More than half of the dialysis patients I see are type 2 diabetic – a few are type 1 (maybe 5 in a hundred) – it’s scary because when I see overweight people I think to myself if they don’t die first of heart disease they will be on dialysis. My advice now is to get our children outside playing and exercising – and watching their diets. Often fat kids grow up to be fat adults – AMEN – Peggy Harum RD, LD renal dietitian for more than 40 years

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.
#1. LEGUMES—Diets rich in legumes—soybeans, black beans, kidney beans, lentils, pinto beans—are good for your blood sugar levels both short-term and long-term. The secret? "Resistant starches," which resist digestion in the small intestine and go straight to the colon, feeding the bacteria in your gut and in the process improve your body's response to insulin.  (These resistant starches are also in green bananas, uncooked oats, and potatoes that have been cooked and cooled. Rejoice, potato salad lovers who can control their portions.)
Protein foods include meat, poultry, seafood, eggs, beans and peas, nuts, seeds, and processed soy foods. Eat fish and poultry more often. Remove the skin from chicken and turkey. Select lean cuts of beef, veal, pork, or wild game. Trim all visible fat from meat. Bake, roast, broil, grill, or boil instead of frying. When frying proteins, use healthy oils such as olive oil.
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.
If you have prediabetes, losing a small amount of weight if you’re overweight and getting regular physical activity can lower your risk for developing type 2 diabetes. A small amount of weight loss means around 5% to 7% of your body weight, just 10 to 14 pounds for a 200-pound person. Regular physical activity means getting at least 150 minutes a week of brisk walking or a similar activity. That’s just 30 minutes a day, five days a week.
If you choose to drink alcohol, remember: To drink with your meal or snack (not on an empty stomach!), to drink slowly or dilute with water or diet soda, that liqueurs, sweet wines and dessert wines have a lot of sugar, to wear your Medic Alert (Alcohol can cause hypoglycemia/low blood glucose), reducing alcohol can promote weight loss and help you lower your blood pressure.
The evidence is growing stronger that eating red meat (beef, pork, lamb) and processed red meat (bacon, hot dogs, deli meats) increases the risk of diabetes, even among people who consume only small amounts. The latest support comes from a “meta analysis,” or statistical summary, that combined findings from the long-running Nurses’ Health Study I and II and the Health Professionals Follow-Up Study with those of six other long-term studies. The researchers looked at data from roughly 440,000 people, about 28,000 of whom developed diabetes during the course of the study. (43) They found that eating just one daily 3-ounce serving of red meat—say, a steak that’s about the size of a deck of cards—increased the risk of type 2 diabetes by 20 percent. Eating even smaller amounts of processed red meat each day—just two slices of bacon, one hot dog, or the like—increased diabetes risk by 51 percent.

According to the study conducted by Bani25 in Saudi Arabia, majority of the patients 97.3% males and 93.1% females were unaware about the importance of monitoring diabetes, with no significant gender difference. Diabetes knowledge, attitude, and practice were also studied in Qatari type 2 diabetics. The patients’ knowledge regarding diabetes was very poor, and their knowledge regarding the effect of diabetes on feet was also not appreciable.26 Results from a study conducted in Najran, Saudi Arabia27 reported that almost half of the patients did not have adequate knowledge regarding diabetes disease. Males in this study had more knowledge regarding diabetes than female patients. Diabetes knowledge among self-reported diabetic female teachers was studied in Al-Khobar, Saudi Arabia.28 The study concluded that diabetes knowledge among diabetic female teachers was very poor. It was further suggested that awareness and education about diabetes should be urgently given to sample patients. The knowledge of diabetes provides the information about eating attitude, workout, weight monitoring, blood glucose levels, and use of medication, eye care, foot care, and control of diabetes complications.29


Diet becomes a critical issue when dealing with disease processes. When exploring dietary factors as a contributor to disease processes, one must take a number of things into account, for example, is it the specific food itself or the weight gain associated with its consumption that causes the risk? Is it the food, or the age/lifestyle of those consuming it that causes the risk? While cinnamon, coffee, and fenugreek seeds are among the many food products that some feel are associated with development/prevention of diabetes, none of these claims have truly been fully scientifically evaluated.
After the birth of her oldest son, Crawford went on Weight Watchers. Eight months later, she had dropped 40 pounds, had an A1C of 5.2, and was able to stop diabetes and blood pressure medications. Her workouts started with daily walks and progressed to cardio and strength training three to four times a week. "I was able to do things I couldn't do before," she says. "I can do push-ups. I can do sit-ups."
Controlling Type II Diabetes by diet is an absolute must. Eating low glycemic foods and staying away from highly processed foods that contain hidden toxins as well as hidden sugars is important. You cannot always trust food labels so I suggest eating as many foods that DO NOT have labels – fresh vegetables, lean proteins and nutrient rich complex carbohydrates. Some examples include, spinach, kale, asparagus, broccoli, brussel sprouts, sweet potatoes, quinoa, brown rice or bean pastas – and of course lots of lean proteins from chicken, turkey and fish. Eliminate high sugar vegetables such as peas, carrots and corn and stay away from white foods such as white flour, bread, pastries, cakes, dairy and milk products (eggs are ok).
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.
Veggies, first: Research suggests that eating vegetables and lean proteins before carbohydrates may result in a lower rise in blood sugar levels over the next few hours (as compared to eating the same foods in the opposite order). While more research is needed on this topic, it’s possible that eating protein and veggies first is delaying how fast the carbohydrates get absorbed.

