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.
When overweight diabetic patients drop some weight by trimming down ‘serving sizes’ and calories, insulin sensitivity improves, thereby optimizing drug therapy. The fundamental principle behind maintenance of body weight is the energy balance. This group should be encouraged to maintain their current weight by: Maintaining current ‘serving sizes,’ eating about the same amount of food each day, eating at about the same times each day, taking their drugs at the same times each day, and exercising at the same times each day. These patients should also endeavor to choose their daily foods from starches, vegetables, fruits, and protein, while limiting the amount of fats.[41,42,43,44,45]

Whole grains don’t contain a magical nutrient that fights diabetes and improves health. It’s the entire package—elements intact and working together—that’s important. The bran and fiber in whole grains make it more difficult for digestive enzymes to break down the starches into glucose. This leads to lower, slower increases in blood sugar and insulin, and a lower glycemic index. As a result, they stress the body’s insulin-making machinery less, and so may help prevent type 2 diabetes. (22) Whole grains are also rich in essential vitamins, minerals, and phytochemicals that may help reduce the risk of diabetes.
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In contrast, white bread, white rice, mashed potatoes, donuts, bagels, and many breakfast cereals have what’s called a high glycemic index and glycemic load. That means they cause sustained spikes in blood sugar and insulin levels, which in turn may lead to increased diabetes risk. (22) In China, for example, where white rice is a staple, the Shanghai Women’s Health Study found that women whose diets had the highest glycemic index had a 21 percent higher risk of developing type 2 diabetes, compared to women whose diets had the lowest glycemic index. (23) Similar findings were reported in the Black Women’s Health Study. (24)

Metformin is likely effective for as long as 10 years, based on long-term follow-up of patients in the Diabetes Prevention Program (DPP). In this trial, investigators randomized 3234 at-risk patients to 3 groups: metformin 850 mg twice daily; lifestyle modification (7% weight loss, 150 minutes of physical activity per week, and a one-to-one 16-lesson curriculum covering diet, exercise, and behavior modification); or placebo.4 At a mean 2.8-year follow-up, the incidence of diabetes was 31% lower in the metformin group (95% confidence interval [CI], 17%-43%) and 58% lower in the lifestyle modification group than in the placebo group (95% CI, 48%-66%; P<.001 for both comparisons).

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.


So you go to your doctor. What does he do? Instead of getting rid of the toxic sugar load, he doubles the dose of the medication. If the luggage doesn’t close, the solution is to empty it out, not use more force to . The higher dose of medication helps, for a time. Blood sugars go down as you force your body to gag down even more sugar. But eventually, this dose fails as well. So then your doctor gives you a second medication, then a third one and then eventually insulin injections.

When incorporating fiber rich foods in your diet, which helps with blood sugar control – remember to stay hydrated with enough daily water intake.  Drink water with meals and snacks and keep a water bottle with you to take sips throughout the day.  Staying well hydrated helps with regularity and promotes blood sugar control.  Aim for 60-100 fluid ounces per day.
People are missing the forest through the trees while trying to be perfect in the way they eat. It has become difficult to accept the tip “eat more fruits and vegetables”. All the food “philosophers” (aka non-science based food guru) have filled our heads with lies about the types, packaging and serving of these foods. Saying things like “they are worthless if they are packaged in such-and-such a way”. STOP with the “all-prefect or nothing” mentality. Just eat fruits and vegetables! Canned, fresh, frozen, cooked, raw, or pulverized; just get them in your belly.
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.
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.
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.
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:
Counting carbohydrates: Dietary fiber may be listed underneath the listing for total carbohydrates. Dietary fiber is not digested by the body and can be subtracted from the total amount of carbohydrates present in food. This gives the net carbohydrates and will give a more accurate count of how much of the carbohydrates that affect blood sugar are present.
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.
A major reason why many people who attempt to control type 2 diabetes with diet and exercise turn back to medications is that lifestyle adjustments are hard to maintain over the long term. Jitahadi became a licensed Zumba instructor with this in mind. "I said, 'I know me and I don't want to let life get in my way of taking care of myself because I've done that before,' " she says. She's a Zumba instructor at her local YMCA. For the past year, she's also been a diabetes prevention lifestyle coach there, helping others reduce their risk for the disease.
#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.)
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.
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]
More recent findings from the Nurses Health Studies I and II and the Health Professionals Follow-Up Study suggest that swapping whole grains for white rice could help lower diabetes risk: Researchers found that women and men who ate the most white rice—five or more servings a week—had a 17 percent higher risk of diabetes than those who ate white rice less than one time a month. People who ate the most brown rice—two or more servings a week—had an 11 percent lower risk of diabetes than those who rarely ate brown rice. Researchers estimate that swapping whole grains in place of even some white rice could lower diabetes risk by 36 percent. (25)
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.
#8. COFFEE—Several studies have found coffee, whether regular or decaf, reduces risk of type 2 diabetes. Some research has found that those drinking 6 or 7 cups a day have about a 35% lower risk of getting diabetes than those drinking less than 2 cups.10 Drink wisely, Weisenberger says. Unfiltered coffee has compounds that raise your bad (LDL) cholesterol, so use a paper filter with methods such as French press. And don't undo the benefits by adding too much sugar, cream or syrup.

