks only occasionally since your body treats alcohol more like a fat than a carb when it comes to calories. Eat a sound breakfast and try to eat a bigger lunch so the bulk of your calories are consumed by the midafternoon as a way to keep your blood glucose level in a healthy range, and lessen the chance of undesirable weight gain.1

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.
Prediabetes means a person's blood glucose (sugar) level is higher than normal, but not high enough yet to be diagnosed as diabetes. If you have prediabetes, you are at increased risk for developing serious health problems such as type 2 diabetes, stroke and heart disease. The sooner people find out they have prediabetes and take action, the better their chances of preventing type 2 diabetes.
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.
Not necessarily. If you can lose weight, change your diet, increase your activity level, or change your medications you may be able to reduce or stop insulin therapy. Under certain circumstances, you may only need insulin temporarily – such as during pregnancy, acute illness, after surgery or when treated with drugs that increase their body’s resistance to the action of insulin (such as prednisone or steroids). Often the insulin therapy can be stopped after the event or stress is over.
Although most vegetable oils are in some ways healthier than animal fats, you will still want to keep them to a minimum. All fats and oils are highly concentrated in calories. A gram of any fat or oil contains 9 calories, compared with only 4 calories for a gram of carbohydrate. Avoid foods fried in oil, oily toppings, and olives, avocados, and peanut butter. Aim for no more than 2-3 grams of fat per serving of food, e.g., white or wheat bread, most cold cereals, watermelon, pineapple, baking potatoes, sugar.
Keeping close tabs on your diet is a major way to help manage type 2 diabetes. A healthy diet for people with type 2 diabetes includes fresh or frozen fruit and vegetables, whole grains, beans, lean meats, and low-fat or fat-free dairy. Focus on eating fruit and non-starchy vegetables, like broccoli, carrots, and lettuce, and having smaller portions of starchy foods, meats, and dairy products. Be especially careful about loading up on foods that are high on the glycemic index (GI) and especially the glycemic load (GL), systems that rank foods according to how they affect glucose levels.
Commit to 30 – 60 minutes of daily exercise. Although not a diet tip, to control blood sugar individuals need to commit to adding 30 to 60 minutes of daily exercise to their routine. Adding exercise will help with weight loss and improve blood sugar since exercise, even at moderate levels, helps your muscles use glucose which ultimately helps to lower your blood sugar. Exercise such as walking, cycling, swimming, yoga or tennis can all be beneficial. What’s most important is choosing an exercise/activity that you will enjoy and stick to!
Download this Shopping List for Diabetics, created by the doctors and dietitians at the Pritikin Longevity Center in Miami. Since 1975, the renowned Pritikin Center has been helping people with diabetes launch new lifestyles that maximize health and minimize the need for pills and insulin. It's all about keeping blood sugar and A1C at normal levels, naturally.
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]
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