As for packaging, frozen veggies without sauce are just as nutritious as fresh, and even low-sodium canned veggies can be a good choice if you’re in a pinch. Just be sure to watch your sodium intake to avoid high blood pressure, and consider draining and rinsing salted canned veggies before eating, per the ADA. If possible, opt for low-sodium or sodium-free canned veggies if going that route.

High blood pressure may also be present with your diabetes. Limiting how much salt you eat can help keep your blood pressure low. Decrease the amount of salt you add during cooking and reduce salt in recipes, before adding salt at the table, taste first, try seasoning your food with (salt-free) herbs, spices, and garlic. Lemon juice brings out the natural saltiness of foods. Avoid processed foods that are high in salt (sodium chloride) such as canned or packaged foods and condiments such as mustard, watch for “Na” (sodium) on food labels. Chips, pretzels, and other such snacks are very high in salt, and check with your physician before using salt substitutes.
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.
If you fall into the second camp, there is plenty you can do to minimize the risk of the prediabetes progressing to diabetes. What's needed is a ''lifestyle reset," says Jill Wiesenberger, MD, RDN, CDE, FAND, a certified health and wellness coach and certified diabetes educator in Newport News, Virginia, and author of Prediabetes: A Complete Guide.2  The new book is published in collaboration with the American Diabetes Association.
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.
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!
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).

Eat every two to three hours. Spreading your energy needs throughout the day allows for healthier choices to be made and your blood sugar to stabilize. Work towards achieving a healthy meal pattern of breakfast (the first meal), followed by a small snack, then lunch (mid-day meal), another snack, dinner (last-meal of the day) and sometimes a small end of the day snack.