Why do red meat and processed red meat appear to boost diabetes risk? It may be that the high iron content of red meat diminishes insulin’s effectiveness or damages the cells that produce insulin; the high levels of sodium and nitrites (preservatives) in processed red meats may also be to blame. Red and processed meats are a hallmark of the unhealthful “Western” dietary pattern, which seems to trigger diabetes in people who are already at genetic risk. (44)

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.


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.
In reality, when people in a study followed the Paleolithic diet, it turned out the diet was lower in total energy, energy density, carbohydrates, dietary glycemic load, fiber, saturated fatty acids, and calcium; but higher in unsaturated fatty acids (good fats), dietary cholesterol, and several vitamins and minerals. Research also demonstrates that people with diabetes are less hungry, have more stable blood sugar, and feel better with lower carbohydrate diets.
Whole grains, such as brown rice, quinoa, and oatmeal are good sources of fiber and nutrients; and have a low glycemic load making them good food choices. Processed food labels make it very confusing to understand whole grains. For example, "whole wheat bread" is made in many different ways, and some are not that different from white bread in its blood sugar impact (glycemic load). The same is true for whole grain pasta, it's still pasta. Whole grains have less of an impact on blood sugar because of the lower glycemic load. Choose whole grains that are still in their grain form like brown rice and quinoa, or look at the fiber content on the nutrition label. For example, a "good" whole grain bread will have 3+ grams of fiber per slice.
A good way to make sure you get all the nutrients you need during meals is to use the plate method. This is a visual food guide that helps you choose the best types and right amounts of food to eat. It encourages larger portions of non-starchy vegetables (half the plate) and moderate portions of protein (one quarter of the plate) and starch (one quarter of the plate). You can find more information about the plate method at the American Diabetes Association website: www.diabetes.org/food-and-fitness/food/planning-meals/create-your-plate/.
Following a type 2 diabetes diet doesn’t mean you have to give up all the things you love — you can still enjoy a wide range of foods and, in some cases, even help reverse type 2 diabetes. Indeed, creating a diet for type 2 diabetes is a balancing act: It includes a variety of healthy carbohydrates, fats, and proteins. The trick is ultimately choosing the right combination of foods that will help keep your blood sugar level in your target range and avoid big swings that can cause type 2 diabetes symptoms — from the frequent urination and thirst of high blood sugar to the fatigue, dizziness, headaches, and mood changes of low blood sugar (hypoglycemia).
The group that made lifestyle changes was 58% less likely to develop diabetes compared to the placebo group. And the group that took Metformin was 31% less likely to develop diabetes compared to the placebo group. In other words – lifestyle changes and Metformin therapy can delay or prevent the onset of type 2 diabetes. Lifestyle changes (weight loss, healthy diet and activity) are the most effective intervention.
It had been about a year since Akua Jitahadi felt like herself. But she was 51 and expected menopause to kick in soon. Plus, she and her daughter had just moved to oppressively hot Arizona. So she brushed off the tired, sluggish feeling as a side effect of being a middle-aged woman adjusting to sweltering temps. And then, overnight, her vision dimmed. Something was most definitely wrong.
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.
When picked well and eaten in moderation, dairy can be a great choice for people with diabetes. Just keep fat content in mind, as being overweight or obese can reduce insulin sensitivity, causing prediabetes to progress to full-blown diabetes or increasing the risk of complications if you have type 2 diabetes. Whenever possible, opt for fat-free dairy options to keep calories down and unhealthy saturated fats at bay.
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.
Of course, carbohydrate types, amounts and frequencies still matter. Setting up a routine is best so the body can become more regulated, and medications can be more easily adjusted with medical guidance. For example, a “consistent carbohydrate diet” may include 4-5 carbohydrate servings (60-75 grams) per meal, with 3 meals spaced 4 or 5 hours apart. The inclusion of an evening snack may be recommended pending morning glucose trends. If morning sugars are running under 70 mg/dl, it may be a wise choice to have a 2-carbohydrate evening snack about 1 hour prior to retiring to bed.

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.
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.
Treat yourself as you would a good friend who is struggling with a lifestyle change. You would be supportive and encouraging – a slip is not the end of it all. Sometimes it’s OK to indulge in a treat, but don’t feel guilty – enjoy it to the fullest – then get back on track. It’s OK to sit and read a book one day – just try to not make it the normal thing to do. I realized this morning when I had breakfast with a friend who is struggling with weight loss and I saw that the biggest difference was our attitude. She was moaning about how hard it was to lose and what she couldn’t eat and how much she had to work out, instead of looking at the fact that she has lost 20 pounds! That said, it’s not always easy to be positive, but all I really need to do is look back 4 months and I know I am making a difference.”
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