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.


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
The review of various studies suggests that T2DM patients require reinforcement of DM education including dietary management through stakeholders (health-care providers, health facilities, etc.) to encourage them to understand the disease management better, for more appropriate self-care and better quality of life. The overall purpose of treating T2DM is to help the patients from developing early end-organ complications which can be achieved through proper dietary management. The success of dietary management requires that the health professionals should have an orientation about the cultural beliefs, thoughts, family, and communal networks of the patients. As diabetes is a disease which continues for the lifetime, proper therapy methods with special emphasis on diet should be given by the healthcare providers in a way to control the disease, reduce the symptoms, and prevent the appearance of the complications. The patients should also have good knowledge about the disease and diet, for this purpose, the health-care providers must inform the patients to make changes in their nutritional habits and food preparations. Active and effective dietary education may prevent the onset of diabetes and its complications.

The breakfast should be 1/3 fruit, 1/3 starchy fiber foods (multigrain bread and cereal products), and 1/3 protein (nuts, eggs, tofu, beans, lentils, low-fat dairy products). The lunch and dinner plates should be 1/2 vegetables, 1/4 starchy fiber foods, and 1/4 protein. Choose whole grains, such as whole wheat pasta, whole wheat bread, and brown rice to increase fiber intake. Most of these are low in fat. Choose only lean meat and poultry.[81,82,83,84] Remove skin and trim fat before cooking (50-100 g or 2-4 oz). See the milk fat (MF) of all dairy products. Use skim or 1% milk products and low-fat cheese (less than 20% MF), or choose fortified soy products. Reduce your total fat intake (less than 25% - 35% of your daily calories). To achieve this, always try to choose low fat foods and avoid fried foods. Limit saturated and trans fats to less than 10% of your daily calories. Try to always choose unsaturated fats such as olive and canola oils and non-hydrogenated margarine (in moderation). Saturated and trans fats raise blood cholesterol levels, while unsaturated fats lower blood cholesterol. Saturated fats are solid at room temperature and are usually of animal origin. They are found in meats, whole milk, dairy products, butter, and hard margarines.[85,86,87,88,89,90] Trans fats are found in baked and pre-packaged foods. Hydrogenation is a process that changes liquid vegetable oil into a solid fat such as hard margarine. The hydrogenation process changes some of the good fats into cholesterol-raising saturated and trans fats. People with diabetes are at a greater risk of developing or have already high levels of fats in their heart and blood vessels. Omega-3 fatty acids are found in cold water fish such as herring, mackerel, salmon, trout, sardines and tuna, and in flaxseeds (2 tbsp per day, freshly ground).[90,91,92,93] Three to four servings of fish per week is recommended as part of a healthy, balanced diet. Omega-enriched foods are also available in supermarkets such as omega-3 eggs and omega-3 enriched dairy products. Omega-3 supplements: Always look for the active ingredients DHA and EPA. Recommendations are 600-900 mg/day. Always check with your doctor or registered dietitian before taking any supplements. Increase fiber in your diet by eating more whole grain foods, vegetables, fruits, and legumes.[94,95,96] These foods also contain vitamins, minerals, and antioxidants and have a lower glycemic index. Low glycemic index foods will help to keep your blood sugar levels in the target range.[97,98,99]
The Centers for Disease Control and Prevention (CDC) and the American Medical Association (AMA) are sounding an alarm about prediabetes because a national effort—by everyone from physicians to employers to patients to community organizations—is required to prevent type 2 diabetes in the United States. In addition to focusing on the person with prediabetes or diabetes, we also must engage the systems and communities where people live, work and play. We can all Act – Today.
Metformin’s effectiveness didn’t change significantly in older adults compared with younger adults (hazard ratio [HR] for developing diabetes at age 60-85 years vs 25-44 years=1.45; 95% CI, 0.98-2.16; P=.06). In contrast, lifestyle modification worked better in older adults than younger adults (HR at age 60-85 years vs 25-44 years=0.47; 95% CI, 0.28- 0.78;P<.01).
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.
Often, people with type 2 diabetes start using insulin with one long-acting shot at night, such as insulin glargine (Lantus) or insulin detemir (Levemir). Discuss the pros and cons of different drugs with your doctor. Together you can decide which medication is best for you after considering many factors, including costs and other aspects of your health.
Trigylcerides are fatty molecules that travel in the bloodstream. Excess sugar and fat can increase triglyceride levels. Triglycerides are also manufactured in the liver. The body uses triglycerides for energy, but excess triglycerides are a risk factor for heart attack, stroke, and obesity. Many lifestyle factors can influence triglyceride levels.
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.