Regular exercise is an equally important part. Not only can it help you maintain your ​ideal body weight, it can have a direct impact on your blood glucose control. This is because insulin resistance is closely linked to increased fat and decreased muscle mass. Muscle cells use insulin far more efficiently than fat, so​ by building muscle and burning fat, you can help lower and better control your blood glucose levels.
Insulin is a hormone made by your pancreas that acts like a key to let blood sugar into the cells in your body for use as energy. If you have type 2 diabetes, cells don’t respond normally to insulin; this is called insulin resistance. Your pancreas makes more insulin to try to get cells to respond. Eventually your pancreas can’t keep up, and your blood sugar rises, setting the stage for prediabetes and type 2 diabetes. High blood sugar is damaging to the body and can cause other serious health problems, such as heart disease, vision loss, and kidney disease.
When the insulin levels are unable to keep up with the increasing resistance, blood sugars rise and your doctor diagnoses you with type 2 diabetes and starts you on a pill, such as metformin. But metformin does not get rid of the sugar. Instead, it simply takes the sugar from the blood and rams it back into the liver. The liver doesn’t want it either, so it ships it out to all the other organs – the kidneys, the nerves, the eyes, the heart. Much of this extra sugar will also just get turned into fat.
Insulin is a hormone made by your pancreas that acts like a key to let blood sugar into cells for use as energy. If you have prediabetes, the cells in your body don’t respond normally to insulin. Your pancreas makes more insulin to try to get cells to respond. Eventually your pancreas can’t keep up, and your blood sugar rises, setting the stage for prediabetes—and type 2 diabetes down the road.
[1] Diabetes Prevention Program Research Group. Long-term effects of lifestyle intervention or metformin on diabetes development and microvascular complications over 15-year follow-up: the Diabetes Prevention Program Outcomes Study. The Lancet Diabetes & Endocrinology. 2015;3(11):866‒875. You can find more information about this study at the Diabetes Prevention Program Outcomes Study website.
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).
According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), you can calculate the amount of carbs you need by first figuring out what percentage of your diet should be made up of carbohydrates. (The NIDDK notes that experts generally recommend this number be somewhere between 45 and 65 percent of your total calories, but people with diabetes are almost always recommended to stay lower than this range.) Multiply that percentage by your calorie target. For example, if you’re aiming to get 50 percent of your calories from carbs and you eat 2,000 calories a day, you’re aiming for about 1,000 calories of carbs. Because the NIDDK says 1 gram (g) of carbohydrates provides 4 calories, you can divide the calories of carbs number by 4 to get your daily target for grams of carbs, which comes out to 250 g in this example. For a more personalized daily carbohydrate goal, it’s best to work with a certified diabetes educator or a registered dietitian to determine a goal that is best for you.
Diabetes mellitus is a disease in which a person's blood sugar (blood glucose) is either too high (hyperglycemia) or too low (hypoglycemia) due to problems with insulin regulation in the body. There are two main types of diabetes mellitus, type 1 and type 2. Type 1 diabetes usually occurs during childhood, while type 2 diabetes usually occurs during adulthood, however, rates of both types of diabetes in children, adolescents, and teens is increasing. More men than women have diabetes in the US, and the disease can affect men differently than women.
Random blood sugar test. Blood sugar values are expressed in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L). Regardless of when you last ate, a blood sample showing that your blood sugar level is 200 mg/dL (11.1 mmol/L) or higher suggests diabetes, especially if you also have signs and symptoms of diabetes, such as frequent urination and extreme thirst.
It’s no secret that diet is essential to managing type 2 diabetes. Although there isn’t a one-size-fits-all diet for diabetes management, certain dietary choices should act as the foundation for your individual diet plan. Your diet plan should work with your body — not against it — so it’s important that the food you eat won’t spike your blood sugar levels to high.
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
In addition, many sugar-containing foods also contain a lot of fat. Foods such as cookies, pastries, ice cream and cakes should be avoided largely because of the fat content and because they don't contribute much nutritional value. If you do want a "sweet," make a low-fat choice, such as low-fat frozen yogurt, gingersnaps, fig bars, or graham crackers and substitute it for other carbohydrates on your meal plan.
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.”
The health benefits of a low-fat vegetarian diet such as portions of vegetables, grains, fruits, and legumes (excluding animal products) in people with type-2 diabetes. The vegan diet is based on American Diabetes Association (ADA) guidelines; the results of this study were astounding: Forty-three percent of the vegan group reduced their diabetes medications. Among those participants who didn't change their lipid-lowering medications, the vegan group also had more substantial decreases in their total and LDL cholesterol levels.
I recommend for my patients to eat a variety of foods when managing Diabetes Type 2 with diet. I particularly encourage patients to include protein from a variety of sources, fiber, and vegetables or fruit with each meal. Including small portions of many food groups with each meal ensures that patients’ bodies are being healthfully fueled and they will often feel more satisfied with their meals preventing overeating and grazing throughout the day.
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.
Eat every two to three hours. Spreading your energy needs throughout the day allows for healthier choices to be made and your blood sugar to stabilize. Work towards achieving a healthy meal pattern of breakfast (the first meal), followed by a small snack, then lunch (mid-day meal), another snack, dinner (last-meal of the day) and sometimes a small end of the day snack.
Some easy-to-follow examples I often provide are adding chopped mixed vegetables to scrambled eggs and including fresh fruit on the side; preparing a green smoothie with low-fat milk, low-fat yogurt, chopped fresh kale, and frozen fruit; preparing vegetarian jambalaya with brown rice; or choosing a hearty salad with mixed greens, nuts, beans, and light salad dressing from a salad bar. Food can be medicine and it can also be enjoyable!
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.

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)
The result of his hard work? He lost 160 pounds in two years, normalized his high blood pressure and high cholesterol, has an A1C of 5.6, and no longer takes metformin and glyburide. His advice to others with type 2: "You need to have a plan, and you need to be consistent," he says. "[Diet and exercise are] something you need to do to survive and control it. Look at it as the same thing as taking a pill or insulin."

This is the advice that diabetics received a hundred years ago. Even in Sweden, with the high fat-Petrén diet that included fatty pork cuts, butter and green cabbage. And when diabetics start eating this way today the same thing happens as it did in the past. Their blood sugar levels improve dramatically from day one. This makes sense, as they avoid eating what raises blood sugar.


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)
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.

Jitahadi bought books on diabetes, nutrition, the glycemic index, and diabetes-friendly meals. Instead of slightly modifying her diet, Jitahadi decided to completely overhaul it. "I started realizing that what ['watch what you eat'] really meant was I needed to eat healthier, more balanced meals," she says. She wrote down everything she ate. And instead of dining out, she cooked meals from scratch. Jitahadi swapped white sugar for lower-glycemic sweeteners, traded in white rice for brown, lowered the amount of sodium she consumed, cut a lot of carbs, and made veggies the mainstay of each meal. (Her favorite: grated cauliflower sautéed with veggies and chicken or egg for low-carb fried "rice.")


