The process of type 2 diabetes begins years or even decades before the diagnosis of diabetes, with insulin resistance. Insulin resistance is the beginning of the body not dealing well with sugar, which is the breakdown product of all carbohydrates. Insulin tells certain body cells to open up and store glucose as fat. When the cells stop responding your blood sugar rises, which triggers the release of more insulin in a vicious cycle. Insulin resistance is associated with abdominal obesity, high blood pressure, high triglycerides, and low HDL ("good cholesterol"). When these occur together, it is known as metabolic syndrome or pre-diabetes. It is a risk factor for heart disease and type 2 diabetes.
High blood sugar (hyperglycemia). Lots of things can cause your blood sugar to rise, including eating too much, being sick or not taking enough glucose-lowering medication. Watch for signs and symptoms of high blood sugar — frequent urination, increased thirst, dry mouth, blurred vision, fatigue and nausea — and check your blood sugar if necessary.
At each meal and snack pair carbohydrates with a protein and heart healthy fat. For meals make half your plate vegetables (raw, steamed or sautéed in a heart healthy oil like olive oil),a quarter lean protein (think less legs are better – choose fish, chicken, pork and have beef (aka red meat) on occasion), the remaining quarter of your plate should be from grains, preferably whole (i.e. quinoa, couscous, rice or even a baked potato- just go easy on the butter and sour cream). Some snack ideas include pairing fruit or vegetable with a protein, such as a banana or apple with peanut butter, raw vegetables (carrots, bell or sweet pepper strips, snap peas, celery) with hummus or even whole grain crackers with a low-fat cheese or plain yogurt with added fruit.
Whole grains don’t contain a magical nutrient that fights diabetes and improves health. It’s the entire package—elements intact and working together—that’s important. The bran and fiber in whole grains make it more difficult for digestive enzymes to break down the starches into glucose. This leads to lower, slower increases in blood sugar and insulin, and a lower glycemic index. As a result, they stress the body’s insulin-making machinery less, and so may help prevent type 2 diabetes. (22) Whole grains are also rich in essential vitamins, minerals, and phytochemicals that may help reduce the risk of diabetes.
The types of fats in your diet can also affect the development of diabetes. Good fats, such as the polyunsaturated fats found in liquid vegetable oils, nuts, and seeds can help ward off type 2 diabetes. (39) Trans fats do just the opposite. (8, 40) These bad fats are found in many margarines, packaged baked goods, fried foods in most fast-food restaurants, and any product that lists “partially hydrogenated vegetable oil” on the label. Eating polyunsaturated fats from fish—also known as “long chain omega 3” or “marine omega 3” fats—does not protect against diabetes, even though there is much evidence that these marine omega 3 fats help prevent heart disease. (41) If you already have diabetes, eating fish can help protect you against a heart attack or dying from heart disease. (42)
Food sources of carbohydrates should always be eaten WITH a source of protein and or unsaturated (“healthy”) fat. Fat and protein digest more slowly which helps prevent blood sugar spikes. Examples of balanced snacks that combine carbohydrate foods with protein/fat include, apple with peanut butter; berries with plain Greek yogurt; whole wheat toast with almond butter; baked potato with cottage cheese.
Recently, evidence suggested a link between the intake of soft drinks with obesity and diabetes, resulting from large amounts of high fructose corn syrup used in the manufacturing of soft drinks, which raises blood glucose levels and BMI to the dangerous levels.38 It was also stated by Assy39 that diet soft drinks contain glycated chemicals that markedly augment insulin resistance. Food intake has been strongly linked with obesity, not only related to the volume of food but also in terms of the composition and quality of diet.40 High intake of red meat, sweets and fried foods, contribute to the increased the risk of insulin resistance and T2DM.41 In contrast, an inverse correlation was observed between intake of vegetables and T2DM. Consumption of fruits and vegetables may protect the development of T2DM, as they are rich in nutrients, fiber and antioxidants which are considered as protective barrier against the diseases.42 Recently, in Japanese women, a report revealed that elevated intake of white rice was associated with an increased risk of T2DM.43 This demands an urgent need for changing lifestyle among general population and further increase the awareness of healthy diet patterns in all groups.