Ketoacidosis occurred in people with type 1 and type 2 diabetes during treatment with FARXIGA. Ketoacidosis is a serious condition which may require hospitalization and may lead to death. Symptoms may include nausea, tiredness, vomiting, trouble breathing, and abdominal pain. If you get any of these symptoms, stop taking FARXIGA and call your healthcare provider right away. If possible, check for ketones in your urine or blood, even if your blood sugar is less than 250 mg/dL
Sometimes life happens and we don’t always have time to prepare breakfast in the morning, pack a nutritious lunch, have healthy snacks readily available,and cook a balanced meal for dinner. If you find yourself unexpectedly stopping at a restaurant for a quick meal, a celebration dinner or to take a break from cooking, go in with motivation to make healthy choices. Try these meal modifications to stay within your daily calorie intake and still feel satisfied. Appetizers Choose an item… Continue reading »
American Diabetes Association has defined self-dietary management as the key step in providing the diabetics, the knowledge and skill in relation with treatment, nutritional aspects, medications and complications. A study showed that the dietary knowledge of the targeted group who were at high risk of developing T2DM was poor. Red meat and fried food were consumed more by males as compared to females. The percent of males to females in daily rice consumption was significantly high.44
Smoking 16 to 20 cigarettes a day or more can increase a person's risk of developing diabetes to more than three times that of nonsmokers. The exact reason for this isn't well understood. It may be that smoking directly decreases the body's ability to utilize insulin. Moreover, it has been observed that after smoking, blood sugar levels increase. Finally, there is also an association between smoking and body fat distribution, smoking tends to encourage the "apple" shape, which is a risk factor for diabetes.

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.
A healthy diet for prediabetes does not necessarily need to be low in carbohydrates. According to U.S. News and World Report rankings, the two types of diet for prediabetes and high cholesterol in 2018 are moderate diet patterns. A Mediterranean diet pattern is ranked first, followed closely by the Dietary Approaches to Stop Hypertension, or DASH, diet.

My specific tip for controlling diabetes with diet is to maintain a healthy lifestyle which includes fresh, mostly unprocessed foods from all food groups. Maintain a reasonable weight which may mean weight loss and stay active. The key here is: MAINTAIN any change you have accomplished. In my opinion and that of at least one of my clients you accomplish maintenance by being good to yourself and liking your lifestyle. Here is a quote from a client who has done well and I asked her for ‘tips’ to share. We can all find inspiration in her reply: “The biggest thing to change is your attitude. Be kind to yourself.
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.
Phelps also made significant changes to his exercise routine, which went from 1/3-mile walks around his neighborhood (it took him 40 minutes and three rest stops the first time) to walking a half marathon a little under a year later. As he lost weight and became fitter, Phelps got addicted to triathlons. At 64, he's now set his sights on Ironman races, which he hopes to compete in next year.
Checking your blood glucose levels several times a day helps you understand how your body responds to medications, exercise, and the foods you eat. When first starting out, keeping your glucose within a tight margin can often feel like hitting a moving target. It can suddenly spike with no reason or plummet the next day despite total adherence to your treatment.

Encourage lots of physical activity. Staying active and limiting the time spent in sedentary activities — like watching TV, being online, or playing video or computer games — can help reduce the risk of weight gain and help prevent the onset of type 2 diabetes. Being active can be as simple as walking the dog or mowing the lawn. Try to do something that gets you and your kids moving every day.
5. Cut back on refined carbs and sugary drinks. White bread, white rice, white pasta and potatoes cause quick increases in blood sugar, as do sugary soft drinks, fruit punch, and fruit juice. Over time, eating lots of these refined carbohydrates and sugar may increase your risk of type 2 diabetes.  To lower your risk, switch to whole grains and skip the sugar — especially the sugary drinks.

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.


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.
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
​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
Acarbose (Precose), a drug designed to reduce small intestinal absorption of carbohydrates has been used with some success as well and is licensed for diabetes prevention in some countries. The STOP NIDDM trial showed that in about 1400 patients with impaired glucose tolerance, acarbose significantly reduced progression to diabetes compared to placebo. However, the occurrence of gastrointestinal side effects have limited the use of this drug for some people.
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.
While some people attempt to manage their type 2 diabetes with diet and exercise alone, this may not work for everyone. In fact, though the Centers for Disease Control and Prevention estimates 16 percent of people with diabetes don't take medication, the majority of people with diabetes require insulin or oral meds at some point, often at diagnosis.

Eat smaller portions of foods and remember that your lunch and dinner plate should be 1/4 protein, 1/4 starch (including potatoes), and 1/2 vegetables. Eat 3 balanced meals per day (no more than 6 hours apart), and don't skip meals; snack with fruit between meals. Choose foods lower in fat and sugar; choose low GI index foods whenever possible; avoid “white” foods (white flour and white sugar).
Yeast infection of skin around the penis (balanitis) in men who take FARXIGA. Talk to your healthcare provider if you experience redness, itching, or swelling of the penis; rash of the penis; foul smelling discharge from the penis; or pain in the skin around penis. Certain uncircumcised men may have swelling of the penis that makes it difficult to pull back the skin around the tip of the penis
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