More than 24 million Americans have diabetes; of those, about 6 million don’t know they have the disease. (1) In 2007, diabetes cost the U.S. an estimated $116 billion in excess medical spending, and an additional $58 billion in reduced productivity. (1) If the spread of type 2 diabetes continues at its present rate, the number of people diagnosed with diabetes in the United States will increase from about 16 million in 2005 to 48 million in 2050. (2) Worldwide, the number of adults with diabetes will rise from 285 million in 2010 to 439 million in the year 2030. (3)
Even if you have not been told that you have prediabetes, you could be worried about it, since 90% of the people with prediabetes are unaware that they have it. You are at higher risk if you are over 45 years old, do not get much exercise, have a family history of diabetes, or are African American, Native American, Hispanic/Latino, or Pacific Islander.
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.
After the birth of her oldest son, Crawford went on Weight Watchers. Eight months later, she had dropped 40 pounds, had an A1C of 5.2, and was able to stop diabetes and blood pressure medications. Her workouts started with daily walks and progressed to cardio and strength training three to four times a week. "I was able to do things I couldn't do before," she says. "I can do push-ups. I can do sit-ups."

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.
Obesity: Obesity is probably the most impressive risk factor and in most situations the most controllable. This is in part due to the fact that obesity increases the body's resistance to insulin. Studies have shown that reversal of obesity through weight reduction improves insulin sensitivity and regulation of blood sugar. However, the distribution of fat is important. The classic "pear" shaped person (smaller waist than hips) has a lower risk of developing diabetes than the "apple" shaped person (larger around the waist). The exact reason for this difference is unknown, but it is thought to have something to do with the metabolic activity of the fat tissue in different areas of the body.
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)
American Diabetes Association has defined self-dietary management as the key step in providing the diabetics, the knowledge and skill in relation with treatment, nutritional aspects, medications and complications. A study showed that the dietary knowledge of the targeted group who were at high risk of developing T2DM was poor. Red meat and fried food were consumed more by males as compared to females. The percent of males to females in daily rice consumption was significantly high.44
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.
Consider signing up for a virtual coach.  Trying to make these changes on your own, at your own pace, and in your own time is very hard. So consider joining a support group like Overeaters Anonymous so you don't have to go it alone. Another way to gain insights and get some help as you attempt to make some changes is to find an app that offers personalized tips and ideas. Having a virtual coach is both convenient has been shown effective in improving diabetes care.
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!
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.
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.
Here’s another big plus to our Shopping List for Diabetics. In addition to icons that are diabetes-focused like “sugar free,” this list uses icons like “low cholesterol” and “low sodium” because many people with diabetes are working to control not just diabetes but related conditions like high cholesterol levels and high blood pressure.  This list can help you identify those foods most advantageous in helping you reach your personal health goals.
Medications and insulin do nothing to slow down the progression of this organ damage, because they do not eliminate the toxic sugar load from our body. We’ve known this inconvenient fact since 2008. No less than 7 multinational, multi-centre, randomized controlled trials of tight blood glucose control with medications (ACCORD, ADVANCE, VADT, ORIGIN, TECOS, ELIXA, SAVOR) failed to demonstrate reductions in heart disease, the major killer of diabetic patients. We pretended that using medications to lower blood sugar makes people healthier. But it’s only been a lie. You can’t use drugs to cure a dietary disease.
Check your risk of diabetes. Take the Life! risk assessment test and learn more about your risk of developing type 2 diabetes. A 12+ score indicates that you are at high risk and may be eligible for the Life! program - a free Victorian lifestyle modification program that helps you reduce your risk of type 2 diabetes and cardiovascular disease, or call 13 RISK (13 7475).

There is much you can do with lifestyle alone to prevent diabetes. In a landmark study, the NIH-sponsored Diabetes Prevention Program, scientists tracked 3,234 pre-diabetic men and women for three years. A third of them adopted lifestyle changes. Another third took a drug – metformin (Glucophage®). The remaining third, the control group, took a placebo. Those on the lifestyle-change plan reduced the progression to full-blown Type 2 diabetes by 58% compared to the control group. The reduction was even greater – 71% – among adults aged 60 and older. Treatment with the drug metformin reduced the progression of Type 2 diabetes by just 31%.
There is an association between the lengthening of the menstrual cycle and the risk for developing diabetes, particularly in obese women. In a national study of nurses, those who had a cycle length of greater than 40 days were twice as likely to develop diabetes then those who cycled every 26 to 31 days. The association is thought to be related to polycystic ovary syndrome (PCOS), which also is known to be associated with insulin resistance. Insulin resistance may be a precursor for type 2 diabetes.
In the picture to the right you can see the lunch that I was unbelievably served at the 11th International Congress on Obesity in Stockholm 2010. This is a major international conference for obesity doctors and scientists. The food contains almost exclusively energy from sugar and starches, things that are broken down to simple sugars in the stomach.
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]

If you have found that your fasting blood glucose is rising over time, even if it is normal, and certainly if you "officially" have impaired glucose intolerance (pre-diabetes), strongly consider getting a home glucose meter and testing your own blood to see if you can determine which lifestyle changes help lower and stabilize your blood glucose. The only problem is that many insurance companies will not pay for this preventative step, and the test strips are admittedly expensive. Still, you might be able to afford to monitor yourself at least occasionally or find a diabetic friend who sometimes has extra strips. Tracking your blood glucose response to meals and over time can be a big help in preventing the progression of diabetes.

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)

Combining the Nurses’ Health Study results with those from seven other studies found a similar link between sugary beverage consumption and type 2 diabetes: For every additional 12-ounce serving of sugary beverage that people drank each day, their risk of type 2 diabetes rose 25 percent. (27) Studies also suggest that fruit drinks— Kool Aid, fortified fruit drinks, or juices—are not the healthy choice that food advertisements often portray them to be: Women in the Black Women’s Health study who drank two or more servings of fruit drinks a day had a 31 percent higher risk of type 2 diabetes, compared to women who drank less than one serving a month. (28)
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.
The oral glucose tolerance test (OGTT), or glucose tolerance test is a blood test used (not routinely however) to diagnose diabetes, and gestational diabetes. Information in regard to reliability of the oral glucose tolerance test is important, as some conditions (common cold), or food (caffeine), or lifestyle habits (smoking) may alter the results of the oral glucose tolerance test.
The data on dairy products seems to vary. In a study of over 289,000 health professionals, Harvard researchers showed that consumption of yogurt, in contrast to other dairy products, was associated with a reduced risk for diabetes. In a pooled analysis of 17 studies about dairy products and diabetes risk, those who consumed more dairy products had a lower risk than those who consumed few dairy products, A Swedish study found that high-fat dairy products, but not low-fat dairy products, lowered the risk for type 2 diabetes.
Acarbose (Precose), a drug designed to reduce small intestinal absorption of carbohydrates has been used with some success as well and is licensed for diabetes prevention in some countries. The STOP NIDDM trial showed that in about 1400 patients with impaired glucose tolerance, acarbose significantly reduced progression to diabetes compared to placebo. However, the occurrence of gastrointestinal side effects have limited the use of this drug for some people.
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.
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