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).
Sugar consumption alone has not been associated with the development of type 2 diabetes. There is of course, weight gain associated with sugar consumption. However, after adjusting for weight gain and other variables, there appears to be a relationship between drinking sugar-laden beverages and the development of type 2 diabetes. Women who drink one or more of these drinks a day have almost twice the risk of developing diabetes than women who drink one a month or less.
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.
Up your soluble fiber intake: There are two types of fiber – the type that does not dissolve in water (insoluble fiber) and the kind that does (soluble fiber). Insoluble fiber can help manage weight and prevent constipation by moving quickly through the digestive tract and adding bulk to stool. Soluble fiber, on the other hand, absorbs water and turns into a gel-like consistency during digestion. This process slows down digestion and nutrient absorption. Soluble fiber can also lower blood sugar and cholesterol levels: because it isn’t well absorbed, it doesn’t contribute to blood sugar spikes and can help manage type 2 diabetes.
Birth weight: There is a relationship between birth weight and developing diabetes, and it's the opposite of what one might intuitively think. The lower the birth weight, the higher the risk of type 2 diabetes. At the other end of the spectrum, a very high birth weight (over 8.8 pounds or 4 kg) also is associated with an increased risk. Additionally, mothers of infants who had a higher birth weight (over 9 pounds) are at increased risk for developing diabetes.
Each person needs individualized treatment. Type-1 diabetes always requires insulin, diet, and exercise. Type-2 diabetics require insulin or oral hypoglycemic agents (medication that helps lower blood sugar), if diet and exercise alone fail to lower blood glucose. If you have diabetes, you need to have a medical team (doctor, nutritionist, and health educator or nurse) working with you. Whichever type of diabetes you have, the key to proper control is balancing the glucose and the insulin in the blood. This means adjusting your diet, activity, and sometimes taking medication.[29,30]
The risk factors for developing diabetes actually vary depending on where a person lives. This is in part due to the environment the person lives in, and in part due to the genetic makeup of the family. In the United States, it is estimated that one in three males and two out of every five females born in the year 2000 will develop diabetes (the lifetime risk). It has also been calculated that for those diagnosed with diabetes before the age of 40, the average life expectancy is reduced by 12 years for men, and 19 years for women.
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.
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.
Diabetes mellitus (DM) was first recognized as a disease around 3000 years ago by the ancient Egyptians and Indians, illustrating some clinical features very similar to what we now know as diabetes.1 DM is a combination of two words, “diabetes” Greek word derivative, means siphon - to pass through and the Latin word “mellitus” means honeyed or sweet. In 1776, excess sugar in blood and urine was first confirmed in Great Britain.2,3 With the passage of time, a widespread knowledge of diabetes along with detailed etiology and pathogenesis has been achieved. DM is defined as “a metabolic disorder characterized by hyperglycemia resulting from either the deficiency in insulin secretion or the action of insulin.” The poorly controlled DM can lead to damage various organs, especially the eyes, kidney, nerves, and cardiovascular system.4 DM can be of three major types, based on etiology and clinical features. These are DM type 1 (T1DM), DM type 2 (T2DM), and gestational DM (GDM). In T1DM, there is absolute insulin deficiency due to the destruction of β cells in the pancreas by a cellular mediated autoimmune process. In T2DM, there is insulin resistance and relative insulin deficiency. GDM is any degree of glucose intolerance that is recognized during pregnancy. DM can arise from other diseases or due to drugs such as genetic syndromes, surgery, malnutrition, infections, and corticosteroids intake.5-7
Those with diabetes should be results oriented. Find the scientist in yourself and track your numbers and push them to your goal ranges: pounds, blood glucose levels, A1c, minutes of moderate exercise every week, etc. Choose what is important to you, and identify concrete strategies to improve your numbers. A dietitian, especially one who is a diabetes educator can assist you to start slow, set goals, and identify sequential steps to reach each goal gradually. They can act as a coach to help you celebrate successes. and move on to another goal or challenge. Along with the other members of your health care them, let them be your cheerleader!

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.


Dr. Erica Oberg, ND, MPH, received a BA in anthropology from the University of Colorado, her doctorate of naturopathic medicine (ND) from Bastyr University, and a masters of public health (MPH) in health services research from the University of Washington. She completed her residency at the Bastyr Center for Natural Health in ambulatory primary care and fellowship training at the Health Promotion Research Center at the University of Washington.
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
At the close of the DPP trial, investigators offered lifestyle intervention to all 3 groups. Patients in the original metformin group continued to take metformin (with participants unblinded to assignment); patients in the original lifestyle intervention group were offered additional lifestyle support.5 At a median follow-up of 10 years after initial enrollment in the DPP trial, metformin reduced the incidence of overt diabetes by 18% compared with placebo (95% CI, 7%-28%), and lifestyle intervention reduced it by 34% (95% CI, 24%-42%; no statistic of comparison supplied).

The medications only hide the blood sugar by cramming it into the engorged body. The diabetes looks better, since you can only see the blood sugars. Doctors can congratulate themselves on a illusion of a job well done, even as the patient gets continually sicker. Patients require ever increasing doses of medications and yet still suffer with heart attacks, congestive heart failure, strokes, kidney failure, amputations and blindness. “Oh well” the doctor tells himself, “It’s a chronic, progressive disease”.
The other form of diabetes tends to creep up on people, taking years to develop into full-blown diabetes. It begins when muscle and other cells stop responding to insulin’s open-up-for-glucose signal. The body responds by making more and more insulin, essentially trying to ram blood sugar into cells. Eventually, the insulin-making cells get exhausted and begin to fail. This is type 2 diabetes.
Unlike many health conditions, diabetes is managed mostly by you, with support from your health care team (including your primary care doctor, foot doctor, dentist, eye doctor, registered dietitian nutritionist, diabetes educator, and pharmacist), family, and other important people in your life. Managing diabetes can be challenging, but everything you do to improve your health is worth it!
Type 2 diabetes can lead to a number of complications such as kidney, nerve, and eye damage, as well as cardiovascular disease. It also means cells are not receiving the glucose they need for healthy functioning. A calculation called a HOMA Score (Homeostatic Model Assessment) can tell doctors the relative proportion of these factors for an individual with type 2 diabetes. Good glycemic control (that is, keeping sugar/carbohydrate intake low so blood sugar isn't high) can prevent long-term complications of type 2 diabetes. A diet for people with type 2 diabetes also is referred to as a diabetic diet for type 2 diabetes and medical nutrition therapy (MNT) for people with diabetes.
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