We tend to hear much emphasis on calories, carbohydrate counting and the glycemic index when asking about type 2 diabetes management through diet. The most often forgotten nutrient for health is the most important: water. Many of our clients with type 2 diabetes are on the run and may remember to eat, yet do not take adequate time for drinking calorie-free, caffeine-free beverages to rehydrate. Since our bodies are comprised of nearly 70% water, it makes good sense to take in fluids daily to balance out our needs. Sometimes the recommended “8, 8 ounces of water per day” is not enough. A quick assessment of the color of urine coming out, depending on vitamin supplements and medications, can help determine what the right amount of liquid is daily. The lighter the color, the better!
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.
So how does one prevent a diabetes diagnosis from happening? Diet is definitely a factor in the development of diabetes, though not the only factor. Other potential influences include age, genetics, family history, physical activity, mental health, income, hormonal conditions, and ethnicity. So even if your diet is perfectly engineered towards preventing the chronic disease, you still might be at risk. That being said, your diet does still play a role. Why not reduce your risk as much as you can?
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.
Meanwhile, processed or packaged foods should be avoided or limited in your diabetes diet because, in addition to added sugars and processed carbohydrates, these foods are often high in sodium and therefore may increase your blood pressure and, in turn, the risk of heart disease or stroke — two common complications of diabetes. It’s important to keep your blood pressure in check when managing diabetes.
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.
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]
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A study was conducted which included the diabetic patients with differing degrees of glycemic control. There were no differences in the mean daily plasma glucose levels or diurnal glucose profiles. As with carbohydrates, the association between dietary fats and T2DM was also inconsistent.34 Many of prospective studies have found relations between fat intake and subsequent risk of developing T2DM. In a diabetes study, conducted at San Louis Valley, a more than thousand subjects without a prior diagnosis of diabetes were prospectively investigated for 4 years. In that study, the researchers found an association between fat intake, T2DM and impaired glucose tolerance.35,36 Another study observed the relationship of the various diet components among two groups of women, including fat, fiber plus sucrose, and the risk of T2DM. After adjustment, no associations were found between intakes of fat, sucrose, carbohydrate or fiber and risk of diabetes in both groups.37
Research has found, too, that the Pritikin Program can actually reverse the Metabolic Syndrome. In 50% of adult Americans studied, the Pritikin Program reversed the clinical diagnosis of Metabolic Syndrome, and in just three weeks. In research following children with the Metabolic Syndrome, 100% no longer had the syndrome within two weeks of starting the Pritikin Program.
The desert’s scorching heat and torrential rainfalls stress the Hintonia latiflora tree and provide the keys to a powerful defense mechanism inherent in the plant and an essential part of its medicinal value. The natural environmental stresses to the tree enhance its ability to survive and thrive in such a harsh environment and are key to hintonia’s traditional use to treat Type 2 diabetes and gastrointestinal problems.
The prediabetes diet plans below are designed to help you lose weight, improve your blood sugar control and overall health, and be easy to follow. Each plan has about 1,200 to 1,400 calories per day. If you need more, you can add in one or more of the healthy snack options listed below the menus. There is are one-week menus for a low-carb ketogenic diet and for a balanced, DPP-based prediabetes diet, and snacks listed for both types of diets.
It's not clear why, but whole grains may reduce your risk of diabetes and help maintain blood sugar levels. Try to make at least half your grains whole grains. Many foods made from whole grains come ready to eat, including various breads, pasta products and cereals. Look for the word "whole" on the package and among the first few items in the ingredient list.
Stay Hydrated. Drinking water throughout the day is always good to keep your organs and skin healthy. Of course, getting some fluid before, during and after exercise is just as important to avoid becoming dehydrated. However, what you choose matters a lot. For example, skip the soda. New findings come out regularly to warn against the negative health effects of added sugar, including fructose (ie, high fructose corn syrup), honey, and agave.
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]
DM can be controlled through improvement in patient’s dietary knowledge, attitudes, and practices. These factors are considered as an integral part of comprehensive diabetes care.51 Although the prevalence of DM is high in gulf countries, patients are still deficient in understanding the importance of diet in diabetes management.52 Studies have shown that assessing patients’ dietary attitude may have a considerable benefit toward treatment compliance and decrease the occurrence rate of complications as well.52 A study conducted in Egypt reported that the attitude of the patients toward food, compliance to treatment, food control with and without drug use and foot care was inadequate.53 Another study presented that one-third of the diabetic patients were aware about the importance of diet planning, and limiting cholesterol intake to prevent CVD. Various studies have documented increased prevalence of eating disorders and eating disorder symptoms in T2DM patients. Most of these studies have discussed about the binge eating disorder, due to its strong correlation with obesity, a condition that leads to T2DM.53 Furthermore, a study revealed that the weight gain among diabetic patients was associated with the eating disorder due to psychological distress.54 In another study that examined eating disorder-related symptoms in T2DM patients, suggested that the dieting-bingeing sequence can be applied to diabetics, especially obese diabetic patients.55 Unhealthy eating habits and physical inactivity are the leading causes of diabetes. Failure to follow a strict diet plan and workout, along with prescribed medication are leading causes of complications among patients of T2DM.56 Previous studies57 conducted in Saudi Arabia have reported that diabetic patients do not regard the advice given by their physicians regularly regarding diet planning, diet modification and exercise.
