Bladder cancer. In studies of FARXIGA in people with diabetes, bladder cancer occurred in a few more people who were taking FARXIGA than in people who were taking other diabetes medications. There were too few cases of bladder cancer to know if bladder cancer was related to FARXIGA. Tell your healthcare provider right away if you have blood or a red color in your urine or pain while you urinate
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. 

Control portions and eat smaller meals. Consuming generous portions and large meals requires your pancreas to work harder to secrete the needed insulin to bring your blood sugar down. The extra calories consumed due to sizeable portions and large meals also makes it harder for you to lose weight which is usually necessary for better blood sugar control.
Some people with type 2 diabetes are treated with insulin. Insulin is either injected with a syringe several times per day, or delivered via an insulin pump. The goal of insulin therapy is to mimic the way the pancreas would produce and distribute its own insulin, if it were able to manufacture it. Taking insulin does not mean you have done a bad job of trying to control your blood glucose—instead it simply means that your body doesn’t produce or use enough of it on its own to cover the foods you eat.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
The American Diabetes Association (ADA) recommends lean proteins low in saturated fat for people with diabetes. If you’re following a vegan or vegetarian diet, getting enough and the right balance of protein may be more challenging, but you can rely on foods like beans, nuts, and tofu to get your fix. Just be sure to keep portion size in mind when snacking on nuts, as they are also high in fat and calories.
If you have type 2 diabetes and your body mass index (BMI) is greater than 35, you may be a candidate for weight-loss surgery (bariatric surgery). Dramatic improvements in blood sugar levels are often seen in people with type 2 diabetes after bariatric surgery, depending on the procedure performed. Surgeries that bypass a portion of the small intestine have more of an effect on blood sugar levels than do other weight-loss surgeries.
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.
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.
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.
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.
Hyperglycemia or high blood sugar is a serious health problem for diabetics. There are two types of hyperglycemia, 1) fasting, and 2)postprandial or after meal hyperglycemia. Hyperglycemia can also lead to ketoacidosis or hyperglycemic hyperosmolar nonketotic syndrome (HHNS). There are a variety of causes of hyperglycemia in people with diabetes. Symptoms of high blood sugar may include increased thirst, headaches, blurred vision, and frequent urination.Treatment can be achieved through lifestyle changes or medications changes. Carefully monitoring blood glucose levels is key to prevention.
“Basic principles of good health like eating right, exercising regularly, and maintaining a healthy weight can be as effective as medicine in the management of type 2 diabetes for most people,” says Sue McLaughlin, RD, CDE, lead medical nutrition therapist at Nebraska Medicine in Omaha. That's backed up by the Look AHEAD study, a large clinical trial funded by the National Institutes of Health and the Centers for Disease Control and Prevention (CDC). The researchers found that over a four-year period, changes like eating a healthier diet and getting more exercise led to weight loss and improved diabetes control in 5,000 overweight or obese participants with type 2 diabetes.
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!
Over a period of years, you went from pre-diabetes, to diabetes, to taking one medication, then two then three and then finally large doses of insulin. Here’s the thing. If you are taking more and more medications to keep your blood sugars at the same level, your diabetes is getting worse! Even if your blood sugars get better, your diabetes is getting worse. This is unfortunately what happens to virtually every patient. The body is already overflowing with sugar.
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.
Although kids and teens might be able to prevent or delay the onset of type 2 diabetes by managing their weight and increasing physical activity, other risk factors for type 2 diabetes can't be changed. Kids with one or more family members with type 2 diabetes have an increased risk for the disease, and some ethnic and racial groups are more likely to developing it.
Hot liquids fill you up better than most anything else – coffee, teas, non-fat hot chocolate. I have become a big fan of soup. I make it myself by browning onions in non-stick cooking spray (to bring out the flavor), then add whatever vegetables I have around with some broth (vegetable or chicken). When the veggies are soft, cool slightly, then blend in small batches. Season with S&P, or experiment with turmeric or cardamon. Makes a lovely thick, creamy soup without the calories. I use sweet potatoes, carrots, broccoli, cauliflower, whatever.
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]
Diabetes mellitus or type-2 diabetes, is one of the major non-communicable and fastest growing public health problems in the world, is a condition difficult to treat and expensive to manage. It has been estimated that the number of diabetes sufferers in the world will double from the current value of about 190 million to 325 million during the next 25 years.[1,2,3] Individuals with type-2 diabetes are at a high risk of developing a range of debilitating complications such as cardiovascular disease, peripheral vascular disease, nephropathy, changes to the retina and blindness that can lead to disability and premature death. It also imposes important medical and economic burdens. Genetic susceptibility and environmental influences seem to be the most important factors responsible for the development of this condition. However, a drastic increase of physical inactivity, obesity, and type-2 diabetes has been recently observed. The fact indicates that obesity and physical inactivity may constitute the main reasons for the increasing burden of diabetes in the developed world.[4,5,6,7,8,9,10]
Another area that I focus on is portion sizes. With the increase in portion sizes in our society, it can be hard to manage food intake. I recommend listening to your body and identifying your needs by being aware of your hunger and fullness. If you are feeling hungry, it is an indicator to eat, and once you start to feel satisfied, it is an indicator to stop eating, knowing that you can eat again later. This small change where someone begins to leave food on their plate or stops eating when feeling satisfied and not overly full can make a big difference in overall health.
It’s best to get fiber from food. But if you can’t get enough, then taking fiber supplements can help. Examples include psyllium, methylcellulose, wheat dextrin, and calcium polycarbophil. If you take a fiber supplement, increase the amount you take slowly. This can help prevent gas and cramping. It’s also important to drink enough liquids when you increase your fiber intake.
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