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:
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.

The glycemic index identifies foods that increase blood sugar rapidly. This handy tool allows you to favor foods that have much less effect on blood sugar. High-glycemic-index foods include sugar itself, white potatoes, most wheat flour products, and most cold cereals, e.g., pumpernickel, rye, multigrain, or sourdough bread, old-fashioned oatmeal, bran cereals, grape-nuts, most fruits, sweet potatoes, pasta, rice, barley, couscous, beans, peas, lentils, most vegetables [Table 1].
Dr. Joel Fuhrman, MD is a board-certified family physician and nutritional researcher who specializes in preventing and reversing disease using excellent nutrition. He’s appeared on hundreds of radio and television shows, and his hugely successful PBS shows have raised more than $30 million for public television. Dr. Fuhrman serves as president of the Nutritional Research Foundation, and is author of six New York Times bestsellers, including Eat to Live and The End of Heart Disease. He’s used a nutrient-dense diet to help tens of thousands of people lose weight and reverse chronic disease permanently. Joel Fuhrman
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
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)
Only looking back could Jitahadi see how self-destructive her old eating habits were. At the time, she had a three-hour daily commute and had just lost one of her daughters. Healthy eating wasn't a top priority. "I realize how much I wasn't taking care of myself, and if I wanted to be here for my other daughter, I needed to turn this around," she says.
Choose lean sources of protein. Lean sources of protein include: eggs, egg whites, chicken breast, turkey breast, lean beef, pork tenderloin, fish (e.g., cod, tilapia, orange roughy), beans, or tofu. Adding protein to your daily intake helps to control spikes in blood sugar and helps with fullness to prevent unnecessary snacking on poor choices later.

The Life! program is a Victorian lifestyle modification program that helps you reduce your risk of type 2 diabetes and cardiovascular disease. Run by expert health professionals, the program is delivered as a Group Course or a Telephone Health Coaching service. Funded by the Victorian Government and managed by Diabetes Victoria it is the biggest prevention program of its type in Australia.

To avoid fast food, a convenient temptation, he prepped meals in advance. "A lot of it, especially as I lost a lot of weight, had to do with saying, 'I just walked x miles and burned x calories, do I really want to ruin it by popping in and having a burger?' " he says. "After a while, it got a little easier. Now I drive by [fast-food restaurants] and I don't even give them a second thought."


In addition, as early as in 2008, the Swedish Board of Health and Welfare examined and approved advice on LCHF within the health care system. Advice on LCHF is, according to the Swedish Board of Health and Welfare’s review, in accordance with science and proven knowledge. In other words, certified healthcare professionals, who give such advice (for example myself) can feel completely confident.
This pattern of eating is very nutrient-dense, meaning you get many vitamins, minerals, and other healthful nutrients for every calorie consumed. A very large recent study demonstrated that two versions of the Mediterranean diet improved diabetes control including better blood sugar and more weight loss. The two versions of the Mediterranean diet that were studied emphasized either more nuts or more olive oil. Since both were beneficial, a common-sense approach to adopting the Mediterranean diet would include both of these. For example, sprinkle chopped almonds on green beans or drizzle zucchini with olive oil, oregano, and hemp seeds.

#10. ALCOHOL—Moderate amounts of alcohol are linked with less type 2 diabetes. Don't go overboard—excess can raise your risk. In a review of published studies looking at more than 477,000 people, researchers found a moderate intake of alcohol was most protective against getting type 2 diabetes. That translates to about 1.5  drinks a day. Note: In the United States, one "standard" drink contains roughly 14 grams of pure alcohol, which is found in: 12 ounces of regular beer (typically 5% alcohol); 5 ounces of wine (about 12% alcohol) and 1.5 ounces of distilled spirits, which is about 40% alcohol. However, it's a good idea to get advice on alcohol intake from your doctor, who knows your personal health history. 12   
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.
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.

And finally, behavioral changes that set up environments for success are extremely helpful. These may include daily food/beverage/activity/glucose logging, and food-proofing environments. Logging can now be completed easily with electronic applications and website support, such as www.choosemyplate.gov . Food-proofing takes more doing and family/significant other assistance. Environments to review may include home, shopping, work, driving, and social. Review foods in each environment that sabotage efforts to manage blood glucose, and develop strategies to cope. For instance, when driving, bring a planned carb-controlled snack (e.g. small apple, 3 graham cracker squares, sparkling calorie-free water), in case travels extend past expected times; and check driving patterns, since some automatic routes may go past a favorite fast food place that magically pulls the car in!
To avoid fast food, a convenient temptation, he prepped meals in advance. "A lot of it, especially as I lost a lot of weight, had to do with saying, 'I just walked x miles and burned x calories, do I really want to ruin it by popping in and having a burger?' " he says. "After a while, it got a little easier. Now I drive by [fast-food restaurants] and I don't even give them a second thought."
Smoking 16 to 20 cigarettes a day or more can increase a person's risk of developing diabetes to more than three times that of nonsmokers. The exact reason for this isn't well understood. It may be that smoking directly decreases the body's ability to utilize insulin. Moreover, it has been observed that after smoking, blood sugar levels increase. Finally, there is also an association between smoking and body fat distribution, smoking tends to encourage the "apple" shape, which is a risk factor for diabetes.
Low-carbohydrate diets have gotten a lot of attention recently as strategies for reversing prediabetes. The carbohydrates in your diet that provide calories include sugars and starches. Starches are in grains and flour, beans, and starchy vegetables. Added sugars include sugars in sweets, sweetened foods such as flavored oatmeal and ketchup, and sugar-sweetened beverages such as soda. There are also natural sugars, which are found in nutritious foods such as dairy products and fruit.
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.

