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.
Imagine our bodies to be a sugar bowl. A bowl of sugar. When we are young, our sugar bowl is empty. Over decades, we eat too much of the wrong things – sugary cereals, desserts and white bread. The sugar bowl gradually fills up with sugar until completely full. The next time you eat, sugar comes into the body, but the bowl is full, so it spills out into the blood.
Designed to support positive behaviour change, the program helps eligible participants plan and action small lifestyle changes that have long term health benefits. The program involves six sessions overs six months and is delivered by qualified health professionals. Participants have the choice of group sessions or phone coaching options. Group sessions in local areas work well for people who enjoy social interaction and learning from others’ experiences while phone coaching appeals to those whose work or life situation make it difficult for them to commit to set days and times.
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.
Chia is a type of seed that provides fiber, protein, and omega-3 fatty acids. Chia is a superfood because it brings down the glycemic load of any meal, increases hunger satisfaction (satiety), and stabilizes bloods sugar. Adding chia to your breakfast will help keep you full longer. They primary type of fiber in chia is soluble fiber. Soluble fibers turn to a gel when mixed with water. This makes chia seeds excellent to use in baking and cooking when a thickener is needed. Chia mixed with almond milk, cocoa, and a low-glycemic index sweetener like agave or stevia makes an excellent healthy pudding!

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.
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.

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.


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.

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.
Not necessarily. If you can lose weight, change your diet, increase your activity level, or change your medications you may be able to reduce or stop insulin therapy. Under certain circumstances, you may only need insulin temporarily – such as during pregnancy, acute illness, after surgery or when treated with drugs that increase their body’s resistance to the action of insulin (such as prednisone or steroids). Often the insulin therapy can be stopped after the event or stress is over.
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.
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.
Download this Shopping List for Diabetics, created by the doctors and dietitians at the Pritikin Longevity Center in Miami. Since 1975, the renowned Pritikin Center has been helping people with diabetes launch new lifestyles that maximize health and minimize the need for pills and insulin. It's all about keeping blood sugar and A1C at normal levels, naturally.

Metformin’s effectiveness didn’t change significantly in older adults compared with younger adults (hazard ratio [HR] for developing diabetes at age 60-85 years vs 25-44 years=1.45; 95% CI, 0.98-2.16; P=.06). In contrast, lifestyle modification worked better in older adults than younger adults (HR at age 60-85 years vs 25-44 years=0.47; 95% CI, 0.28- 0.78;P<.01).
While there is still no cure for diabetes, there is good news; the progression from prediabetes to diabetes is not inevitable. The National Institutes of Health clinical trial, the Diabetes Prevention Program, found that for people with prediabetes modest lifestyle changes led to weight loss of 5 to 7 percent in participants and can reduce the risk of type 2 diabetes by 58% in individuals at high risk.
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.

Prediabetes is a serious health condition where blood sugar levels are higher than normal, but not high enough yet to be diagnosed as type 2 diabetes. Approximately 84 million American adults—more than 1 out of 3—have prediabetes. Of those with prediabetes, 90% don’t know they have it. Prediabetes puts you at increased risk of developing type 2 diabetes, heart disease, and stroke.
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.
Diabetes is a serious disease requiring professional medical attention. The information and recipes on this site, although as accurate and timely as feasibly possible, should not be considered as medical advice, nor as a substitute for the same. All recipes and menus are provided with the implied understanding that directions for exchange sizes will be strictly adhered to, and that blood glucose levels can be affected by not following individualized dietary guidelines as directed by your physician and/or healthcare team.
Imagine that you hide your kitchen garbage under the rug instead throwing it outside in the trash. You can’t see it, so you can pretend your house is clean. When there’s no more room underneath the rug, you throw the garbage into your bedroom, and bathroom, too. Anywhere where you don’t have to see it. Eventually, it begins to smell. Really, really bad.
Type 2 diabetes can lead to a number of complications such as kidney, nerve, and eye damage, as well as cardiovascular disease. It also means cells are not receiving the glucose they need for healthy functioning. A calculation called a HOMA Score (Homeostatic Model Assessment) can tell doctors the relative proportion of these factors for an individual with type 2 diabetes. Good glycemic control (that is, keeping sugar/carbohydrate intake low so blood sugar isn't high) can prevent long-term complications of type 2 diabetes. A diet for people with type 2 diabetes also is referred to as a diabetic diet for type 2 diabetes and medical nutrition therapy (MNT) for people with diabetes.
The problem, of course, has not been solved – the sugar bowl is still overflowing. You’ve only moved sugar from the blood (where you could see it) into the body (where you couldn’t see it). So, the very next time you eat, the exact same thing happens. Sugar comes in, spills out into the blood and you take metformin to cram the sugar back into the body. This works for a while, but eventually, the body fills up with sugar, too. Now, that same dose of metformin cannot force any more sugar into the body.
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

I recommend for my patients to eat a variety of foods when managing Diabetes Type 2 with diet. I particularly encourage patients to include protein from a variety of sources, fiber, and vegetables or fruit with each meal. Including small portions of many food groups with each meal ensures that patients’ bodies are being healthfully fueled and they will often feel more satisfied with their meals preventing overeating and grazing throughout the day.


[1] Diabetes Prevention Program Research Group. Long-term effects of lifestyle intervention or metformin on diabetes development and microvascular complications over 15-year follow-up: the Diabetes Prevention Program Outcomes Study. The Lancet Diabetes & Endocrinology. 2015;3(11):866‒875. You can find more information about this study at the Diabetes Prevention Program Outcomes Study website.
People who have hypertension may follow a similar dietary plan to those who have diabetes. However, people with hypertension should also reduce sodium and caffeine intake. Individuals with both diabetes and hypertension should look for foods with low sodium counts, avoid coffee or caffeinated beverages, and avoid foods high in saturated and trans fats.
The American Diabetes Association (ADA) advocates for a healthy diet with an emphasis on balancing energy intake with exercise. Historically, they have advocated for the majority of calories coming from complex carbohydrates from whole grains such as whole-grain bread and other whole-grain cereal products and a decreased intake of total fat with most of it coming from unsaturated fat.
Veggies, first: Research suggests that eating vegetables and lean proteins before carbohydrates may result in a lower rise in blood sugar levels over the next few hours (as compared to eating the same foods in the opposite order). While more research is needed on this topic, it’s possible that eating protein and veggies first is delaying how fast the carbohydrates get absorbed.
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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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