After Jitahadi spent a few weeks on medication, her vision cleared and she began to feel better. It didn't last long. "I hated metformin. I had all the colon and digestive issues on it," she says. "I never knew if I would be OK on it or if I'd be nauseous. I'd question whether I wanted to go out with my friends." When she asked for an alternative medication, her doctor said metformin was the best drug for the job, so Jitahadi stuck it out for a year. After that, she decided to make major lifestyle changes in hopes of quitting her medications.

There is no single best diet plan for prediabetes. If you ask 100 people, “What is the best diet for prediabetes?,” you may get 100 different answers – and they may all be correct. Your plan should help you control your weight, provide the nutrients and healthy foods you need to lower risk for diabetes and other chronic diseases, and fit into your lifestyle so that you can make it work for the long term.
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.
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.

Although the genes you inherit may influence the development of type 2 diabetes, they take a back seat to behavioral and lifestyle factors. Data from the Nurses’ Health Study suggest that 90 percent of type 2 diabetes in women can be attributed to five such factors: excess weight, lack of exercise, a less-than-healthy diet, smoking, and abstaining from alcohol. (8)


But some pleasant news: When consumed in moderation and made with whole ingredients and without added sugar, fruit smoothies can be a good food for diabetes. Consider stocking your fridge with unsweetened frozen fruit so you can whip up one in a hurry for breakfast. Adding ingredients with protein, such as yogurt or a small amount of nut butter, will also help your body break down the carbohydrates more slowly, leading to less of a spike in blood sugar.
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.
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.
Cut back on added sugar. Read nutrition facts and ingredient lists to help with this. If sugar is one of the first 3 ingredients- the product may have too much sugar. Use fresh or frozen (without added sugar) fruit to flavor or sweetened things instead of buying things already flavored with less healthy sugars or flavorings. For example: instead of buying strawberry yogurt. Buy plain yogurt and add fresh berries. You will not only be cutting back on added sugars, but you will be adding fiber and volume which can help fill you up and control your blood sugar.

Charlene Crawford has spent more than half of her life with diabetes. At 14, she was diagnosed with prediabetes. By 18, she had type 2. She was prescribed medication, which she barely took, and advised to make lifestyle changes, which she didn't do. But when she got pregnant, her priorities shifted. "Having a child makes you see things differently," says Crawford, a mother of two. "I wanted to be there for him and not be so tired and be active when he needed me."
Sometimes pills for diabetes — even when combined with diet and exercise — aren't enough to keep blood sugar levels under control. Some people with type 2 diabetes also have to take insulin. The only way to get insulin into the body now is by injection with a needle or with an insulin pump. If someone tried to take insulin as a pill, the acids and digestive juices in the stomach and intestines would break down the medicine, and it wouldn't work.
Controlling Type II Diabetes by diet is an absolute must. Eating low glycemic foods and staying away from highly processed foods that contain hidden toxins as well as hidden sugars is important. You cannot always trust food labels so I suggest eating as many foods that DO NOT have labels – fresh vegetables, lean proteins and nutrient rich complex carbohydrates. Some examples include, spinach, kale, asparagus, broccoli, brussel sprouts, sweet potatoes, quinoa, brown rice or bean pastas – and of course lots of lean proteins from chicken, turkey and fish. Eliminate high sugar vegetables such as peas, carrots and corn and stay away from white foods such as white flour, bread, pastries, cakes, dairy and milk products (eggs are ok).
Ketoacidosis occurred in people with type 1 and type 2 diabetes during treatment with FARXIGA. Ketoacidosis is a serious condition which may require hospitalization and may lead to death. Symptoms may include nausea, tiredness, vomiting, trouble breathing, and abdominal pain. If you get any of these symptoms, stop taking FARXIGA and call your healthcare provider right away. If possible, check for ketones in your urine or blood, even if your blood sugar is less than 250 mg/dL
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.
In conclusion, effective lifestyle modifications including counseling on weight loss, adoption of a healthy dietary pattern like the Mediterranean diet, together with physical activity are the cornerstone in the prevention of type-2 diabetes. Therefore, emphasis must be given to promoting a healthier lifestyle and finding solutions in order to increase adherence and compliance to the lifestyle modifications, especially for high-risk individuals. Results from epidemiological studies and clinical trials evaluating the role of the Mediterranean dietary pattern regarding the development and treatment of type-2 diabetes indicate the protective role of this pattern. As a result, promoting adherence to the Mediterranean diet is of considerable public health importance as this dietary pattern, apart from its various health benefits, is tasty and easy to follow in the long-term. Diet is an important aspect in the management of a diabetic patient. The diabetic healthcare provider and the patient should understand the basic dietary needs of the patient. In this form, there may be plenty of insulin in the bloodstream, but the cells are resistant to it. Glucose cannot easily get into the cells, and it backs up in the bloodstream. Over the short run, people with uncontrolled diabetes may experience fatigue, thirst, frequent urination, and blurred vision. In the long run, they are at risk for heart disease, kidney problems, disorders of vision, nerve damage, and other difficulties.
You can find an in-person DPP program to attend, or see whether you are eligible for a digital program. Lark Health Coach, for example, is a CDC DPP program that delivers the program via your smartphone, on your time. Lark also helps with tracking weight, food, and exercise, and customizes the program according to preferences such as low-carb, gluten-free, or vegan.

