There is much you can do with lifestyle alone to prevent diabetes. In a landmark study, the NIH-sponsored Diabetes Prevention Program, scientists tracked 3,234 pre-diabetic men and women for three years. A third of them adopted lifestyle changes. Another third took a drug – metformin (Glucophage®). The remaining third, the control group, took a placebo. Those on the lifestyle-change plan reduced the progression to full-blown Type 2 diabetes by 58% compared to the control group. The reduction was even greater – 71% – among adults aged 60 and older. Treatment with the drug metformin reduced the progression of Type 2 diabetes by just 31%.

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.


Among 85,000 married female nurses, 3,300 developed type 2 diabetes over a 16-year period. Women in the low-risk group were 90 percent less likely to have developed diabetes than the rest of the women. Low-risk meant a healthy weight (body mass index less than 25), a healthy diet, 30 minutes or more of exercise daily, no smoking, and having about three alcoholic drinks per week.

Bacterial infections under the skin of the genitals and areas around them. Rare but serious infections that cause severe tissue damage under the skin of the genitals and areas around them have happened with FARXIGA. This infection has happened in women and men and may lead to hospitalization, surgeries and death. Seek medical attention immediately if you have fever or you are feeling very weak, tired or uncomfortable and you also develop any pain or tenderness, swelling, or redness of the skin in the genitals and areas around them


To help you avoid or limit fast food, Chong recommends planning ahead by packing healthy meals or snacks. Diabetes-friendly snack ideas include a piece of fruit, a handful of nuts, and yogurt. Also, if you absolutely must stop at a fast-food restaurant, steer clear of anything that’s deep-fried — such as french fries, chicken nuggets, and breaded fish or chicken, Chong says.
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

The best way to avoid these foods is to shop around the edges of the grocery store and minimize the number of processed, packaged foods in the middle. Sticking with "real" food in its whole, minimally processed form is the best way to eat well for diabetes. People with type 2 diabetes who eat a healthy diet pattern like the ones discussed here reduce the risk of complications that stem from high blood sugar, like cardiovascular disease and obesity.
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 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].
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.
Ethnic background: For example, the actual prevalence of diabetes in the Caucasian population of the US is about 7.1% while in the African American population; it increases to about 12.6%. Approximately 8.4% of Asian Americans and 11.6% of Hispanic Americans are affected. In a well-studied group of Native Americans, the Pima Indians, the prevalence increases to almost 35%.
If your mood, sleep, blood sugar, and energy are being affected, limiting intake may be advised. The most important thing when choosing coffee for people with diabetes or those managing their weight is to pay attention to the carbohydrate content from milk and added sweeteners. Cutting back or eliminating artificial sweeteners is advised as these have shown to disrupt gut bacteria, cause cravings and overeating, and negatively impact weight and blood sugar management.
Since type 2 diabetes is merely excessive glucose in the body, burning it off will reverse the disease. While it may sound severe, fasting has been practiced for at least 2000 years. It is the oldest dietary therapy known. Literally millions of people throughout human history have fasted without problems. If you are taking prescription medications, you should seek the advice of a physician. But the bottom line comes to this.
Choose fresh or frozen vegetables without added sauces, fats, or salt. Non-starchy vegetables include dark green and deep yellow vegetables, such as cucumber, spinach, broccoli, romaine lettuce, cabbage, chard, and bell peppers. Starchy vegetables include corn, green peas, lima beans, carrots, yams and taro. Note that potato should be considered a pure starch, like white bread or white rice, instead of a vegetable.

You also might hear about alternative treatments for diabetes, such as herbal remedies and vitamin or mineral supplements. These practices can be risky, especially when people stop following the treatment plan their doctor has given them. So get the facts by talking to your diabetes health care team. They keep track of the latest research developments, and will introduce new products as they become available.