Meanwhile, saturated fats and trans fats can harm your heart and overall health, according to the American Heart Association. To spot trans fats, look for the term “hydrogenated” on labels of processed foods, such as packaged snacks, baked goods, and crackers. “I always tell my clients to double-check the ingredient list to make sure they don’t see any partially hydrogenated oil in their food products,” Massey says.

Another essential element of Crawford's new lifestyle: her new food philosophy. "If you want something good for yourself, it's worth the time to invest in cooking," she says of her switch from eating out to staying in. "I let go of the processed foods and rely on foods as a whole. Everything we need is in our backyard." Crawford, now 30, tries to eat seasonally, makes fresh produce the center of her meals, and prefers organic food over conventional.


Research has shown that there are some ways of preventing type 2 diabetes, or at least delaying its onset. Lifestyle changes such as becoming more active (or staying active, if you already engage in regular physical activity) and making sure your weight stays in a healthy range are two ways to help ward off type 2 diabetes, but talk to your doctor about what else you can do to prevent or manage the disease.

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).
The attempts to adhere to the conventional food measurements in order to comply with prescriptions of the so-called ‘diabetic diet’ usually result in unnecessary restrictions, overindulgence, or monotonous consumption of certain food items, e.g., unripe plantain/beans. This is a consequence of illiteracy, poverty, and cultural misconceptions about the role of diet in the management of diabetes. This is usually the most problematic aspect of diabetes care. The usually recommended daily energy intake for the non-obese diabetic patient is between 1500 and 2500 calories per day, the average allowance being 2000 k calories per day. The recommendation for the overweight diabetic patient is between 800 and 1500 k calories per day, while the underweight (including growing children and adolescents) should be allowed at least 2500 k calories/day.[16,17]
Only looking back could Jitahadi see how self-destructive her old eating habits were. At the time, she had a three-hour daily commute and had just lost one of her daughters. Healthy eating wasn't a top priority. "I realize how much I wasn't taking care of myself, and if I wanted to be here for my other daughter, I needed to turn this around," she says.
For most people with type 2 diabetes, the general guideline for moderate alcohol consumption applies. Research shows that one drink per day for women and two a day for men reduces cardiovascular risk and doesn't have a negative impact on diabetes. However, alcohol can lower blood sugar, and people with type 2 diabetes who are prone to hypoglycemia (such as those using insulin) should be aware of delayed hypoglycemia.
When overweight diabetic patients drop some weight by trimming down ‘serving sizes’ and calories, insulin sensitivity improves, thereby optimizing drug therapy. The fundamental principle behind maintenance of body weight is the energy balance. This group should be encouraged to maintain their current weight by: Maintaining current ‘serving sizes,’ eating about the same amount of food each day, eating at about the same times each day, taking their drugs at the same times each day, and exercising at the same times each day. These patients should also endeavor to choose their daily foods from starches, vegetables, fruits, and protein, while limiting the amount of fats.[41,42,43,44,45]

Smoking 16 to 20 cigarettes a day or more can increase a person's risk of developing diabetes to more than three times that of nonsmokers. The exact reason for this isn't well understood. It may be that smoking directly decreases the body's ability to utilize insulin. Moreover, it has been observed that after smoking, blood sugar levels increase. Finally, there is also an association between smoking and body fat distribution, smoking tends to encourage the "apple" shape, which is a risk factor for diabetes.
Smoking 16 to 20 cigarettes a day or more can increase a person's risk of developing diabetes to more than three times that of nonsmokers. The exact reason for this isn't well understood. It may be that smoking directly decreases the body's ability to utilize insulin. Moreover, it has been observed that after smoking, blood sugar levels increase. Finally, there is also an association between smoking and body fat distribution, smoking tends to encourage the "apple" shape, which is a risk factor for diabetes.

Contrary to popular belief, not all carbs are off-limits if you’re managing diabetes. In fact, the ADA recommends vitamin-rich whole grains in a healthy diabetes diet. These foods contain fiber, which is beneficial for digestive health. Fiber can also promote feelings of fullness, preventing you from reaching for unhealthy snacks, and it can help slow the rise of blood sugar. Plus, whole grains contain healthy vitamins, minerals, and phytochemicals that are healthy for anyone, regardless of whether they have diabetes or not.

I think the best response to a one sentence question that includes the words diet and control is Mindfulness. Get knowledgeable about this topic so that you realize that eating is a continuum. There are so many decisions that go into what and how much we eat, that if we do not elevate intention to the priority level it requires to attain control, we will flounder in reaching our goals. Food choices, eating, and time management are so complex in our lives that clarifying our specific goals related to food and our health is imperative to approach control in a positive way.


Our advice to anyone trying to live healthier lifestyles is simple, including diabetics trying to manage their disease. Our mantra: Eat real food. What does that mean? Eat whole foods that grow from the ground, are picked from a bush or tree, or came from an animal. Whole vegetables, fruit (both preferably organic), and responsibly raised and fed animals are all a part of a healthy, nutrient-rich diet. If one can stick to this simple rule and minimize or avoid processed and packaged foods and food-like items, you’ll find you look, feel, and perform better than ever.
Today’s widespread availability of oral diabetes medications has decreased the number of adult diabetics taking long-term insulin. However, as we learned in Chapter 5, those diabetes medications carry serious side effects with them. Furthermore, why would you want your condition to deteriorate, requiring progressively more potent medications with increasingly serious side effects? It sounds like it is definitely time for a better solution. The good news? Hintonia to the rescue!
In general, prediabetes is not associated with any specific symptoms. However, there may be indicators of problems in blood sugar metabolism that can be seen years before the development of overt diabetes. Health-care professionals in the field of endocrinology are now routinely looking at these indicators in patients who are high risk for developing diabetes.
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. 
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