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).
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

Carry a Rescue Snack: Going too long without eating can lead to dips in blood sugar, sometimes called “lows”, which create unpleasant symptoms, including ravenous hunger. This often leads to poor food choices, since we’re more focused on eating anything in sight, even if it’s not healthy. Rather than getting to this point, keep a healthy snack with you throughout the day in case you get stuck somewhere you didn’t plan at a mealtime. A balanced snack will combine a nutritious carb or veggie + source of protein or healthy fat.The chart below provides portable options you can mix and match to your tastes: 

"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.
The types of fats in your diet can also affect the development of diabetes. Good fats, such as the polyunsaturated fats found in liquid vegetable oils, nuts, and seeds can help ward off type 2 diabetes. (39) Trans fats do just the opposite. (8, 40) These bad fats are found in many margarines, packaged baked goods, fried foods in most fast-food restaurants, and any product that lists “partially hydrogenated vegetable oil” on the label. Eating polyunsaturated fats from fish—also known as “long chain omega 3” or “marine omega 3” fats—does not protect against diabetes, even though there is much evidence that these marine omega 3 fats help prevent heart disease. (41) If you already have diabetes, eating fish can help protect you against a heart attack or dying from heart disease. (42)
Long bouts of hot, sweaty exercise aren’t necessary to reap this benefit. Findings from the Nurses’ Health Study and Health Professionals Follow-up Study suggest that walking briskly for a half hour every day reduces the risk of developing type 2 diabetes by 30 percent. (18, 19) More recently, The Black Women’s Health Study reported similar diabetes-prevention benefits for brisk walking of more than 5 hours per week. (20) This amount of exercise has a variety of other benefits as well. And even greater cardiovascular and other advantages can be attained by more, and more intense, exercise.
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%.
One serving in a category is called a "choice." A food choice has about the same amount of carbohydrates, protein, fat and calories — and the same effect on your blood glucose — as a serving of every other food in that same category. So, for example, you could choose to eat half of a large ear of corn or 1/3 cup of cooked pasta for one starch choice.

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.
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).
Eventually, even though the pancreas is working at its best to produce more and more insulin, the body tissues (for example, muscle and fat cells) do not respond and become insensitive to the insulin. At this point, overt diabetes occurs as the body is no longer able to effectively use its insulin to maintain normal blood sugar levels. Over time, these high levels of sugar result in the complications we see all too often in patients with diabetes.
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.
Dehydration (the loss of body water and salt), which may cause you to feel dizzy, faint, lightheaded, or weak, especially when you stand up (orthostatic hypotension). You may be at a higher risk of dehydration if you have low blood pressure; take medicines to lower your blood pressure, including water pills (diuretics); are 65 years of age or older; are on a low salt diet, or have kidney problems

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.
Diabetes is a disease that is increasingly making its way into the public consciousness, and not in a good way. In fact, according to this article from USA Today, diabetes has a greater health impact on Americans than heart disease, substance use disorder or COPD, with 30.3 million Americans diagnosed with the illness — and many more who are at risk for developing it.
Heart-healthy fish. Eat heart-healthy fish at least twice a week. Fish can be a good alternative to high-fat meats. For example, cod, tuna and halibut have less total fat, saturated fat and cholesterol than do meat and poultry. Fish such as salmon, mackerel, tuna, sardines and bluefish are rich in omega-3 fatty acids, which promote heart health by lowering blood fats called triglycerides.

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%.

To follow a healthy diet for diabetes, you must first understand how different foods affect your blood sugar. Carbohydrates, which are found to the largest degree in grains, bread, pasta, milk, sweets, fruit, and starchy vegetables, are broken down into glucose in the blood faster than other types of food, which raises blood sugar, potentially leading to hyperglycemia. Protein and fats do not directly impact blood sugar, but both should be consumed in moderation to keep calories down and weight in a healthy range.


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.


You don't have to live your life at the gym to reap the benefits of exercise. A brisk half-hour walk five days per week can be enough to help improve insulin sensitivity (the opposite of insulin resistance) and prevent diabetes. Also, just being generally more active can help a lot. To motivate yourself, get a pedometer to count your steps, and gradually increase the number of steps you are taking.
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.
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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