Type-2 diabetes is a major, non-communicable disease with increasing prevalence at a global level. Type-2 diabetes results when the body does not make enough insulin or the body cannot use the insulin it produces. Type-2 diabetes is the leading cause of premature deaths. Improperly managed, it can lead to a number of health issues, including heart diseases, stroke, kidney disease, blindness, nerve damage, leg and foot amputations, and death. Type-2 diabetes or adult-onset diabetes is most common type of diabetes, usually begins when a person is in his or her mid-50s, but diabetes is not inevitable. Minor changes in your lifestyle can greatly reduce your chances of getting this disease. Therefore, in order to prevent this condition, action should be taken regarding the modifiable factors that influence its development-lifestyle and dietary habits. However, with proper testing, treatment and lifestyle changes, healthy eating as a strategy, promote walking, exercise, and other physical activities have beneficial effects on human health and prevention or treatment of diabetes, promoting adherence to this pattern is of considerable public health importance.
A vegetarian or vegan diet can be a good choice for people with diabetes. Vegetarian and vegan diets are typically high in carbohydrates - about 13% higher than a diet with that includes both plant and animal products (omnivorous) – which we generally think is bad for diabetes. However, a vegetarian or vegan diet is typically higher in fiber and lower in calories and saturated fat, so the inflammatory risks associated with high meat consumption are avoided. Research studies that have tested vegetarian and vegan diets for people with diabetes; have found them to be beneficial at reducing blood sugar.12
There are a few methods that can be used for diabetic meal planning. It is good to research more than one, but also important to remember that diabetic diet needs are going to vary based on your sex, age, activity level, medications, height, and weight. If you have not yet met with a registered dietitian, seek one out who can help you develop an individualized meal plan that will meet all of your specific needs.

The Centers for Disease Control and Prevention (CDC) also recommends the hepatitis B vaccination if you haven't previously received this vaccine and you're an adult between ages 19 and 59 with type 1 or type 2 diabetes. The CDC advises vaccination as soon as possible after diagnosis with type 1 or type 2 diabetes. If you are age 60 or older, have diabetes and haven't previously received the vaccine, talk to your doctor about whether it's right for you.
Interventional studies showed that high carbohydrate and high monounsaturated fat diets improve insulin sensitivity, whereas glucose disposal dietary measures comprise the first line intervention for control of dyslipidemia in diabetic patients.78 Several dietary interventional studies recommended nutrition therapy and lifestyle changes as the initial treatment for dyslipidemia.79,80 Metabolic control can be considered as the cornerstone in diabetes management and its complications. Acquiring HbA1c target minimizes the risk for developing microvascular complications and may also protect CVD, particularly in newly diagnosed patients.81 Carbohydrate intake has a direct effect on postprandial glucose levels in people with diabetes and is the principal macronutrient of worry in glycemic management.82 In addition, an individual’s food choices and energy balance have an effect on body weight, blood pressure, and lipid levels directly. Through the mutual efforts, health-care professionals can help their patients in achieving health goals by individualizing their nutrition interventions and continuing the support for changes.83-85 A study suggested that intake of virgin olive oil diet in the Mediterranean area has a beneficial effect on the reduction of progression of T2DM retinopathy.86 Dietary habits are essential elements of individual cardiovascular and metabolic risk.87 Numerous health benefits have been observed to the Mediterranean diet over the last decades, which contains abundant intake of fruit and vegetables. The beneficial effects of using fish and olive oil have been reported to be associated with improved glucose metabolism and decreased risk of T2DM, obesity and CVD.88
Eat Slower: Once we start eating, it takes about 15 to 20 minutes for our bodies to realize we are full. Eating too fast can lead to overeating, which can lead to a spike in blood sugar and/or weight gain…which can lead to greater insulin resistance. Consciously aim to eat slowly – give yourself at least 15 minutes – especially if you start a meal very hungry. If you are a fast eater or do not have a lot of time, eat 50% to 75% of your planned portion and then wait 10 to 15 minutes (call a friend, work a little, take a walk, anything). If you are still hungry, then eat half of what’s left. Repeat until you are satisfied, not stuffed. Pay attention to how much food it actually takes to make you full so if you are in a pinch, you can make sure your eyes don’t become bigger than your stomach.
The DPP study showed a similar result. In this study, there was also a group taking metformin (Glucophage) as a preventative measure. At the end of the study, the lifestyle group actually did better at prevention of diabetes than those taking metformin. In fact, the study was stopped early, because the benefit of weight loss (the weight loss group lost about 15 pounds on average and kept it off) was so dramatic.
Even if you have not been told that you have prediabetes, you could be worried about it, since 90% of the people with prediabetes are unaware that they have it. You are at higher risk if you are over 45 years old, do not get much exercise, have a family history of diabetes, or are African American, Native American, Hispanic/Latino, or Pacific Islander.

are allergic to dapagliflozin or any of the ingredients in FARXIGA. Symptoms of a serious allergic reaction may include skin rash, raised red patches on your skin (hives), swelling of the face, lips, tongue, and throat that may cause difficulty in breathing or swallowing. If you have any of these symptoms, stop taking FARXIGA and contact your healthcare provider or go to the nearest hospital emergency room right away