Type 2 diabetes is almost always reversible and this is almost ridiculously easy to prove. This is great news for the more than 50% of American adults who have been diagnosed with pre-diabetes or diabetes. Recognizing this truth is the crucial first step in reversing your diabetes or pre-diabetes. Actually, it something that most people already instinctively recognized to be true.
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.

Medications in this drug class may reduce the risk of heart attack and stroke in people with a high risk of those conditions. Side effects may include vaginal yeast infections, urinary tract infections, low blood pressure, and a higher risk of diabetic ketoacidosis. Canagliflozin, but not the other drugs in the class, has been associated with increased risk of lower limb amputation.
Salmon is a type 2 diabetes superfood because salmon is a great source of anti-inflammatory omega-3 fatty acids. There are differences in the fatty acids in wild vs. farmed salmon. This is because of what the fish eat. Wild salmon eat smaller fish and live in colder waters, which causes them to develop a higher ratio of anti-inflammatory omega-3s to saturated fats in their meat. Farmed fish are up to 10 times higher in persistent organic pollutants, antibiotics, and other contaminants. These harmful chemicals are pro-inflammatory and have been associated with increased risk of cancer and heart disease.

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!
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.

She still plans to lose more weight, but she knows that slow and steady beats the quick loss (and equally quick regain) she experienced on countless fad diets in her past. Because she's not trying to drop a dress size—she wants to change her life. "My goal is to be as healthy as I can," she says. "If something happens and one day I'm back on medication, my goal is still to be healthy."
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

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.
Aside from weight, certain nutrients are linked to improved health and lower diabetes risk. For example, increasing consumption of vegetables, fruits, and beans, eating more whole grains instead of refined, and choosing olive oil can all lower diabetes risk. Limiting sweets, refined carbohydrates such as white bread and pasta, and unhealthy fats from fried foods and fatty meats are examples of dietary patterns to slow any progression of prediabetes.
At Stanford Medical Center in California, while working as a clinical dietitian, I teamed up with a clinical research dietitian who specialized in diabetes.Our goal was to help women reach a weight recommended for their actual height. What resulted was a book Help! My Underwear is Shrinking: One woman’s story of how to eat right, lose weight, and win the battle against diabetes.The book tells the story of one woman as she struggles with her daily routine and responsibilities while trying to follow the plan and lose weight. The character provides humorous insight and methods she used for achieving her goal.

Childhood obesity rates are rising, and so are the rates of type 2 diabetes in youth. More than 75% of children with type 2 diabetes have a close relative who has it, too. But it’s not always because family members are related; it can also be because they share certain habits that can increase their risk. Parents can help prevent or delay type 2 diabetes by developing a plan for the whole family:
Although most vegetable oils are in some ways healthier than animal fats, you will still want to keep them to a minimum. All fats and oils are highly concentrated in calories. A gram of any fat or oil contains 9 calories, compared with only 4 calories for a gram of carbohydrate. Avoid foods fried in oil, oily toppings, and olives, avocados, and peanut butter. Aim for no more than 2-3 grams of fat per serving of food, e.g., white or wheat bread, most cold cereals, watermelon, pineapple, baking potatoes, sugar.

Choose carbs wisely: The glycemic index (GI) is a value assigned to foods based on how quickly or slowly they spike your blood sugar levels. For someone with diabetes, high GI foods (like refined sugar or other simple carbohydrates like white rice and bread) can cause blood glucose levels to shoot up rapidly. Make sure that your carbs are high-fiber, whole grains – like legumes, brown rice, or quinoa – as these foods are high in nutrients and break down slowly into the bloodstream.


Imagine that you hide your kitchen garbage under the rug instead throwing it outside in the trash. You can’t see it, so you can pretend your house is clean. When there’s no more room underneath the rug, you throw the garbage into your bedroom, and bathroom, too. Anywhere where you don’t have to see it. Eventually, it begins to smell. Really, really bad.
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.
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