The role of diet in the etiology of T2DM was proposed by Indians as mentioned earlier, who observed that the disease was almost confined to rich people who consumed oil, flour, and sugar in excessive amounts.30 During the First and Second World Wars, declines in the diabetes mortality rates were documented due to food shortage and famines in the involved countries such as Germany and other European countries. In Berlin, diabetes mortality rate declined from 23.1/100,000 in 1914 to 10.9 in 1919. In contrast, there was no change in diabetes mortality rate in other countries with no shortage of food at the same time period such as Japan and North American countries.31 Whereas few studies have found strong association of T2DM with high intake of carbohydrates and fats. Many studies have reported a positive association between high intake of sugars and development of T2DM.32 In a study, Ludwig33 investigated more than 500 ethnically diverse schoolchildren for 19 months. It was found that for each additional serving of carbonated drinks consumed, frequency of obesity increased, after adjusting for different parameters such as dietary, demographic, anthropometric, and lifestyle.
As a bonus, stress relief may help you sleep better, which is important because studies show that not getting enough sleep can worsen type 2 diabetes. Sleeping less than six hours a night has also been found to contribute to impaired glucose tolerance, a condition that often precedes type 2 diabetes. In fact, a review published in 2015 in Diabetes Care analyzed 10 studies that involved more than 18,000 participants combined and found the lowest risk of type 2 diabetes in the group of participants that slept seven to eight hours per day. That’s the minimum recommended amount of sleep for most adults, according to the National Sleep Foundation.
The majority of our dialysis patients lose kidney function completely – in other words they no longer urinate. So imagine what happens when they eat salty foods (not salt) – they get thirsty and drink – Then the dialysis treatment must try (only try) to remove the fluid they accumulate. It is true that high blood sugar also causes thirst – which I must keep in mind. I have many patients who rely on their PCP for advice with their insulin. They take the same amount of insulin regardless of their blood sugar – and the A1C remains elevated – I can’t change how they administer the insulin – but only recommend asking for a referral to an endocrinologist.
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/.

"If you have a job or lifestyle that involves a lot of sitting, you can lower your risk of early death by moving more," says the primary investigator, Keith Diaz, PhD, assistant professor of behavioral medicine at Columbia University Irving Medical Center in New York. Even sitting at a desk or on the couch for an hour or more raises your risk for poorer outcomes so get up, walk around, and stand periodically to improve your health status.
I believe that individuals with and without Type 2 diabetes need to ensure they are eating at least eight servings of non-starchy vegetables like broccoli, cauliflower, dark leafy greens, bell peppers, green beans, okra, and so much more. One serving of vegetable is equal to 1cup, which is really about one handful worth. If you cook one serving of say greens, it will shrink, but it still counts!

Aside from managing your diabetes, a diabetes diet offers other benefits, too. Because a diabetes diet recommends generous amounts of fruits, vegetables and fiber, following it is likely to reduce your risk of cardiovascular diseases and certain types of cancer. And consuming low-fat dairy products can reduce your risk of low bone mass in the future.

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.
Don’t be surprised if you have to use multiple medications to control the blood sugar. Multiple medications, also known as combination therapy is common in the treatment of diabetes! If one medication is not enough, you medical provider may give you two or three or more different types of pills. Insulin or other injected medications also may be prescribed. Or, depending on your medical condition, you may be treated only with insulin or injected medication therapy.
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