Hyperglycemia or high blood sugar is a serious health problem for diabetics. There are two types of hyperglycemia, 1) fasting, and 2)postprandial or after meal hyperglycemia. Hyperglycemia can also lead to ketoacidosis or hyperglycemic hyperosmolar nonketotic syndrome (HHNS). There are a variety of causes of hyperglycemia in people with diabetes. Symptoms of high blood sugar may include increased thirst, headaches, blurred vision, and frequent urination.Treatment can be achieved through lifestyle changes or medications changes. Carefully monitoring blood glucose levels is key to prevention.
#6. VINEGAR—Sprinkled on your salad, roasted vegetables, and other foods, vinegar may improve your blood sugar and insulin when you're planning to eat a high-carb meal. In a small study, researchers gave those who had unhealthy insulin sensitivity a drink of apple cider vinegar and water before a high-carb meal and found it helped increase their insulin sensitivity and normalize blood sugar levels. 8
Recently, evidence suggested a link between the intake of soft drinks with obesity and diabetes, resulting from large amounts of high fructose corn syrup used in the manufacturing of soft drinks, which raises blood glucose levels and BMI to the dangerous levels.38 It was also stated by Assy39 that diet soft drinks contain glycated chemicals that markedly augment insulin resistance. Food intake has been strongly linked with obesity, not only related to the volume of food but also in terms of the composition and quality of diet.40 High intake of red meat, sweets and fried foods, contribute to the increased the risk of insulin resistance and T2DM.41 In contrast, an inverse correlation was observed between intake of vegetables and T2DM. Consumption of fruits and vegetables may protect the development of T2DM, as they are rich in nutrients, fiber and antioxidants which are considered as protective barrier against the diseases.42 Recently, in Japanese women, a report revealed that elevated intake of white rice was associated with an increased risk of T2DM.43 This demands an urgent need for changing lifestyle among general population and further increase the awareness of healthy diet patterns in all groups.
The data on dairy products seems to vary. In a study of over 289,000 health professionals, Harvard researchers showed that consumption of yogurt, in contrast to other dairy products, was associated with a reduced risk for diabetes. In a pooled analysis of 17 studies about dairy products and diabetes risk, those who consumed more dairy products had a lower risk than those who consumed few dairy products, A Swedish study found that high-fat dairy products, but not low-fat dairy products, lowered the risk for type 2 diabetes.
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You can find an in-person DPP program to attend, or see whether you are eligible for a digital program. Lark Health Coach, for example, is a CDC DPP program that delivers the program via your smartphone, on your time. Lark also helps with tracking weight, food, and exercise, and customizes the program according to preferences such as low-carb, gluten-free, or vegan.

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


Imagine our bodies to be a sugar bowl. A bowl of sugar. When we are young, our sugar bowl is empty. Over decades, we eat too much of the wrong things – sugary cereals, desserts and white bread. The sugar bowl gradually fills up with sugar until completely full. The next time you eat, sugar comes into the body, but the bowl is full, so it spills out into the blood.


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.
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!
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.

Along with healthy eating, you can help keep your blood sugar in target range by maintaining a healthy weight. People with type 2 diabetes are often overweight or obese. Losing even 10 pounds (4.5 kilograms) can help you manage your diabetes better. Eating healthy foods and staying active (for example, 60 total minutes of walking or other activity per day) can help you meet and maintain your weight loss goal.
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.
Talk to your friends and family beforehand about your reasons for eating healthy. Tell them it's important to your long-term health that you stay on your healthy eating plan and ask them not to encourage you to eat things that aren't good for you. Friends and family are often just trying to demonstrate their love by wanting you to enjoy a dessert, however mistaken that is. Help them understand they can best help you by not making it more difficult to stay on track and by supporting you in your efforts to take good care of yourself.

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.


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.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Type 2 diabetes is often treated with oral medication because many people with this type of diabetes make some insulin on their own. The pills people take to control type 2 diabetes do not contain insulin. Instead, medications such as metformin, sulfonylureas, alpha-glucosidase inhibitors and many others are used to make the insulin that the body still produces more effective.
Diabetes mellitus is a metabolic condition in which a person's blood sugar (glucose) levels are too high. Over 29.1 million children and adults in the US have diabetes. Of that, 8.1 million people have diabetes and don't even know it. Type 1 diabetes (insulin-dependent, juvenile) is caused by a problem with insulin production by the pancreas. Type 2 diabetes (non-insulin dependent) is caused by:

The first thing to understand when it comes to treating diabetes is your blood glucose level, which is just what it sounds like — the amount of glucose in the blood. Glucose is a sugar that comes from the foods we eat and also is formed and stored inside the body. It's the main source of energy for the cells of the body, and is carried to them through the blood. Glucose gets into the cells with the help of the hormone insulin.
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.
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