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.
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.
One of the key factors in Joslin’s treatment of diabetes is tight blood glucose control, so be certain that your treatment helps get your blood glucose readings as close to normal as safely possible. Patients should discuss with their doctors what their target blood glucose range is. It is also important to determine what your goal is for A1C readings (a test that determines how well your diabetes is controlled over the past 2-3 months). By maintaining blood glucose in the desired range, you’ll likely avoid many of the complications some people with diabetes face.
What to drink in place of the sugary stuff? Water is an excellent choice. Coffee and tea are also good calorie-free substitutes for sugared beverages (as long as you don’t load them up with sugar and cream). And there’s convincing evidence that coffee may help protect against diabetes; (33, 34) emerging research suggests that tea may hold diabetes-prevention benefits as well, but more research is needed.
There’s more troubling news. The pre-cursors of Type 2 diabetes – pre-diabetes and the Metabolic Syndrome – increase our risk of heart disease almost as much as Type 2 diabetes does. These pre-cursors are so widespread in 21st century America that scientists now estimate that the majority of the current U.S. population over the age of 65 has them. And they put people at dangerously high risk of developing full-blown Type 2 diabetes and cardiovascular disease, and dying prematurely.
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.
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.
There are two main types of diabetes – Type 1 and Type 2. At least 90% of diabetics in America have Type 2 diabetes. Studying the evolution and lifestyle habits of humankind, we can confidently assert that Type 2 diabetes is virtually entirely preventable. Worldwide, many populations are now suffering epidemic rates of Type 2 diabetes because many populations live in a “food toxic” environment and exercise little or not at all.
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.")
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.
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.
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.
Elevated blood sugar can also come from the body’s response to inflammation. If you feel like you’re eating right but can’t figure out why your blood sugar is spiking, it may be due to a food sensitivity. The diarrhea you thought was a side effect of your medication may actually be a food sensitivity. Food sensitivities can also be the root cause of headaches, arthritis, heartburn, fibromyalgia, sinus problems, and more. The stress of these ailments has the potential to elevate blood sugars.
They would often say to me, “Doctor. You’ve always said that weight loss is the key to reversing diabetes. Yet you prescribed me a drug that made me gain 25 pounds. How is that good?” I never had a good answer, because none existed. It was not good. The key was weight loss, whereupon the diabetes often goes away or at least gets significantly better. So, logically, insulin does not help reverse the disease, but actually worsens it.
Losing weight can lower your blood sugar levels. Losing just 5 to 10 percent of your body weight can make a difference, although a sustained weight loss of 7 percent or more of your initial weight seems to be ideal. That means someone who weighs 180 pounds (82 kilograms) would need to lose a little less than 13 pounds (5.9 kilograms) to make an impact on blood sugar levels.
DM is the fourth among the leading causes of global deaths due to complications. Annually, more than three million people die because of diabetes or its complications. Worldwide, this disease weighs down on health systems and also on patients and their families who have to face too much financial, social and emotional strains. Diabetic patients have an increased risk of developing complications such as stroke, myocardial infarction, and coronary artery disease. However, complications such as retinopathy, nephropathy, and neuropathy can have a distressing impact on patient’s quality of life and a significant increase in financial burden. The prevalence reported from studies conducted worldwide on the complications of T2DM showed varying rates. The prevalence of cataracts was 26-62%, retinopathy 17-50%, blindness 3%, nephropathy 17-28%, cardiovascular complications 10-22.5%, stroke 6-12%, neuropathy 19-42%, and foot problems 5-23%. Mortality from all causes was reported between 14% and 40%.71 In a study, researchers found that 15.8% incidence of DR is in the developing countries. The prevalence of DR reported from Saudi Arabia, Sri Lanka, and Brazil was 30%, 31.3%, and 35.4%, respectively; while in Kashmir it was 27% and in South Africa it was 40%. The prevalence of DR 26.1% was observed among 3000 diabetic patients from Pakistan; it was significantly higher than that what was reported in India (18%) and in Malaysia (14.9%).72-76 Studies conducted on diabetes complications in Saudi Arabia are very few and restricted. A 1992 study from Saudi Arabia showed that in T2DM patients; occurrence rate of cataract was 42.7%, neuropathy in 35.9% patients, retinopathy in 31.5% patients, hypertension in 25% patients, nephropathy in 17.8% patients, ischemic heart disease in 41.3% patients, stroke in 9.4% patients, and foot infections in 10.4% of the patients. However, this study reported complications for both types of diabetes.77
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.